BackgroundComplex metabolic changes cause obesity, making weight loss difficult. For this reason, understanding metabolism is important, and considering the shortcomings of conventional treatment options for obesity, acupuncture is a possible option. However, evidence supporting its efficacy on metabolic parameters in obese patients is lacking. The aim of this study is to investigate the effects of acupuncture on serum metabolic parameters in premenopausal obese women.Methods/designThis ongoing study is a randomized, patient-assessor blind, two-arm parallel non-penetrating sham-controlled clinical trial. Eligible participants, premenopausal adult women (19 years of age or older) with a clinical diagnosis of obesity (body mass index of 25 kg/m2 or more) blinded to the treatment received, will be randomly allocated blindly into the real acupuncture treatment group (manual acupuncture plus electroacupuncture, n = 60) or the sham acupuncture control group (sham acupuncture plus placebo acupuncture without electrical stimulation, n = 60) and receive treatment two times a week for a total of 12 sessions over 6 weeks. The primary outcome measure is the serum cholesterol and triglyceride (TG) levels at baseline and endpoint. The secondary outcomes are body weight, body fat mass, muscle mass, waist and hip circumference, other serum metabolic profiles, International Physical Activity Questionnaire (IPAQ), Social Readjustment Rating Scale (SRRS), Stress Response Inventory (SRI), Fatigue Severity Scale (FSS), the Korean version of the Beck Depression Inventory (BDI), and urine metabolites. Adverse events will be assessed at every visit.DiscussionThe results of this trial (which will be available in 2015) will provide important clinical evidence for the effect of acupuncture on serum metabolites and demonstrate how acupuncture can be helpful for the treatment of obesity.Trial registrationTrial registration registered via US National Institutes of Health Clinical Trials registry (ClinicalTrials.gov) on 11 November 2014, identifier: NCT02066090.

Objectives The purpose of this study was to investigate the relationship between the effects of acupuncture treatment and heart rate variability (HRV) in pre-menopausal obese women. Methods Thirty-seven obese women who met the inclusion criteria were recruited. To estimate the effects of acupuncture, obesity indices, such as body weight (BW), waist circumference (WC), hip circumference (HC), and the waist-hip ratio (WHR), were measured before and after the treatment. The HRV test was conducted before treatment and analyzed using the frequency domain method. Results The lnLF/HF ratio (natural logarithm of low frequency power/high frequency power ratio of the HRV value) before treatments was negatively correlated with differences in WC, HC, and WHR during treatment. The correlation coefficients between the lnLF/HF ratio and the differences in WC, HC, and WHR were r=−0.459 (p＜0.01), r=−0.327 (p＜0.05), and r=−0.339 (p＜0.05) respectively. Conclusions As the baseline ratio of sympathetic activity to parasympathetic activity decreases, WC, HC, and WHR reduction significantly increased during treatment. Further study is needed to uncover the relationship between obesity-related variables and the autonomic nervous system to predict the effect of acupuncture. (J Korean Med Rehabil 2016;26(4):85-96)

Although the autonomic nervous system (ANS) is thought to play an important role in treatment of obesity, no study has been conducted to investigate acupuncture's effects on this aspect of the ANS. This study aimed to describe the effects of acupuncture in the ANS by means of heart rate variability (HRV) analysis. Methods: A total of 46 obese women aged from 21 to 54 with body mass index ranging from 25.1 to 39.3 kg/m 2 were recruited and randomized into both the real acupuncture group (n=23) and sham acupuncture group (n=23). A total of 3 instances of HRV analysis were conducted before, during, and after treatment. Statistically significant differences between time and groups were analyzed using repeated measure analysis of variance. Results: All parameters of time domain analysis and frequency domain analysis except for the square root of the mean squared differences of successive normal sinus intervals (RMSSD) and very low frequency (VLF) showed significant differences between times. The mean of all R-R intervals (mean RR) showed significant level of interaction between time and group. Between groups, time domain analysis of standard deviation of the normal-to-normal intervals (SDNN), RMSSD and frequency domain analysis of total power (TP) and high frequency (HF) showed significant differences. Conclusions: The real acupuncture group showed deactivation of parasympathetic function and relative increase of sympathetic activity in obese subjects. Further studies are necessary to uncover the mechanisms of acupuncture in obesity treatment.