Electroacupuncture Reduces Waistline in Patients with Abdominal Obesity: A Randomized Controlled Trial with Mechanistic Analysis of Lipidomic and Intestinal Microbiota.

Background: Abdominal obesity is a major risk factor for metabolic diseases and certain cancers. Although lifestyle intervention is the cornerstone of treatment, maintaining weight reduction is challenging. Electroacupuncture (EA) has shown potential in improving abdominal obesity, but its underlying mechanisms remain unclear. Objective: This randomized controlled trial evaluates the efficacy of electroacupuncture combined with lifestyle intervention for reducing waist circumference in adults with abdominal obesity, and explores potential mechanisms through lipidomics and intestinal microbiota analyses. Methods: The studies were performed in Hubei Provincial Hospital of Traditional Chinese Medicine between July 2020 and March 2023. Sixty-eight patients with abdominal obesity and 34 matched - healthy controls (HC) were recruited. After randomization, patients with abdominal obesity received an 8-week EA treatment or sham electroacupuncture (SA) treatment followed by 24-week follow-up. The change of waistline was to evaluate the efficacy of EA. Serum and stool specimen of EA group (pre- and post-treatment) and HC were collected for lipid metabolism markers and intestinal microbiota analysis. Results: Compared with baseline, the difference of waistline between EA and SA was 7.38 (95% CI, 2.88 to 11.87; P = 0.002) cm at the end of treatment (week 8) and 8.99 (95% CI, 4.48 to 13.50; P < 0.001) cm at the end of follow-up (week 32), respectively. Lipidomic analysis indicated that some lipid species previously found to differ between patients with abdominal obesity and healthy controls showed a trend toward reversal after EA treatment. Microbiota analysis showed that EA did not significantly alter overall richness, but the abundance of certain taxa changed, particularly Akkermansia muciniphila. Trial Registration: ClinicalTrials, NCT04957134. Registered 30 June 2021, https://clinicaltrials.gov/study/NCT04957134?term=NCT04957134&rank=1. Conclusion: Our findings suggest that electroacupuncture is effective and safe in reducing waistline in patients with abdominal obesity. These results provide preliminary evidence that its benefits may be related to changes in lipid metabolism and intestinal microbiota, although further studies are warranted.