Clinical Study On The Treatment Of Abdominal Obesity With Mild Cognitive Dysfunction By Pulse Acupuncture

Objective Abdominal obesity's epidemic and rapid spread has become the global public health problem.Recent studies have shown that abdominal obesity was not only the cardiovascular and cerebrovascular diseases' risk factor,it also has had obviously adverse effects on cognitive dysfunction and dementia's development.As an important and preventable risk factor,to intervene abdominal obesity has become one of the important ways to prevent cognitive dysfunction and dementia.However,the clinical applicability of drugs,surgery and other methods to loss weight is not extensive.So to find a way which is generally accepted by patients,has obvious clinical effects and high practical means is the important strategy of the early prevention and treatment of cognitive dysfunction.This study was conducted to investigate the effectiveness of method treated by regulating belt vesel(Daimai)acupuncture in patients with mild cognitive impairment with abdominal obesity,and to explore possible mechanisms of interaction between abdominal obesity and cognitive dysfunction.Methods Sixty patients were randomly divided into the acupuncture group(n=30)and the control group(n=30).Acupuncture group is with intercourse with acupuncture in regulating belt vesel(Daimai)method and health education intervention for 3 months,while the control group is with health education intervention for 3 months.Before and after the treatments,the neuropsychology scale,body fat parameters,abdominal fat thickness measurement and biochemical indicators of the two groups were compared.The neuropsychology scale included the Mini-mental State Examination(MMSE),the Montreal Cognitive Assessment(MOCA),the Logical Memory Test(LMT),the Hopkins verbal learning test-revised(HVLT-R)and Clock drawing test(CDT).The body fat parameters included Waist circumference(WC),hip circumference(HC),waist to hip ratio(WHR),waist height ratio(WHtR),body weight,body mass index(BMI),body fat rate.The abdominal fat thickness measurement indicators included V1,V2,S1,S2,ultrasound viscerofatty index(UVI),antero-hepatic fat thickness,perirenal fat thickness.The biochemical indicators included fasting blood glucose(FBG),fasting insulin(FINS),insulin resistance index(HOMA-IR),insulin sensitivity index(HOMA-ISI),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),blood pressure:systolic blood pressure(DBP)and diastolic blood pressure(SBP).These were used to evaluate the effects of acupuncture with regulating belt vesel(Daimai)method on the influence of cognitive function glucose and lipid metabolism in patients with mild cognitive impairment and abdominal obesity.Results(1)The neuropsychology scales:In the acupuncture group the score of MoCA was significantly improved after treatments(P<0.05).The scores LMT,HVLT3,HVLT4 and the sum of the first three ratings of HVLT showed an increasing trend,and there was a significant difference(P<0.01).The HVLT2 score showed an increasing trend,but there was no significant difference(P>0.05).In the control group there was no significant difference in the scores of MoCA,HVLT3 and HVLT4 after health education intervention(P>0.05).LMT decreased,and there was significant difference(P<0.01).There was a significant difference between the scores of HVLT2 and the sum of the first three ratings of HVLT,which had the down trend(P<0.05).There were no significant differences in MMSE,HVLT1,HVLT preservation and CDT scores between the acupuncture group and the control group(P>0.05).There were significant differences in MoCA?LMT?HVLT3?HVLT4 and the sum of the first three ratings of HVLT between the two groups(P<0.01).There were significant differences in HVLT2 and MMSE scores between the two groups(P<0.05).The degree of improvement is better than the control group.There was no significant difference in HVLT1 between the two groups(P>0.05).(2)Body fat parameters:There were significant differences in WC,HC,WHR,WHtR,body weight,BMI and body fat rate after the treatments in acupuncture group(P<0.01).In the control group there was significant difference in HC after after health education intervention(P<0.05).WHtR,body weight,BMI,body fat rate decreased,but with no significant differences(P>0.05).WHR increased,and there was no significant difference(P>0.05).There were significant differences in WC,WHR,WHtR,body weight,BMI and body fat rate between the two groups(P<0.01).The improvement of acupuncture group was better than that of control group.There was no significant difference in HC between the two groups(P>0.05).(3)Abdominal fat thickness measurements:There were significant differences in V1,V2 and S1 in acupuncture group after treatments(P<0.01).S2 and perirenal fat thickness decreased,and there were significant differences(P<0.05).There were significant differences in V1,V2 and S1 in the control group after health education intervention(P<0.05).S2 and perirenal fat thickness decreased,but there were no significant differences(P>0.05).UVI have increased,antero-hepatic fat thickness have decreased,but there was no significant differences in the acupuncture group and the control group(P>0.05).There were significant differences between the two groups in V1(P<0.01)and V2(P<0.05).The improvement of acupuncture group was better than that of control group.There were no significant differences in the effects of S1,S2,UVI,antero-hepatic fat thickness and perirenal fat thickness between the two groups(P>0.05).(4)Biochemical indicators:There were significant differences in TC,TG and LDL-C in the acupuncture group after treatments(P<0.01).There were significant differences in FINS and HOMA-IR in the acupuncture group after treatments(P<0.05).HOMA-ISI increased,and with significant difference(P<0.05).In the control group there was significant difference in TC(P<0.01).HOMA-ISI and LDL-C decreased,but there were no significant differences(P>0.05).In the control group FINS,HOMA-IR and TG increased with no significant difference(P>0.05).The FPG of the acupuncture group decreased,the FPG of the control group increased;the HDL-C of the acupuncture group increased,the HDL-C of the control group decreased,while there were no significant differences in FBG and HDL-C in the acupuncture group and the control group(P>0.05).There were significant differences in TG and LDL-C between the two groups(P<0.01).There were significant differences in FINS,HOMA-IR and HOMA-ISI between the two groups(P<0.05).The improvement of acupuncture group was better than that of control group.There were no significant differences in FBG,TC,HDL-C between the two groups(P>0.05).(5)Blood pressures:Acupuncture group's and control group's SBP and DBP were decreased,with significant differences(P<0.05).There were no significant differences in SBP and DBP between the acupuncture group and the control group(P>0.05).(6)Correlative analysis of changes of every indicators with cognitive function:There were significant correlations between the changes of MoCA and the decrease of WC,HC,WHtR,FINS and the increase of HOMA-ISI(P<0.05).MMSE's change was significantly correlated with the decrease of WC,WHR,V1 and TG(P<0.05).The change of LMT score was significantly correlated with WC,HC,WHR,WHtR,body weight,BMI,body fat rate,VI,V2,S2,antero-hepatic fat thickness,FINS,HOMA-IR and TG(P<0.01,P<0.05).There was a significant correlation between the changes of WC,HC,WHtR,body weight,BMI,body fat rate.Sl and the sum of the first three ratings of HVLT's changes(P<0.01,P<0.05).The change of HVLT4 was negatively correlated with WC,WHR,WHtR and S1(P<0.01,P<0.05).Logistic regression analysis showed that the changes of MMSE were correlated with TG(P=0.042),and the change of LMT was related to HOMA-IR and LDL-C(P=0.034,P=0.049),as the dependent variable and HVLT4(P=0.050,P=0.016,P=0.004),and the percentage of HVLT preservation was correlated with LDR-C(P=0.049).Conclusion The acupuncture group had a better benign adjustment effect on neuropsychology scales,body fat parameters,abdominal fat thickness measurements and biochemical indicators,and its effect was superior to the control group in most indicators.It was suggested that the acupuncture in regulating belt vesel(Daimai)method could effectively interfere with abdominal obesity and play a role in delaying the development of cognitive dysfunction and improvement and treatment for cognitive function.The possible mechanism of acupuncture in abdominal obesity and cognitive dysfunction are acupuncture's effect on the fat metabolism,insulin resistance and other mechanisms related to the regulatory roles.