Autonomic nervous system activation mediates the increase in whole‐body glucose uptake in response to electroacupuncture

Abstract

A single bout of low-frequency electroacupuncture (EA) causing muscle contractions increases whole-body glucose uptake in insulin-resistant rats. We explored the underlying mechanism of this finding and whether it can be translated into clinical settings. Changes in glucose infusion rate (GIR) were measured by euglycemic-hyperinsulinemic clamp during and after 45 min of low-frequency EA in 21 overweight/obese women with polycystic ovary syndrome (PCOS) and 21 controls matched for age, weight, and body mass index (experiment 1) and in rats receiving autonomic receptor blockers (experiment 2). GIR was higher after EA in controls and women with PCOS. Plasma serotonin levels and homovanillic acid, markers of vagal activity, decreased in both controls and patients with PCOS. Adipose tissue expression of pro-nerve growth factor (proNGF) decreased, and the mature NGF/proNGF ratio increased after EA in PCOS, but not in controls, suggesting increased sympathetic-driven adipose tissue metabolism. Administration of α-/β-adrenergic receptor blockers in rats blocked the increase in GIR in response to EA. Muscarinic and dopamine receptor antagonist also blocked the response but with slower onset. In conclusion, a single bout of EA increases whole-body glucose uptake by activation of the sympathetic and partly the parasympathetic nervous systems, which could have important clinical implications for the treatment of insulin resistance.-Benrick, A., Kokosar, M., Hu, M., Larsson, M., Maliqueo, M., Marcondes, R. R., Soligo, M., Protto, V., Jerlhag, E., Sazonova, A., Behre, C. J., Højlund, K., Thorén, P., Stener-Victorin, E. Autonomic nervous system activation mediates the increase in whole-body glucose uptake in response to electroacupuncture.

The Effect of Acupuncture on MiRNA Expression Profiles in the Ovaries of Rats with PCOS and Insulin Resistance

“…Moreover, acupuncture could promote ovulation in women with PCOS, and improve follicle development by decreasing AMH expression to regulate FSH and AMH in granulosa cells 20,21 . In addition, an animal model confirmed the effect of acupuncture was, at least in part, medicated by decreasing sympathetic nerve activity 22 .…”

“…Clinical studies have indicated that acupuncture can increase menstrual frequency, promote ovulation, decrease testosterone levels, and improve insulin sensitivity in women with PCOS 20,23,33 . Moreover, animal studies verified that acupuncture could promote normal reproduction and alleviate metabolic disorder of PCOS, at least in part, mediate by sympathetic nerve activity 22,34,35 . In the present study, acupuncture decreased body weight, reduced testosterone, and increased insulin sensitivity in rats with PCOS and insulin resistance, which was consistent with previous studies.…”

Acupuncture for Infertility in Women with Polycystic Ovary Syndrome: What Does It Add?

“…Thus, a woman with irregular cycles may use acupuncture to get more regular cycles and to improve PCOS-related symptoms, including health-related quality of life, mood, and insulin sensitivity, as there were few negative side effects of acupuncture. 10,11,[47][48][49][58][59][60][61] The recent RCT 18 has important clinical implications not only for women with PCOS with an active wish for pregnancy but also for those women with no active wish for pregnancy, as acupuncture induced ovulation to a higher degree than no treatment and also relieved other PCOS-related symptoms.…”

A multicenter randomized trial of personalized acupuncture, fixed acupuncture, letrozole, and placebo letrozole on live birth in infertile women with polycystic ovary syndrome

“…Johansson et al [8] demonstrated that repeated acupuncture resulted in higher ovulation frequency during the treatment period in women with PCOS. In addition, acupuncture has been shown to restore dysfunctional glucose homeostasis as well as adipose tissue gene expression and DNA methylation in patients with PCOS, in part via activation of the autonomic nervous system [9]. Despite these previous findings, a recent large multicenter trial in China demonstrated that acupuncture given as a fixed protocol did not improve the live birth rate in women with PCOS when compared with placebo acupuncture or clomiphene citrate [10].…”