| Objective:To observe the clinical efficacy of the acupuncture therapy named unblocking and regulating the Dai Meridian by acupunctureon anthropometric parameters,glucolipid metabolism and chronic inflammatory state of patients with abdominal obesity,as well as the regulation and influence of acupuncture on plasma exosome miRNAs,and further explore the mechanism of acupuncture on regulating plasma exosome miRNAs in the treatment of abdominal obesity.Method:This study is divided into three chapters,randomized controlled trial method,simple abdominal obesity patients were divided into treatment group and control group 20 people each,the control group to adopt lifestyle intervention adjustment,treatment group on the basis of lifestyle adjustment combined with acupuncture three times a week,a total of 8 weeks of intervention.Chapter 1:Observe the changes of indicators in the treatment group and the control group before and after 8 weeks of intervention,and evaluate the efficacy from anthropometric parameters,body fat parameters,insulin resistance and inflammation,and improvement of quality of life,with waist circumference as the main efficacy observation index.Chapter 2:5 patients with abdominal obesity were selected from the treatment group and the control group,and 5 healthy adults were selected as the blank group.Plasma exosomes were extracted by differential centrifugation and identified by electron microscopy.Differential expression of plasma exosomes miRNAs was detected by RNA hole technique.First,the plasma exosome miRNAs differentially expressed in patients with abdominal obesity were observed compared with healthy subjects.Then,wien analysis was used to screen the plasma exosome miRNAs in patients with abdominal obesity by general modulation band pulse acupuncture.Finally,TargetScan,miRanda and RNAhybrid prediction software were used to predict target genes in miRTarBase database,and the predicted target genes were compared with six databases(GO,KEGG,COG,NR,Swiss-Prot and Pfam).Comprehensive functional annotations of target genes were obtained,and the signal pathways most closely related to acupuncture intervention were screened according to their significance.The third chapter:Combined with the results of the first two parts,MAPK signaling pathway was screened out as the most closely related signal pathway of plasma exosomes in patients with abdominal obesity after acupuncture intervention,and the protein expression levels of p38MAPK,TNFα,RBP4 and IL-6 in the blood of patients in the two groups before and after intervention were determined by ELISA using its family factor p38MAPK as the entry point.To further study the mechanism of regulating plasma exosome miRNAs in the treatment of abdominal obesity by using p38MAPK/TNFα signaling pathway,observe the effects of acupuncture on chronic inflammation and insulin resistance in patients with abdominal obesity,and explore the internal mechanism of regulating plasma exosome miRNAs by using p38MAPK/TNFa signaling pathway in the treatment of abdominal obesity.Results:Chapter 1.(1)Intra-group comparison:after intervention,the treatment group BW,WC,HC,BMI,WHtR,REE,FBG,IL-6,TNFα,SNAQ,IPAQ-SF,IWQOL-Lite improved significantly(P<0.05),while WHR,VFI,BFI,BMR,TG,TC,LDL,HDL FINS,HOMA-IR,APPETITE VAS,IWQOL-Lite had no significant difference(P<0.05);BW,WC,HC,BMI,REE,IL-6,TNFa appetite VAS IPAQ-SF improved significantly after in tervention(P<0.05),TG increased significantly(P<0.01),while WHR,VFI,BFI,TC,LDL,BMR,HDL,FBG,FINS,HOMA-IR,TNFα,IWQol-Lite was not significantly changed(P<0.05)(2)Difference between groups:the difference of other efficacy indicators before and after intervention(D)was compared between the two groups,and the results showed that the treatment group was significantly better than the control group in improving BW,WC,HC,BMI,WHtR,BFI,IWQOL-Lite(P<0.01);The treatment group was superior to the control group in improving HDL,FBG,FINS appetite VAS and inferior to the control group in WHR,BMR,SNAQ,but the differences were not significant(P<0.05)(3)Efficacy and correlation analysis:in the main observation indexes,both groups in the control group were improved effectively,but the effective rate in the treatment group was significantly better than that in the control group(P<0.01);The treatment group had advantages in the improvement of patients’ quality of life in terms of appetite,food intake and short-term nutrition,and the improvement of quality of life was significantly better than the control group(P<0.05);Spearman bivariate correlation analysis was conducted between WC difference and BW,HC,BMI difference between the two groups,and the results showed that WC difference was positively correlated with BW,HC,BMI difference(r=0.52,0.43,0.48,P<0.01),and there is no significant correlation with the difference values of other indicators;Spearman bivariate correlation analysis of waist circumference difference and index difference between the two groups before and after intervention showed no significant correlation.In addition,the improvement of waist circumference was positively correlated with the improvement of body fat percentage and quality of life(R=0.529,0.353.P<0.05).Chapter 2.(1)There was no significant difference in total plasma exobody content between the treatment group and the control group before and after intervention(P<0.05)(2)Compared with healthy subjects,116 exosomal mirnas were differentially expressed in patients with abdominal obesity,including 35 up-regulated mirnas and 81 down-regulated mirnas;A total of 60 mirnas were differentially expressed in plasma exosomes in the treatment group after 8 weeks,of which 27 were up-regulated and 33 were down-regulated.In the control group,98 mirnas were differentially expressed in plasma exosomes after 8 weeks,54 were down-regulated and 44 were up-regulated.The results of Wien analysis showed that acupuncture intervention mainly down-regulated 4 mimas,all of which were unknown,and there were 4 mirnas with differentially up-regulated expression,among which the significant difference was HSA-Mir-125a-5p,HSA-Mir-361-3p,hSA-Mir-486-5p(3)25 of the 1000 target genes of three significantly different mirnas were recorded in miRTarBase database;The results of GO and KEGG enrichment analysis showed that the function of target genes may be mainly involved in lipid metabolism genetic information signal molecular transduction and other physiological processes,and closely related to endocrine and metabolic diseases,cardiovascular diseases,cancer infectious diseases,immune system,nervous system and digestive system diseases.The signaling pathways of target genes mainly focus on synaptic guided MAPK signaling pathway,cAMP signaling pathway,insulin resistance,neuroactive ligand-receptor interaction,endocrine resistance,cholinergic synaptic cancer TRP pathway,inflammatory mediators and tumor necrosis factor signaling pathway.Chapter 3.The protein and mRNA expression levels of p38MAPK,TNFα,RBP4 and IL-6 in the treatment group and the control group were comparable at baseline before intervention.The protein content of each molecule in the treatment group and the control group had significant statistical difference before and after intervention(P<0.01).The difference of protein con tent(D)between the two groups before and after intervention showed no statistical difference(P>0.05).The mRNA content of each molecule in the treatment group before and after intervention was compared,and there were statistical differences(P<0.05),among which P38MAPK and IL-6 had significant differences(P<0.01).The mRNA content of each molecule in the control group before and after intervention was compared,only P38MAPK had statistical differences(P<0.05).There were no significant differences in other molecules,and the difference(D)of each indicator mRNA content between the two groups before and after intervention showed no statistical difference(P>0.05).Conclusion:Unblocking and regulating the Dai Meridian by acupuncture can effectively improve anthropometric parameters,chronic inflammatory state,appetite and quality of life in patients with abdominal obesity,and regulate the content and types of plasma exosome miRNAs.Acupuncture may regulate appetite and basal metabolic rate by improving insulin resistance and inflammation,thus further reducing weight and reducing abdominal obesity.Acupuncture may regulate plasma exsome HSA-Mir-125a-5p,HSA-Mir-361-3p and HSA-Mir-486-5P to act on NF-κB/MAPK signaling pathway,reduce inflammatory factors in vivo,improve insulin resistance and chronic inflammatory state,and reduce abdominal fat accumulation.Inhibit the occurrence and development of abdominal obesity. |
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