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The Effect of Acupuncture on Insulin Sensitivity Polycystic Ovary Syndrome

Not Applicable
Conditions
Insulin Resistance
Polycystic Ovary Syndrome
Interventions
Other: acupuncture
Registration Number
NCT02026323
Lead Sponsor
The First Affiliated Hospital of Guangzhou Medical University
Brief Summary

Hyperinsulinemia and insulin resistance play a key role in the pathogenesis of polycystic ovary syndrome (PCOS). Insulin resistance is significantly associated with the long-term risks of metabolic syndrome and cardiovascular disease. Acupuncture with electrical stimulation has in rats with dihydrotestosterone (DHT)-induced PCOS been shown to improve insulin sensitivity. Whether these findings can be translated into women with PCOS has not been investigated. Therefore, this study aims to evaluate whether acupuncture improves insulin sensitivity, ovulation rate and quality of life in women with PCOS. Our hypothesis is that acupuncture with combined manual and low-frequency electrical stimulation of the needles improves insulin resistance, induces ovulation and improves quality of life.

Detailed Description

This is a prospective observational study. A total of 112 women with PCOS and insulin resistance will be recruited and randomized into two groups according to their body mass index (BMI), i.e. normal weight (BMI=18.5-23Kg/m2) group and overweight or obese (BMI \> 23Kg/m2) group1. The acupuncture treatment will last for six months, 3 times per week, 30 minutes per treatment. The primary outcome is changes in insulin sensitivity from baseline to after 6 months of acupuncture treatment measured by OGTT.

Recruitment & Eligibility

Status
UNKNOWN
Sex
Female
Target Recruitment
112
Inclusion Criteria
  1. Age ≥ 18 years.
  2. BMI ≥18.5Kg/m2
  3. Confirmed diagnosis of PCOS according to the Rotterdam criteria: Oligo-, amenorrhea (less than 8 cycles per year) or/clinical or biochemical hyperandrogenism and/or polycystic ovarian morphology.
  4. IR defined by the homeostatic model assessment (HOMA-IR: fasting insulin x fasting glucose/22.5) and 2.14 will be used as the cut off 33.
  5. No desire of children and using barrier methods of contraception for 1 year.
  6. Willing to sign the consent form
Exclusion Criteria
  1. With other endocrine disorders such as hyperprolactinemia (defined as two prolactin levels at least one week apart 25 ng/mL or greater or as determined by local normative values), nonclassic congenital adrenal hyperplasia (17-hydroxyprogesterone <3nmol/L), and androgen secreting tumors.
  2. Patients with FSH levels > 15 mIU/mL. A normal level within the last year is adequate for entry.
  3. Patients with uncorrected thyroid disease (defined as TSH < 0.2 mIU/mL or >5.5 mIU/mL). A normal level within the last year is adequate for entry.
  4. Patients diagnosed with Type I diabetes, or Type I and Type II patients who receiving antidiabetic medications such as insulin, thiazolidinediones, acarbose, or sulfonylureas likely to confound the effects of study medication; patients currently receiving metformin for a diagnosis of Type I or Type II diabetes or for PCOS are also specifically excluded.
  5. Patients with suspected Cushing's syndrome.
  6. Use of hormonal or other medication including Chinese Herbal prescriptions which may affect the outcome at least in the past 3 months.
  7. Pregnancy within the last 6 weeks.
  8. Post-abortion or postpartum within last 6 weeks.
  9. Breastfeeding within the last 6 months.
  10. Patients received Acupuncture treatment related to PCOS within the last 2 months.
  11. Patients who have undergone a bariatric surgery procedure in the recent past (<12 months) and are in a period of acute weight loss.
  12. Patients with known congenital adrenal hyperplasia.
  13. Not willing to give written consent to the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
acupunctureacupuncture"Normal weight" group,the PCOS women with insulin resistance who are normal weight( BMI=18.5-23Kg/m2).The acupuncture treatment will last for six months, 3 times per week, 30 minutes per treatment.
acupuncture 2acupuncture"Over weight or obese" group ,the PCOS women with insulin resistance who are overweight or obese: BMI \>23 Kg/m2.The acupuncture treatment will last for six months, 3 times per week, 30 minutes per treatment.
Primary Outcome Measures
NameTimeMethod
HOMA-IRbaseline,treat for 3 and 6 month ,3 or 6 month follow-up
Secondary Outcome Measures
NameTimeMethod
FSHbaseline,up to 6 month,the follow-up of 3 or 6 month

Determine FSH by electrogenerated chemiluminescence.

LHbaseline,up to 6 month,the follow-up of 3 or 6 month
Androgenbaseline,up to 6 month,the follow-up of 3 or 6 month
Progesteronebaseline,up to 6 month,the follow-up of 3 or 6 month
Prolactinbaseline,up to 6 month,the follow-up of 3 or 6 month
dehydroepiandrosterone(sodium)sulfatebaseline,up to 6 month,the follow-up of 3 or 6 month
sex hormone binding globulinbaseline,up to 6 month,the follow-up of 3 or 6 month
c-peptidebaseline,up to 6 month,the follow-up of 3 or 6 month
Apoa1baseline,up to 6 month,the follow-up of 3 or 6 month
Estradiolbaseline,up to 6 month,the follow-up of 3 or 6 month
ApoBbaseline,up to 6 month,the follow-up of 3 or 6 month
TCbaseline,up to 6 month,the follow-up of 3 or 6 month
TGbaseline,up to 6 month,the follow-up of 3 or 6 month
glycosylated hemoglobinbaseline,up to 6 month,the follow-up of 3 or 6 month
Questionnaire investigationbaseline,up to 6 month,the follow-up of 3 or 6 month

Health related quality of life, affective symptoms and personality: Will be determined by short form-36 (SF36), polycystic ovary syndrome questionnaire (PCOSQ),(generic and diagnosis-specific HRQL questionnaire),and the Chinese Quality of Life (ChQOL) ,and symptoms of anxiety and depression assessed by the Zung Self-Rating Anxiety Scale (Zung SAS) and Zung Self-Rating Depression Scale (Zung SDS).

Transvaginal ultrasoundbaseline,up to 6 month,the follow-up of 3 or 6 month

Trial Locations

Locations (1)

The first affiliated hospital of Guangzhou Medical University

🇨🇳

Guangzhou, Guangdong, China

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