The efficacy and safety of acupuncture on serum leptin levels in obese patients: A systematic review and meta-analysis

Abstract

IntroductionObesity is characterized by hyperleptinemia and leptin resistance. Numerous animal and clinical studies on obesity previously demonstrated a reduction in leptin levels using acupuncture. In this study, we aimed to evaluate the available evidence regarding the efficacy and safety of acupuncture on serum leptin levels in obese patients. MethodsWe searched 10 data bases (EMBASE, MEDLINE, CENTRAL, KoreaMed, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang, Allied and complementary medicine database (AMED), Cumulative index to nursing and allied health literature (CINAHL), and Japan medical abstracts society (JAMAS)). Our study included randomized controlled trials(RCTs) that measured serum leptin level to evaluate the efficacy of acupuncture in obese patients. Risk of bias in each article was assessed according to Cochrane risk of bias tool for RCTs. A meta-analysis was performed using the Review Manager software (RevMan v5.3). ResultsEight RCTs (n=468) were finally included in this meta-analysis, and most showed low or unclear risk of bias. Compared to the control arm receiving no treatment (95% confidence interval (CI) [7.79, 12.31]; P<0.00001), oral anorexiant (95% CI [3.49, 9.11]; P<0.0001), diet therapy or exercise (95% CI [0.17, 6.88]; P=0.04), acupuncture significantly reduced serum leptin levels. However, compared to sham acupuncture, acupuncture showed no significant reduction of serum leptin levels (95% CI [-2.41, 8.76]; P=0.26). ConclusionsOur review suggests that acupuncture for obesity has beneficial effect on serum leptin levels compared to no treatment or oral anorexiant. Additional acupuncture treatment on diet therapy or exercise demonstrated greater reduction in serum leptin levels, whereas no significant difference was shown between the acupuncture and sham acupuncture groups. Although the results are of limited value due to the moderate quality and clinical heterogeneity, acupuncture can be used as an effective and safe treatment in obese patients.