Acupuncture and related techniques for obesity and cardiovascular risk factors: a systematic review and...

To assess how acupuncture and related techniques affect weight-related indicators and cardiovascular risk factors compared with non-acupuncture interventions in overweight and obese patients.

We searched PubMed, Embase and CENTRAL up to 19 April 2018 and included relevant randomised controlled trials (RCTs). Weighted mean differences (WMDs) and 95% confidence intervals (CI) were pooled using the inverse variance method with random-effects model. Prespecified hypotheses were tested in meta-regression to investigate the source of heterogeneity. Statistical software packages used were RevMan 5.3.5 and Stata 14.0.

Thirty-three RCTs were included (n=2503 patients). Compared with non-acupuncture interventions, acupuncture produced a greater reduction in body weight (WMD -1.76 kg, 95% CI -2.22 to -1.30, I²=77%; moderate quality), body mass index (WMD -1.13 kg/m², 95% CI -1.38 to -0.88, I²=85%; low quality) and waist circumference (WMD -2.42 cm, 95% CI -3.22 to -1.62, I²=75%; moderate quality). Acupuncture plus lifestyle intervention resulted in a greater reduction in body weight than acupuncture alone (MD -1.94 kg, 95% CI -3.17 to -0.70). Acupuncture also led to a greater reduction in total cholesterol (WMD -12.87 mg/dL, 95% CI -22.17 to -3.57, I²=87%; very low quality) and low-density lipoprotein cholesterol (WMD -13.52 mg/dL, 95% CI -21.47 to -5.58, I²=74%; low quality). The differences were not statistically significant for blood glucose or blood pressure.

In the short term, acupuncture and related techniques may produce a small but statistically significant degree of weight loss based on moderate- to low-quality evidence, and improve serum lipid parameters based on low- to very-low-quality evidence. Their effects on blood glucose and blood pressure remain uncertain.