title: Changes in HbA1cand circulating and adipose tissue androgen levels in overweight-obese women with polycystic ovary syndrome in response to electroacupuncture.
abstract: Insulin sensitivity is ~40% lower in women with polycystic ovary syndrome (PCOS) than in controls. We tested the hypothesis that 5 weeks of electroacupuncture treatment improves glucose regulation and androgen levels in overweight/obese women with PCOS.
  
  
  
  Seventeen women with PCOS, aged 18 to 38 years, with a body mass index (BMI) ≥25 kg/m2and diagnosed with PCOS were included in this experimental and feasibility study and subjected to five weeks of electroacupuncture treatments three times/week. The primary outcome was changes in whole-body glucose homeostasis measured by euglycemic hyperinsulinemic clamp before and after the intervention. Secondary outcome were changes in HbA1c, circulating catecholamines, adipocyte size and adipose tissue expression of sex steroids and nerve growth factor (NGF).
  
  
  
  No significant change in glucose homeostasis was observed, but HbA1cdecreased by 9.5% (p= 0.004), circulating testosterone decreased by 22% (p= 0.0007) and dihydrotestosterone decreased by 12% (p= 0.007). The two vagal activity markers of plasma serotonin levels and the dopamine metabolite homovanillic acid decreased by 21% (p= 0.027) and 20% (p= 0.011), respectively. Adipose tissue concentrations of testosterone decreased by 18% (p= 0.049), and androstenedione decreased by 13% (p= 0.035), and mature NGF/proNGF ratio, a marker of sympathetic activity, increased (p= 0.04). These changes occurred without changes in anthropometrics.
  
  
  
  Five weeks of electroacupuncture treatment improves HbA1cand circulating and adipose tissue androgens in women with PCOS. This effect is mediated, at least in part, via modulation of vagal activity and adipose tissue sympathetic activity. Based on these findings, we have recently initiated a randomized controlled study (NTC02647827).
authors.affiliation: Department of Physiology and Pharmacology Karolinska Institutet Stockholm Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Stener-Victorin
authors.affiliation: Department of Physiology and Pharmacology Karolinska Institutet Stockholm Sweden; Endocrinology and Metabolism Laboratory, West Division, School of Medicine University of Chile Santiago Chile.
authors.forename: M
authors.initials: M
authors.lastname: Maliqueo
authors.affiliation: Institute of Translational Pharmacology - CNR, via del Fosso del Cavaliere 100 Rome Italy.
authors.forename: M
authors.initials: M
authors.lastname: Soligo
authors.affiliation: Institute of Translational Pharmacology - CNR, via del Fosso del Cavaliere 100 Rome Italy.
authors.forename: V
authors.initials: V
authors.lastname: Protto
authors.affiliation: Institute of Translational Pharmacology - CNR, via del Fosso del Cavaliere 100 Rome Italy.
authors.forename: L
authors.initials: L
authors.lastname: Manni
authors.affiliation: Institute of Neuroscience and Physiology, Department of Pharmacology, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Jerlhag
authors.affiliation: Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Kokosar
authors.affiliation: Department of Obstetrics and Gynecology, Sahlgrenska Academy University of Gothenburg Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Sazonova
authors.affiliation: Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.
authors.forename: C J
authors.initials: CJ
authors.lastname: Behre
authors.affiliation: Department of Molecular and Clinical Medicine, Institute of Medicine University of Gothenburg Gothenburg Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Lind
authors.affiliation: Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Ohlsson
authors.affiliation: Department of Endocrinology Odense University Hospital Odense Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Højlund
authors.affiliation: Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden; School of Health and Education University of Skövde Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Benrick
keywords: Acupuncture; adipose tissue; hyperandrogenism; insulin resistance; sympathetic nervous system