title: Acupuncture Improves Intestinal Absorption of Iron in Iron-deficient Obese Patients: A Randomized Controlled Preliminary Trial.
abstract: BACKGROUND
  Obesity has an adverse effect on iron status. Hepcidin-mediated inhibition of iron absorption in the duodenum is a potential mechanism. Iron-deficient obese patients have diminished response to oral iron therapy. This study was designed to assess whether acupuncture could promote the efficacy of oral iron supplementation for the treatment of obesity-related iron deficiency (ID).
  
  
  METHODS
  Sixty ID or ID anemia (IDA) patients with obesity were screened at Beijing Hospital of Traditional Chinese Medicine and were randomly allocated to receive either oral iron replacement allied with acupuncture weight loss treatment (acupuncture group, n = 30) or oral iron combined with sham-acupuncture treatment (control group, n = 30). Anthropometric parameters were measured and blood samples were tested pre- and post-treatment. Differences in the treatment outcomes of ID/IDA were compared between the two groups.
  
  
  RESULTS
  After 8 weeks of acupuncture treatment, there was a significant decrease in body weight, body mass index, waist circumference, and waist/hip circumference ratio of patients in the acupuncture group, while no significant changes were observed in the control group. Oral iron supplementation brought more obvious improvements of iron status indicators including absolute increases in serum iron (11.08 ± 2.19 μmol/L vs. 4.43 ± 0.47 μmol/L), transferrin saturation (11.26 ± 1.65% vs. 1.01 ± 0.23%), and hemoglobin (31.47 ± 1.19 g/L vs. 21.00 ± 2.69 g/L) in the acupuncture group than control group (all P < 0.05). Meanwhile, serum leptin (2.26 ± 0.45 ng/ml vs. 8.13 ± 0.55 ng/ml, P < 0.05) and hepcidin (3.52 ± 1.23 ng/ml vs. 6.77 ± 0.84 ng/ml, P < 0.05) concentrations declined significantly in the acupuncture group than those in the control group.
  
  
  CONCLUSIONS
  Acupuncture-based weight loss can enhance the therapeutic effects of iron replacement therapy for obesity-related ID/IDA through improving intestinal iron absorption, probably by downregulating the systemic leptin-hepcidin levels.
authors.affiliation: Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China.
authors.forename: Xin-Cai
authors.initials: XC
authors.lastname: Xie
authors.affiliation: Department of Children's and Women's Health, School of Public Health, Capital Medical University, Beijing 100069, China.
authors.forename: Yan-Qiang
authors.initials: YQ
authors.lastname: Cao
authors.affiliation: Department of Children's and Women's Health, School of Public Health, Capital Medical University, Beijing 100069, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Gao
authors.affiliation: Department of Children's and Women's Health, School of Public Health, Capital Medical University, Beijing 100069, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Children's and Women's Health, School of Public Health, Capital Medical University, Beijing 100069, China.
authors.forename: Man
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Children's and Women's Health, School of Public Health, Capital Medical University, Beijing 100069, China.
authors.forename: Shou-Gang
authors.initials: SG
authors.lastname: Wei
mesh_terms: D015670:Acupuncture Therapy; D000328:Adult; D005260:Female; D064451:Hepcidins / Q000097:blood; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology*; D007501:Iron / Q000378:metabolism*; D000090463:Iron Deficiencies; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000378:metabolism* / Q000628:therapy*; D055815:Young Adult
chemical_list: D064451:Hepcidins; D020738:Leptin; D007501:Iron