THE EFFECTIVENESS OF ACUPUNCTURE ON WOMEN WITH POLYCYSTIC OVARY SYNDROME: SYSTEMATIC LITERATURE REVIEW
AbstractBackground: Women with polycystic ovary syndrome (PCOS) experience metabolic disorders and hyperandrogenism. The acupuncture is an alternative medicinal treatment and complimentary for the women with PCOS. The aim of this research was to identify acupuncture effectiveness for metabolism problem and hyperandrogenism for the women with PCOS.Methods: This was a systematic review using several published literature obtained from direct electronic data of science, PubMed, and other sites through the PRISMA method using the Boolean operator's system (AND). The inclusion criteria consisted of the studies with Randomized controlled trial (RCT) published in 2009 to 2019, women with PCOS aged 18 to 45 years old as the subjects, the intervention using all of the kind of acupuncture that was compared to placebo, physical training, sham, and medicines. Meanwhile, exclusion criteria were studies with systematic review and meta-analysis, focusing on intervention, medicines, and physical training by using experimental animals. The measurement value of HOMA-IR, LH, FSH, ratio LH/FSH, TT, FT, SHBG, and DHEA-S.Results: The search resulted in 509 studies, of which a total of 6 studies were included in this systematic review. The acupuncture has effects on metabolism problem and hyperandrogenism for the women with PCOS, such as the decrease of HOMA-IR (3 studies) and LH tense (2 studies), LH/FSH ratio reduction (3 studies), as well as, the decline of TT tense (4 studies) and FT tense (4 studies), but the increase of SHBG tense (3 studies), and the decrease of DHEA-S (2 studies). However, the tense of LH had no significant change in all of the studies.Conclusions: The acupuncture can be effective in solving the metabolism problem and hyperandrogenism of women with PCOS.
Patel, S., Polycystic ovary syndrome (PCOS), an inflammatory, systemic, lifestyle endocrinopathy. The Journal of steroid biochemistry and molecular biology, 2018. 182: p. 27-36 .
Franik, S., et al., Aromatase inhibitors for subfertile women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews, 2014.103(2): p.1-125
Dokras, A., et al., Androgen Excess-Polycystic Ovary Syndrome Society: Position statement on depression, anxiety, quality of life, and eating disorders in polycystic ovary syndrome. Fertility and sterility, 2018. 109(5): p. 888-899.
Azziz, R., et al., The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertility and sterility, 2009. 91(2): p. 456-488.
Dunaif, A. and D.T. Finegood, Beta-cell dysfunction independent of obesity and glucose intolerance in the polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism, 1996. 81(3): p. 942-947.
Legro, R.S., Polycystic ovary syndrome: phenotype to genotype. Endocrinology and metabolism clinics of North America, 1999. 28(2): p. 379-396.
Belivani, M., et al., Acupuncture in the treatment of obesity: a narrative review of the literature. Acupuncture in Medicine, 2013. 31(1): p. 88-97.
Mannerås, L., et al., Acupuncture and exercise restore adipose tissue expression of sympathetic markers and improve ovarian morphology in rats with dihydrotestosterone-induced PCOS. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 2009. 296(4): p.1124-1131
Qu, F., et al., Transcutaneous electrical acupoint stimulation alleviates the hyperandrogenism of polycystic ovarian syndrome rats by regulating the expression of P450arom and CTGF in the ovaries. International journal of clinical and experimental medicine, 2015. 8(5): p. 7754.
Witt, C.M., et al., Safety of acupuncture: results of a prospective observational study with 229,230 patients and introduction of a medical information and consent form. Complementary Medicine Research, 2009. 16(2): p. 91-97.
Baldani, D.P., et al., The cardiometabolic effect of current management of polycystic ovary syndrome: strategies of prevention and treatment. Gynecological Endocrinology, 2018. 34(2): p. 87-91.
Edmondson, E.S., Understanding Polycystic Ovarian Syndrome. Physician Assistant Clinics, 2018. 3(3): p. 353-362.
Kriedt, K.J., A. Alchami, and M.C. Davies, PCOS: diagnosis and management of related infertility. Obstetrics, Gynaecology & Reproductive Medicine, 2019. 29(1): p.1-5
Jayasena, C.N. and S. Franks, The management of patients with polycystic ovary syndrome. Nature Reviews Endocrinology, 2014. 10(10): p. 624.
Carmina, E. and R.A. Lobo, Use of fasting blood to assess the prevalence of insulin resistance in women with polycystic ovary syndrome. Fertility and sterility, 2004. 82(3): p. 661-665.
DeUgarte, C.M., A.A. Bartolucci, and R. Azziz, Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertility and sterility, 2005. 83(5): p. 1454-1460.
Conway, G., et al., European survey of diagnosis and management of the polycystic ovary syndrome: results of the ESE PCOS Special Interest Group's Questionnaire. European journal of endocrinology, 2014. 171(4): p. 489-498.
Benrick, A., et al., Enhanced insulin sensitivity and acute regulation of metabolic genes and signaling pathways after a single electrical or manual acupuncture session in female insulin-resistant rats. Acta diabetologica, 2014. 51(6): p. 963-972.
Stener‐Victorin, E., et al., Changes in HbA1c and circulating and adipose tissue androgen levels in overweight‐obese women with polycystic ovary syndrome in response to electroacupuncture. Obesity science & practice, 2016. 2(4): p. 426-435.
Huang, A., K. Brennan, and R. Azziz, Prevalence of hyperandrogenemia in the polycystic ovary syndrome diagnosed by the National Institutes of Health 1990 criteria. Fertility and sterility, 2010. 93(6): p. 1938-1941.
Williams, T., R. Mortada, and S. Porter, Diagnosis and Treatment of Polycystic Ovary Syndrome. American family physician, 2016. 94(2): p. 106-113
Hong, L. and L.-c. FENG, Study on effects of acupuncture on menstruation and endocrine in patients of normal body weight with polycystic ovary syndrome. World Journal of Acupuncture-Moxibustion, 2014. 24(2): p. 10-14.
Feng, Y., et al., Electrical and manual acupuncture stimulation affect oestrous cyclicity and neuroendocrine function in an 5α‐dihydrotestosterone‐induced rat polycystic ovary syndrome model. Experimental Physiology, 2012. 97(5): p. 651-662.
Feng, Y., et al., Hypothalamic neuroendocrine functions in rats with dihydrotestosterone-induced polycystic ovary syndrome: effects of low-frequency electro-acupuncture. PLoS One, 2009. 4(8): p. e6638.
Pastore, L.M., et al., True and sham acupuncture produced similar frequency of ovulation and improved LH to FSH ratios in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism, 2011. 96(10): p. 3143-3150.
Fayiz, F., S.S. El-Kholy, and M.M.A. El-Rahman, Effectiveness of Laser Acupoints on Women With Polycystic Ovarian Syndrome: A Randomized Controlled Trial. Journal of lasers in medical sciences, 2018. 9(2): p. 113-120
Johansson, J., et al., Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial. American Journal of Physiology-Heart and Circulatory Physiology, 2013. 304(9): p. 934-943
Stener-Victorin, E., et al., Low-frequency electro-acupuncture and physical exercise decrease high muscle sympathetic nerve activity in polycystic ovary syndrome. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 2009. 297(2): p. 387-395
Zheng, Y.-H., et al., Effectiveness of abdominal acupuncture for patients with obesity-type polycystic ovary syndrome: a randomized controlled trial. The journal of alternative and complementary medicine, 2013. 19(9): p. 740-745.
Jedel, E., et al., Impact of electro-acupuncture and physical exercise on hyperandrogenism and oligo/amenorrhea in women with polycystic ovary syndrome: a randomized controlled trial. American Journal of Physiology-Endocrinology and Metabolism, 2011. 300(1): p. E37-E45.
Macut, D., et al., Insulin and the polycystic ovary syndrome. Diabetes Research and Clinical Practice, 2017. 130: p. 163-170.
Livadas, S. and E. Diamanti-Kandarakis, Polycystic ovary syndrome: definitions, phenotypes and diagnostic approach, in Polycystic Ovary Syndrome, Karger Publishers. 2013. 40: p. 1-21.
Franks, S., Polycystic Ovary Syndrome. Elsevier, 2018. 2: p. 451-455.
Tang, Q., et al., Optimal cut-off values for the homeostasis model assessment of insulin resistance (HOMA-IR) and pre-diabetes screening: developments in research and prospects for the future. Drug discoveries & therapeutics, 2015. 9(6): p. 380-385.
Cho, S., et al., Acupuncture for obesity: a systematic review and meta-analysis. International journal of obesity, 2009. 33(2): p. 183-196.
Firouzjaei, A., et al., Comparative evaluation of the therapeutic effect of metformin monotherapy with metformin and acupuncture combined therapy on weight loss and insulin sensitivity in diabetic patients. Nutrition & diabetes, 2016. 6(5): p. 1-9
Hu, Y., et al., A comparison study of metformin only therapy and metformin combined with Chinese medicine jianyutangkang therapy in patients with type 2 diabetes: a randomized placebo-controlled double-blind study. Complementary therapies in medicine, 2016. 24: p. 13-18.
Yang, Y. and Y. Liu, BO's abdominal acupuncture for obese type-2 diabetes mellitus. Zhongguo zhen jiu= Chinese acupuncture & moxibustion, 2015. 35(4): p. 330-334.
Zhiyuan, W., et al., Effect of transcutaneous electrical nerve stimulation at acupoints on patients with type 2 diabetes mellitus: a randomized controlled trial. Journal of traditional chinese medicine, 2015. 35(2): p. 134-140.
Liang, F., et al., Low-frequency electroacupuncture improves insulin sensitivity in obese diabetic mice through activation of SIRT1/PGC-1 in skeletal muscle. Evidence-Based Complementary and Alternative Medicine, 2011. 2011: p. 1-9
Belivani, M., et al., Immediate effect of three different electroacupuncture protocols on fasting blood glucose in obese patients: a pilot study. Acupuncture in Medicine, 2015. 33(2): p. 110-114.
Tür, F.Ç., et al., Therapeutic effects of acupuncture on obesity and HbA1c. European Journal of Integrative Medicine, 2015. 7(2): p. 88-93.
Guo, Y., et al., Plasma nesfatin-1 level in obese patients after acupuncture: a randomised controlled trial. Acupuncture in Medicine, 2014. 32(4): p. 313-317.
Liu, X., et al., Electroacupuncture improves insulin resistance by reducing neuroprotein Y/Agouti-related protein levels and inhibiting expression of protein tyrosine phosphatase 1B in diet-induced obese rats. Journal of acupuncture and meridian studies, 2016. 9(2): p. 58-64.
Cornejo-Garrido, J., et al., Antihyperglycaemic effect of laser acupuncture treatment at BL20 in diabetic rats. Acupuncture in Medicine, 2014. 32(6): p. 486-494.
Namazi, N., et al., Is laser acupuncture an effective complementary therapy for obesity management? A systematic review of clinical trials. Acupuncture in Medicine, 2017. 35(6): p. 452-459.
Malini, N. and K.R. George, Evaluation of different ranges of LH: FSH ratios in polycystic ovarian syndrome (PCOS)–Clinical based case control study. General and comparative endocrinology, 2018. 260: p. 51-57.
WALDSTREICHER, J., et al., Hyperfunction of the hypothalamic-pituitary axis in women with polycystic ovarian disease: indirect evidence for partial gonadotroph desensitization. The Journal of Clinical Endocrinology & Metabolism, 1988. 66(1): p. 165-172.
Taylor, A.E., et al., Determinants of abnormal gonadotropin secretion in clinically defined women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism, 1997. 82(7): p. 2248-2256.
Walters, K.A., et al., New perspectives on the pathogenesis of PCOS: neuroendocrine origins. Trends in Endocrinology & Metabolism, 2018. 29(12): p. 841-852
Yu, J.-S., B.-Y. Zeng, and C.-L. Hsieh, Acupuncture stimulation and neuroendocrine regulation, in International review of neurobiology, 2013. 111: p. 125-140.
Baptiste, C.G., et al., Insulin and hyperandrogenism in women with polycystic ovary syndrome. The Journal of steroid biochemistry and molecular biology, 2010. 122(1-3): p. 42-52.
Karakas, S.E., New biomarkers for diagnosis and management of polycystic ovary syndrome. Clinica Chimica Acta, 2017. 471: p. 248-253.
Thaler, M.A., V. Seifert-Klauss, and P.B. Luppa, The biomarker sex hormone-binding globulin–from established applications to emerging trends in clinical medicine. Best practice & research Clinical endocrinology & metabolism, 2015. 29(5): p. 749-760.
Goldrat, O. and A. Delbaere, PCOS: update and diagnostic approach. Clinical biochemistry, 2018. 62: p. 24-31
Rosenfield, R., R. Barnes, and D. Ehrmann, Hyperandrogenism, hirsutism, and polycystic ovary syndrome. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia: Elsevier, 2015. 133: p. 2275-2296.
Chen, L., et al., Electroacupuncture decreases the progression of ovarian hyperstimulation syndrome in a rat model. Reproductive biomedicine online, 2016. 32(5): p. 538-544.
O'reilly, M.W., et al., Hyperandrogenemia predicts metabolic phenotype in polycystic ovary syndrome: the utility of serum androstenedione. The Journal of Clinical Endocrinology & Metabolism, 2014. 99(3): p. 1027-1036.
Sørensen, A.E., et al., MicroRNAs related to androgen metabolism and polycystic ovary syndrome. Chemico-biological interactions, 2016. 259: p. 8-16.
A.F. Turcu, A.T.N., R.J. Auchus, The Rise, Fall, and Resurrection of 11-Oxygenated Androgens in Human Physiology and Disease. Horm Res Paediatr, 2018. 89: p. 284–291.
Bernhardt, R., & Waterman, M. R, Cytochrome P450 and steroid hormone biosynthesis. The ubiquitous roles of cytochrome P450 proteins. John Wiley & Sons, Ltd, 2007. 3: p. 361–396.
F. Labrie, V.L.-T., A. Bélanger, S.X. Lin, J. Simard, G. Pelletier, C. Labrie, Is dehydroepiandrosterone a hormone? J. Endocrinol, 2005. 187: p. 169–196.
Bindu N. Chimote, N.M.C., Dehydroepiandrosterone (DHEA) and Its Sulfate (DHEA-S) in Mammalian Reproduction: Known Roles and Novel Paradigms. Elsevier Inc., 2018. 108: p. 223-250.
Stener-Victorin, E., Hypothetical physiological and molecular basis for the effect of acupuncture in the treatment of polycystic ovary syndrome. Molecular and Cellular Endocrionology., 2013. 373(1-2): p. 83-90.