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J Acupunct Meridian Stud 2023; 16(6): 255-262

Published online December 31, 2023 https://doi.org/10.51507/j.jams.2023.16.6.255

Copyright © Medical Association of Pharmacopuncture Institute.

Laser Diode – GaAlAs Acupuncture in the Treatment of Central Obesity: a Randomized Clinical Trial

Mohammadreza Razzaghi1,* , Zahra Akbari1,* , Soheila Mokmeli2 , Zahra Razzaghi1 , Mostafa Rezaei-Tavirani3 , Maryam Afzalimehr1 , Ehsan Kamani1

1Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2Canadian Optic and Laser Center, Victoria, BC, Canada
3Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Correspondence to:Mohammadreza Razzaghi
Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
E-mail m-razaghi@sbmu.ac.ir

Zahra Akbari
Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
E-mail drzahra.akbar@outlook.com

Received: May 20, 2023; Revised: July 27, 2023; Accepted: October 10, 2023

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Obesity is a global health challenge. Traditional approaches, including increased physical activity, dietary interventions, and medical therapy, often yield limited success, propelling some patients toward costly and invasive procedures like bariatric surgery. Laser acupuncture has been suggested as a complementary therapeutic approach to overcome this challenge. The present study investigated the effectiveness of laser acupuncture treatment in weight loss and abdominal subcutaneous fat reduction.
Methods: A randomized, blinded, sham-controlled clinical trial was conducted, with 30 subjects each in the intervention and control groups. Patients in the intervention group underwent 12 sessions of laser acupuncture treatment within a month (three sessions/week), whereas those in the control group received sham laser treatment on identical acupoints. The patients were instructed not to alter their physical activity levels or dietary regimens. All parameters were evaluated before and after the treatment.
Results: Significant reductions in weight, body mass index, and waist circumference were noted in both intervention and control groups. Further analysis revealed a more significant decrease in the laser acupuncture group. Abdominal sonography revealed a marked decrease in periumbilical fat thickness in the intervention group. Conversely, laboratory evaluations showed no significant difference between the two groups.
Conclusion: Laser acupuncture is an effective method for weight loss in patients with periumbilical abdominal fat. The observed impact on subcutaneous fat suggests its potential as a non-invasive intervention for individuals seeking weight management alternatives. Further research is warranted to validate these findings and explore the underlying mechanisms of laser acupuncture in adipose tissue modulation.

Keywords: Acupuncture, Periumbilical abdominal fat, Obesity, Laser acupuncture, Visceral fat

INTRODUCTION

Obesity is a global health challenge. According to the World Health Organization, obesity has an overall prevalence exceeding 10% worldwide, reaching up to 50% in some developed and developing countries. Furthermore, alarming annual increases in obesity rates from 0.2% to 18.5% and 0.1% to 35.3% have been documented in developed and developing countries, respectively [1,2].

A meta-analysis revealed that all the causes for mortality increased by 20% in obese patients, reaching up to 200% in morbidly obese patients [3]. The economic burden is also substantial, with 0.7%-2.8% of the health budget of each country being allocated for the treatment of obesity and its related complications. Notably, obese individuals incur 30% more healthcare expenses than individuals with normal weight [4].

Numerous treatment modalities, including lifestyle changes, medical treatment, and gastrointestinal surgeries have been employed to mitigate the prevalence of this health problem. However, these methods often yield inconclusive results, entail various side effects, and incur substantial costs. Thus, alternative methods that increase metabolism and cause weight loss find favor among both researchers and patients [5].

Acupuncture, a long-standing alternative therapy, has shown significant efficacy in addressing obesity and metabolic disorders [6,7]. In this treatment method, the stimulation of certain points in the body, called acupoints, initiates processes that enhance basal metabolic rate and positively alter adipose tissue metabolic pathways [8].

Although numerous studies have investigated the use of different acupuncture methods in obesity, a meta-analysis revealed the prevalence of low-power studies with inherent design weaknesses and limited sample sizes [9].

Traditional acupuncture involves the use of needles. However, fear of needle insertion and the possibility of some serious complications, such as retroperitoneal abscess, cardiac tamponade, pneumothorax, and viral hepatitis, have prompted the introduction of new methods such as laser acupuncture. Laser acupuncture employs a low-level laser instead of needles, producing similar effects in stimulating specific body points. Moreover, it is painless, non-invasive, and easy to perform [10].

Laser acupuncture was introduced approximately 50 years ago and its safety has been demonstrated through its diverse applications in various treatments, including obesity treatment and control [11]. In a meta-analysis evaluating the use of laser acupuncture in obesity treatment, seven clinical trials met the minimum eligibility criteria. However, the lack of robust statistical evidence on the effectiveness of laser acupuncture in obesity treatment poses a challenge to reaching conclusive decisions [12]. Notably, Siedentopf et al. [13] observed increased activities in certain parts of the brain during laser acupuncture treatment. Histologic studies on acupoints have revealed the presence of numerous mechanoreceptors in these areas, providing a plausible explanation for the transmission of these stimulations to specific parts of the brain [14]. Notably, rats treated for obesity using acupuncture exhibited heightened hypothalamic sirtuin1 mRNA and proopiomelanocortin protein levels [15]. Unfortunately, most existing clinical trials exhibit numerous shortcomings, such as the lack of a randomized and blinded control group, as well as confounding variables, notably dietary regimen and exercise. While the effect of laser acupuncture on anthropometric measurements and appetite sensation in obese individuals has been investigated, these studies relied only on anthropometric parameters to assess changes in body fat percentage [16]. On the other hand, obese patients frequently struggle with persistent fat accumulation in the femoral or abdominal regions, showing no improvements despite rigorous dietary regimens and weight loss efforts. Consequently, these individuals often resort to aggressive treatments, such as liposuction, to address these specific types of fat accumulation. Previous studies suggest that laser acupuncture can reduce abdominal storage fat tissue. However, to the best of our knowledge, this hypothesis has not yet been evaluated. Therefore, this study is a randomized, sham-controlled, patient-assessor-blinded clinical trial aiming to assess the efficacy and safety of using laser acupuncture in obesity treatment. In this study, the effects of laser acupuncture on subcutaneous abdominal fat before and after treatments were evaluated using ultrasonography.

MATERIALS AND METHODS

Patients referred to the Shohada Tajrish Hospital between August 2017 and March 2018 for the treatment of central obesity were enrolled in this randomized, patient-assessor-blinded, sham-controlled clinical trial.

1. Inclusion and exclusion criteria

The inclusion criteria comprised patients aged over 20 years, with a body mass index (BMI) ≥ 25, providing fully written consent to participate in the study, and committing to completing the treatment and follow-up processes. Patients with a previous history of cardiovascular diseases, diabetes mellitus, and endocrine and kidney disorders were excluded. Additionally, patients suffering from epilepsy, tumors and cancers, mental health problems, infectious skin disorders, or sensitivity to light were not enrolled. Pregnant or breastfeeding individuals and those who had used medications affecting body weight within one month before the study were also excluded. All eligible participants were provided with comprehensive information about the project process and its objectives, and written consent was obtained from each patient.

2. Patients and randomization

Sixty-four obese patients were selected for this study based on a random number table (prepared by a biostatistician) with a ratio of 1:1.

The patients were divided into two groups: the intervention group (laser acupuncture) and the control group (sham laser). Information regarding the assigned group for each patient was put in an opaque envelope and opened only by the treating physician after the pre-treatment evaluation. Neither the patient nor the outcome assessor knew the patient’s allocated treatment group.

The patients were instructed to maintain their existing dietary regimen and physical activity levels without any changes. The flow chart of the study is depicted in Fig. 1.

Figure 1. Flowchart of study.

3. Intervention

Treatment was performed using a continuous wave diode laser (Gallium-Aluminum-Arsenide, GaAlAs) with a wavelength of 810 nm (Canadian Optic and Laser Center, Canada). The power was set at 300 ± 10 mW, with a power density of 1.2 W/cm2. Laser irradiation at a dose of 300 mJ/s for 10 s was applied to each treatment point (radiation area: 0.25 cm2). During irradiation, brief skin contact was made to minimize laser light scattering; however, the patients did not feel any heat from the laser. The treatment procedure was performed thrice a week for 4 consecutive weeks, amounting to a total of 12 sessions. The relevant points targeted for obesity treatment in traditional Chinese medicine were manipulated as follows: GV20 (Baihui), HT7 (Shenmen), PC6 (Nei Guan), LI4 (He Gu), St36 (Zu San Li), LR3 (Taichong), LR13 (Zhangmen), BL20 (Pishu), BL21 (Weishu), BL23 (Shenshu), CV6 (Qihai), CV12 (Zhongwan), Gb25 (Jingmen), Li11 (Quchi), Sp6 (San Yin Jiao), and Ki7 (Fu Liu) [7-12].

In the control group, a sham laser without any output was used on the same acupuncture points as those in the intervention group to blind the patients to their treatment group. All variables, including acupuncture points, duration of irradiation, and the number of treatment sessions, were identical to those in the intervention group, and all treatment procedures were performed by the same physician.

4. Outcome measurement

Evaluations were conducted both before assigning the patients to treatment groups and at the end of the treatment. All evaluations were made by an unbiased and skilled physician, unaffiliated with the project and blinded to treatment groups. Laboratory and paraclinical evaluations were also conducted blindly. Additionally, the patients were encouraged to report any adverse events during each treatment session.

1) The following project parameters were considered

Anthropometric parameters, including weight, BMI (weight/height2 [kg/m2]), waist circumference (the trunk circumference at the level of the umbilicus [cm]), hip circumference (the circumference at the widest point over the buttocks [cm]), and waist-to-hip ratio, were measured using a stretch-resistant tape measure and a digital weighing scale.

Systolic and diastolic blood pressure (BP) was measured using a digital BP monitor. Mean BP was estimated using the following formula: Mean BP = (systolic BP + 2 × diastolic BP) / 3.

Periumbilical fat thickness at the navel was measured using ultrasonography (Toshiba, Aplio 300, China), performed by a skilled radiologist. The average fat thickness (mm) at four points—2 cm above, 2 cm below, 2 cm right, and 2 cm left to the navel—was measured and calculated as the final index.

Laboratory evaluations encompassed measurements of fasting blood sugar (FBS), triglycerides (TG), total cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, and tiCRP (C-Reactive Protein was measured as a clinical marker of metabolic problems). The patients were asked not to consume food for at least 14 h before laboratory testing. Approximately 10 ml of blood was drawn from each patient and sent to the Shohada Tajrish Hospital laboratory as a clotted sample for laboratory testing.

The patients were also queried about their hunger sensation and requested to record their hunger intensity using a visual analogue scale (VAS) featuring a horizontal line from 0 (no hunger) to 100 (highest intensity of hunger). Patients’ previous VAS results were not made available to them in subsequent evaluation sessions.

5. Statistical analysis and sample size

Using the pilot study results obtained before the initiation of the study (M1 = 8.9, S1 = 6.3, M2 = 5.1, S2 = 3.8), the sample size for each group was calculated to be 32 persons, based on 5% type I error and 80% power.

Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 20. In this study, quantitative variables are presented as mean ± standard deviation and qualitative variables are presented as frequency and percentage. Normality was assessed using the Shapiro–Wilk test. The independent samples t-test or the Mann–Whitney U test was performed to compare the primary characteristics of the variables calculated from the difference between the two values. Furthermore, the paired samples t-test or the Wilcoxon test was used for comparing the characteristics of the variables before and after the intervention. Additionally, the chi-square test was used to compare the frequency between the groups. Statistical significance was determined at p < 0.05.

RESULTS

Out of the initial 64 obese patients, two individuals from the intervention group withdrew from the study due to their inability to attend the laser sessions and follow-ups, and two subjects from the control group withdrew citing lack of effectiveness. Finally, 60 obese patients participated in this study (8 males and 52 females). The patients were divided into two groups: the intervention group (laser acupuncture) and the control group (sham laser). Table 1 summarizes the basic characteristics of the patients in the intervention and control groups. The randomization process resulted in a statistically insignificant difference between the two groups concerning age, gender, anthropometric parameters, periumbilical fat thickness, laboratory variables, appetite sensations, and BP.

Data are presented as mean ± standard deviation (SD)..

FBS = fasting blood sugar; TG = triglycerides; HDL = high-density lipoprotein; LDL = low-density lipoprotein; CRP = C-reactive protein..

&md=tbl&idx=1' data-target="#file-modal"">Table 1

Basic characteristics of patients inthe intervention and control group.

VariablesIntervention group
Mean ± SD
Control group
Mean ± SD
p-value
Age (year)42.53 ± 9.8440.77 ± 7.870.446
Gender0.448
Male5 (16.7%)3 (10%)
Female25 (83.3%)27 (90%)
Weight (kg)85.33 ± 14.6083.50 ± 14.450.912
BMI (kg/m2)31.29 ± 3.9631.90 ± 5.070.605
Waist circumferences (cm)101.60 ± 10.023102.10 ± 15.930.885
Hip circumferences (cm)114.27 ± 7.96114.30 ± 12.350.990
Waist-to-hip ratio1.13 ± 0.081.14 ± 0.150.867
Periumbilical fat thickness (mm)31.13 ± 14.4929.58 ± 7.870.430
Degree of hungry59.67 ± 14.4958.33 ± 12.620.852
FBS (mg/dL)96.47 ± 15.03101.47 ± 17.230.110
Cholesterol (mg/dL)192.43 ± 33.29196.60 ± 30.840.618
TG (mg/dL)175.10 ± 115.20155.83 ± 109.230.482
HDL (mg/dL)47.74 ± 10.6150.84 ± 12.640.308
LDL (mg/dL)109.77 ± 26.85117.033 ± 22.490.261
CRP (mg/L)8.17 ± 6.769.18 ± 8.140.604
Mean blood pressure (mmHg)8.91 ± 0.999.00 ± 1.030.735

Data are presented as mean ± standard deviation (SD)..

FBS = fasting blood sugar; TG = triglycerides; HDL = high-density lipoprotein; LDL = low-density lipoprotein; CRP = C-reactive protein..



Table 2 illustrates the anthropometric parameters between the variables before and after the treatment in each group separately, along with the mean difference comparison between the two groups.

**p-values based on paired t-test or Wilcoxon test; p-values based on independent samples t-test or Mann-Whitney U test..

&md=tbl&idx=2' data-target="#file-modal"">Table 2

Effect of laser acupuncture on outcome measures.

Intervention group
Mean ± SD
Control group
Mean ± SD
p-value (mean difference)
BeforeAfter 4-weekp-value**BeforeAfter 4-weekp-value**
Mean differenceMean difference
Weight85.33 ± 14.682.47 ± 15.480.000183.50 ± 14.4582.38 ± 14.620.0001
2.87 ± 2.311.12 ± 2.880.0001
BMI31.29 ± 3.9630.21 ± 4.180.000131.64 ± 4.7831.61 ± 5.280.017
1.09 ± 0.880.03 ± 2.990.004
Waist circumferences (cm)101.60 ± 10.0296.33 ± 9.870.0001102.10 ± 15.9399.77 ± 15.980.0001
5.27 ± 3.122.33 ± 1.920.0001
Hip circumferences (cm)114.27 ± 7.96110.27 ± 8.020.0001114.30 ± 12.35111.97 ± 12.130.002
4.00 ± 3.762.33 ± 3.790.524
Waist-to-hip ratio1.13 ± 0.081.15 ± 0.100.9271.14 ± 0.151.14 ± 0.140.136
0.02 ± 0.050.003 ± 0.040.209
Periumbilical fat thickness (mm)31.13 ± 7.2021.92 ± 13.730.000129.58 ± 7.8826.63 ± 10.990.056
9.22 ± 9.212.96 ± 7.570.0001
Degree of hunger (visual analogue scale)59.67 ± 14.4946.00 ± 12.210.00357.92 ± 11.4150.00 ± 13.190.017
13.66 ± 20.257.92 ± 16.140.003

**p-values based on paired t-test or Wilcoxon test; p-values based on independent samples t-test or Mann-Whitney U test..



After 1 month of treatment, individuals in both groups showed significant changes in weight and BMI. Moreover, the waist and hip circumferences of individuals in both groups decreased significantly. However, the waist-to-hip ratio had a non-significant difference in each group. Periumbilical fat thickness showed statistically significant differences in the intervention group post-treatment, but these differences were insignificant in the control group. Nevertheless, appetite sensations decreased significantly in both groups.

Upon comparing each parameter between the intervention and control groups, it was evident that the reductions in weight, BMI, and periumbilical fat thickness were significantly higher in the laser acupuncture group than in the control group. Moreover, differences in waist circumference, hip circumference, waist-to-hip ratio, and degree of hunger mitigation between the two groups were not significant.

Table 3 presents a comparison of the laboratory evaluation. Fasting plasma glucose, total cholesterol, serum triglycerides levels, and CRP reduced significantly in both groups but these differences were non-significant across the two groups. Moreover, LDL and HDL levels showed no significant differences between the two groups. Mean BP also demonstrated no significant differences before and after the intervention between the two groups.

FBS = fasting blood sugar; TG = triglycerides; HDL = high-density lipoprotein; LDL = low-density lipoprotein; CRP = C-reactive protein..

**p-values based on paired t-test or Wilcoxon test; p-values based on independent samples t-test or Mann-Whitney U test..

&md=tbl&idx=3' data-target="#file-modal"">Table 3

Comparison of laboratory variables before and after treatment in each group separately and mean difference comparison between two groups.

Intervention group
Mean ± SD
Control group
Mean ± SD
p-value (mean difference)
BeforeAfter 4-weekp-value**BeforeAfter 4-weekp-value**
Mean differenceMean difference
FBS (mg/dL)96.47 ± 15.0394.47 ± 14.790.003101.47 ± 17.2399.20 ± 15.950.036
2.00 ± 3.582.27 ± 6.160.540
TG (mg/dL)175.10 ± 115.20162.43 ± 104.080.0001155.83 ± 109.23147.80 ± 99.610.012
12.67 ± 17.348.03 ± 15.940.296
Cholesterol (mg/dL)192.43 ± 33.24181.93 ± 27.980.0001196.60 ± 30.84186.37 ± 29.880.010
10.50 ± 12.1610.23 ± 15.980.424
HDL (mg/dL)47.74 ± 10.6146.63 ± 8.810.12750.84 ± 12.6448.90 ± 11.140.009
1.11 ± 3.871.94 ± 3.800.353
LDL (mg/dL)109.77 ± 26.86107.57 ± 24.390.108117.03 ± 22.49114.20 ± 20.090.169
2.20 ± 7.262.83 ± 11.010.651
CRP (mg/L)8.17 ± 6.766.41 ± 5.010.0069.18 ± 8.137.17 ± 5.590.022
1.76 ± 3.262.01 ± 4.560.778

FBS = fasting blood sugar; TG = triglycerides; HDL = high-density lipoprotein; LDL = low-density lipoprotein; CRP = C-reactive protein..

**p-values based on paired t-test or Wilcoxon test; p-values based on independent samples t-test or Mann-Whitney U test..



Notably, HDL levels decreased significantly only in the control group, and changes in LDL levels were not significant in either group.

The mean BP before and after treatment were 89.11 ± 9.93 mmHg and 85.89 ± 10.12 mmHg in the intervention group (p = 0.073) and 87.5 ± 9.59 mmHg and 85.0 ± 8.95 mmHg in the control group (p = 0.193), respectively.

DISCUSSION

Designing a standardized method for obesity treatment is challenging, primarily due to the multifactorial nature of the condition, influenced by genetic and psychological factors.

While a low-calorie regimen and increased physical activity are the cornerstones of obesity treatment, many patients undergo these lifestyle changes without achieving significant outcomes [5]. Consequently, alternative methods are being explored to improve the body’s metabolism and weight loss. The present study showed that laser acupuncture can significantly reduce weight, BMI, and periumbilical fat thickness.

While numerous meta-analyses and systematic reviews support the effectiveness of traditional manual acupuncture in obesity treatment [6,7,16,17], studies on laser acupuncture in obesity treatment are limited or inconclusive due to methodological weaknesses [12].

In a cross-over randomized control trial by Tseng et al. [18], weight loss in the laser acupuncture group was 1.7 kg, whereas that in the control group was 0.2 kg. While this study had an acceptable design, the lack of data on the dietary regimen and mobility changes—the main confounding variables—was a major drawback. Hung et al. [19] demonstrated that laser acupuncture can significantly decrease BMI and fat mass index. The present study also revealed a mean weight loss of 2.9 kg in the laser acupuncture group. Interestingly, a significant weight loss was also observed in the control group in our study, possibly attributed to a placebo effect. However, a detailed comparison between the two groups demonstrated the significant effects of laser acupuncture on obesity treatment, enhancing the robustness of this study. Unfortunately, due to psychological effects during treatment sessions for obesity, only studies with a control arm can be deemed reliable.

In a study conducted by El-Mekawy et al. [20], 16 cm and 10 cm differences in the abdominal and hip circumferences, respectively, were documented in the laser acupuncture group compared with the control group. Our results showed similar outcomes, with a 5 cm greater reduction in abdominal circumference in the laser acupuncture group compared with the control group.

While it is established that laser acupuncture decreases metabolic fat mass by increasing the basal metabolic rate, sonographic results for the evaluation of abdominal subcutaneous fat exhibited a noteworthy decrease of more than 9 mm in periumbilical thickness. A decrease in the waist-to-hip ratio further underscored the efficacy of laser acupuncture in abdominal fat thickness treatment. Ultrasound is a common and reliable method for evaluating subcutaneous abdominal fat thickness in studies [21,22]. Different types of imaging techniques, like CT scans, MRIs, and sonography, have been used to accurately measure fat deposits in different areas of the body. Among these methods, sonography has garnered significant attention because it is safe, affordable, and accurate [23]. This is an important outcome of treatment besides weight loss because hip and abdominal fat exhibit minimal changes in response to most treatments, ultimately leading to reliance on invasive procedures, including various suction methods.

The neuroendocrine system, especially plasma glucose and lipid profile, can also be affected by obesity treatment. Several studies have reported that laser acupuncture causes a significant reduction in the lipid profile compared to the control group [21,24,25]. In our study, reductions in the lipid profile and plasma glucose levels were observed in both the laser acupuncture and control groups, attributed to the weight loss in both groups. However, no significant differences in these parameters were observed between the two groups, which could partly be attributed to the short-term follow-up of the patients. In summary, it can be stated that factors such as the number of treatment sessions, their frequency, and laser parameters, especially doses, may contribute to variations in the efficacy of laser treatment.

On the other hand, the effects of laser acupuncture on the gene expressions in adipose tissue are remarkable. Morphologic changes including a reduction in adipose cell sizes and subcutaneous fat amounts have been reported post-laser acupuncture treatment [25]. Moreover, stimulating obesity- and appetite-related acupoints is suggested to affect the levels of appetite-influencing neuropeptides, such as ghrelin and serotonin [19]. In the study by Tseng et al. [18], treatment with laser acupuncture caused a significant reduction in appetite. Conversely, in our study, while patients in the laser acupuncture group repeatedly expressed less hunger and thirst compared to the control group, changes in appetite between the two groups before and after the treatment were not significantly different. Overall, all mechanisms affecting IGF-1 and different insulin-resisting factors can cause changes in glucose and lipid metabolisms, thus decreasing body fat percentage and promoting weight loss [25-28].

This study employed a randomized, patient-assessor-blinded design, minimizing the effects of confounding factors, including psychological aspects, on the weight loss observed post-laser acupuncture treatment. Furthermore, the lack of changes in the dietary regimen and physical activity levels of the patients ensured that the results were solely linked to laser acupuncture. Moreover, the evaluation of the thickness of periumbilical fat was another important aspect of this study, and to the best of our knowledge, this is the first study that has evaluated this parameter objectively.

CONCLUSIONS

In conclusion, this study provides evidence that laser acupuncture is an effective approach for reducing weight and BMI in patients with subcutaneous abdominal fat. Moreover, it significantly reduces abdominal fat thickness. Furthermore, the weight loss observed in the control group undergoing sham laser treatment suggests that the psychological aspects of this intervention could play a motivating role in weight management in obese patients.

ACKNOWLEDGEMENTS

This study was conducted at Laser application in the medical research center and Canadian Optic and Laser Center (COL Center).

LIMITATION

The primary limitation of this study is the short follow-up duration, which complicates the assessment of the long-term effects of laser acupuncture on obesity. Thus, we recommend designing additional clinical trials to evaluate the long-term effects of laser acupuncture on obesity, focusing on abdominal obesity.

FUNDING

The authors received no financial support for the research, authorship and publication of this article.

ETHICAL CONSIDERATIONS

The study protocol was approved by the institutional ethical board on the human research center of Shahid Beheshti University of Medical Sciences (registration code: IR.SBMU.RETECH.REC.1396.862) and registered in the Iranian registry of clinic trial (IRCT: IRCT20111121008146N31).

CONFLICT OF INTEREST

The authors declare no conflict of interest.

Fig 1.

Figure 1.Flowchart of study.
Journal of Acupuncture and Meridian Studies 2023; 16: 255-262https://doi.org/10.51507/j.jams.2023.16.6.255

Table 1 . Basic characteristics of patients inthe intervention and control group.

VariablesIntervention group
Mean ± SD
Control group
Mean ± SD
p-value
Age (year)42.53 ± 9.8440.77 ± 7.870.446
Gender0.448
Male5 (16.7%)3 (10%)
Female25 (83.3%)27 (90%)
Weight (kg)85.33 ± 14.6083.50 ± 14.450.912
BMI (kg/m2)31.29 ± 3.9631.90 ± 5.070.605
Waist circumferences (cm)101.60 ± 10.023102.10 ± 15.930.885
Hip circumferences (cm)114.27 ± 7.96114.30 ± 12.350.990
Waist-to-hip ratio1.13 ± 0.081.14 ± 0.150.867
Periumbilical fat thickness (mm)31.13 ± 14.4929.58 ± 7.870.430
Degree of hungry59.67 ± 14.4958.33 ± 12.620.852
FBS (mg/dL)96.47 ± 15.03101.47 ± 17.230.110
Cholesterol (mg/dL)192.43 ± 33.29196.60 ± 30.840.618
TG (mg/dL)175.10 ± 115.20155.83 ± 109.230.482
HDL (mg/dL)47.74 ± 10.6150.84 ± 12.640.308
LDL (mg/dL)109.77 ± 26.85117.033 ± 22.490.261
CRP (mg/L)8.17 ± 6.769.18 ± 8.140.604
Mean blood pressure (mmHg)8.91 ± 0.999.00 ± 1.030.735

Data are presented as mean ± standard deviation (SD)..

FBS = fasting blood sugar; TG = triglycerides; HDL = high-density lipoprotein; LDL = low-density lipoprotein; CRP = C-reactive protein..


Table 2 . Effect of laser acupuncture on outcome measures.

Intervention group
Mean ± SD
Control group
Mean ± SD
p-value (mean difference)
BeforeAfter 4-weekp-value**BeforeAfter 4-weekp-value**
Mean differenceMean difference
Weight85.33 ± 14.682.47 ± 15.480.000183.50 ± 14.4582.38 ± 14.620.0001
2.87 ± 2.311.12 ± 2.880.0001
BMI31.29 ± 3.9630.21 ± 4.180.000131.64 ± 4.7831.61 ± 5.280.017
1.09 ± 0.880.03 ± 2.990.004
Waist circumferences (cm)101.60 ± 10.0296.33 ± 9.870.0001102.10 ± 15.9399.77 ± 15.980.0001
5.27 ± 3.122.33 ± 1.920.0001
Hip circumferences (cm)114.27 ± 7.96110.27 ± 8.020.0001114.30 ± 12.35111.97 ± 12.130.002
4.00 ± 3.762.33 ± 3.790.524
Waist-to-hip ratio1.13 ± 0.081.15 ± 0.100.9271.14 ± 0.151.14 ± 0.140.136
0.02 ± 0.050.003 ± 0.040.209
Periumbilical fat thickness (mm)31.13 ± 7.2021.92 ± 13.730.000129.58 ± 7.8826.63 ± 10.990.056
9.22 ± 9.212.96 ± 7.570.0001
Degree of hunger (visual analogue scale)59.67 ± 14.4946.00 ± 12.210.00357.92 ± 11.4150.00 ± 13.190.017
13.66 ± 20.257.92 ± 16.140.003

**p-values based on paired t-test or Wilcoxon test; p-values based on independent samples t-test or Mann-Whitney U test..


Table 3 . Comparison of laboratory variables before and after treatment in each group separately and mean difference comparison between two groups.

Intervention group
Mean ± SD
Control group
Mean ± SD
p-value (mean difference)
BeforeAfter 4-weekp-value**BeforeAfter 4-weekp-value**
Mean differenceMean difference
FBS (mg/dL)96.47 ± 15.0394.47 ± 14.790.003101.47 ± 17.2399.20 ± 15.950.036
2.00 ± 3.582.27 ± 6.160.540
TG (mg/dL)175.10 ± 115.20162.43 ± 104.080.0001155.83 ± 109.23147.80 ± 99.610.012
12.67 ± 17.348.03 ± 15.940.296
Cholesterol (mg/dL)192.43 ± 33.24181.93 ± 27.980.0001196.60 ± 30.84186.37 ± 29.880.010
10.50 ± 12.1610.23 ± 15.980.424
HDL (mg/dL)47.74 ± 10.6146.63 ± 8.810.12750.84 ± 12.6448.90 ± 11.140.009
1.11 ± 3.871.94 ± 3.800.353
LDL (mg/dL)109.77 ± 26.86107.57 ± 24.390.108117.03 ± 22.49114.20 ± 20.090.169
2.20 ± 7.262.83 ± 11.010.651
CRP (mg/L)8.17 ± 6.766.41 ± 5.010.0069.18 ± 8.137.17 ± 5.590.022
1.76 ± 3.262.01 ± 4.560.778

FBS = fasting blood sugar; TG = triglycerides; HDL = high-density lipoprotein; LDL = low-density lipoprotein; CRP = C-reactive protein..

**p-values based on paired t-test or Wilcoxon test; p-values based on independent samples t-test or Mann-Whitney U test..


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