Electroacupuncture Treatment on Sarcopenia in Patients Undergoing Maintenance Haemodialysis: An Effective Therapy.

چکیده اصلی

BACKGROUND: Electroacupuncture (EA) treatment has been utilized for recovery from neuromuscular-related diseases and may play a significant role in the treatment of sarcopenia. This interventional, randomized controlled clinical study aims to explore the efficacy of EA treatment in maintenance haemodialysis (MHD) patients with sarcopenia. METHODS: Thirty-six participants with sarcopenia undergoing MHD were randomly divided into the control group and the EA group. The participants in the EA group received a total of 24 treatments, each lasting 30 min, and were administered three times per week. Participants in the control group were instructed to continue their current lifestyle and treatment plans. The assessments were conducted at baseline and after 8 weeks. Statistical analysis was performed using two-way analysis of covariance (ANCOVA) adjusted according to gender and baseline values. Repeated measures analysis of variance (ANOVA) was used to assess EA effects, reporting main effects and the time × group interaction with partial eta squared (η2p) effect sizes. The primary outcome was 6-m gait speed; the secondary outcomes were skeletal muscle mass index (SMI) and handgrip strength. Fasting blood samples were collected, and serum metabolomics using the liquid chromatography-mass spectrometry method was employed to reveal metabolic changes. RESULTS: One participant from the EA group dropped out, and 35 participants were included in the analysis, aged (59.06 ± 11.69) years, including 22 men and 13 women. After intervention, the 6-m gait speed of the EA group increased (Δ = 0.10 ± 0.08; p < 0.001), whereas that of the control group decreased (Δ = -0.06 ± 0.09; p = 0.018). The handgrip strength of the EA group increased (Δ = 0.68 ± 0.98; p = 0.011), whereas that of the control group decreased (Δ = -0.76 ± 1.19; p = 0.015). The SMI in the EA group increased (Δ = 0.19 ± 0.22; p = 0.003), although there was no significant difference in the control group. No serious adverse events were observed during the EA treatment. The results of serum metabolomics indicated that a total of 127 differentially expressed metabolites were identified (p < 0.05, VIP > 1), including 35 up-regulated metabolites and 92 down-regulated metabolites. KEGG pathway enrichment analysis showed that glycerophospholipid metabolism, linoleic acid metabolism and other pathways related to lipid metabolism were significantly changed. CONCLUSIONS: EA treatment was an effective therapy for sarcopenia in patients undergoing MHD. Its therapeutic effect may be related to the positive regulation of systemic metabolism (including amino acid and lipid profiles).

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