Effects of Acupuncture on the Glutathione System in Overweight and Obese Individuals

Document Type : Research Paper


1 Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Chinese and complementary medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences (MUMS), Paradise Daneshgah, Azadi Square, Mashad, Iran

6 Department of Clinical Biochemistry, Mashhad University of Medical Sciences


Introduction: Obesity is the fifth leading cause of death worldwide. Several approaches are used for the treatment of obesity, and acupuncture has attracted attention globally in this regard. However, the therapeutic effects of acupuncture at a molecular level remain unclear. Obesity is reported to cause oxidative stress through various mechanisms. The glutathione system is one of the main antioxidant defense mechanism. The present study aimed to evaluate the effects of acupuncture on the glutathione system as the most abundant intracellular antioxidant mechanism in overweight and obese individuals. Methods: This study was conducted on 40 obese and overweight individuals with the BMI of ≥24.9 kg/m2 who were selected randomly. The participants received authentic acupuncture (case) or sham acupuncture (control) for six weeks combined with a low-calorie diet. Before and after the intervention, the activity of glutathione peroxidase, glutathione reductase, and reduced/oxidized glutathione levels were measured. Results: Higher glutathione peroxidase activity was observed in both groups after the treatment, while the increase was more significant in the case group compared to the control group (P=0.005). In addition, reduced glutathione levels were observed to increase in both groups after the treatment. Similarly, the rate of increase in the case group was more significant than the control group (P=0.02). A significant increase was also denoted in the reduced glutathione (GSH)/oxidized glutathione (GSSG) ratio in the case group compared to the control group (P=0.02). Conclusion: According to the results, the combination of acupuncture with a standard obesity diet could increase antioxidant activity in the overweight individuals. Furthermore, the approach could further prevent oxidative damage through increasing reduced glutathione and improving the GSH/GSSG ratio.


1. Jung RT. Obesity as a disease. British medical bulletin. 1997;53(2):307-21.
2. Pi-Sunyer FX. Health implications of obesity. The American journal of clinical nutrition. 1991;53(6):1595S-603S.
3.Rahmani A, Sayehmiri K, Asadollahi K, Sarokhani D, Islami F, Sarokhani M. Investigation of the prevalence of obesity in Iran: a systematic review and meta-analysis study. Acta Med Iran. 2015;53(10):596-607.
4.Finkelstein EA, Khavjou OA, Thompson H, Trogdon JG, Pan L, Sherry B, et al. Obesity and severe obesity forecasts through 2030. Am J Prev Med. 2012;42(6):563-70.
5.Cho S, Lee J, Thabane L, Lee J. Acupuncture for obesity: a systematic review and meta-analysis.  Int J Obes. 2009;33(2):183.
6.Nammi S, Koka S, Chinnala KM, Boini KM. Obesity: an overview on its current perspectives and treatment options. Nutr J. 2004;3(1):3.
7.Furukawa S, Fujita T, Shimabukuro M, Iwaki M, Yamada Y, Nakajima Y, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Investig. 2017;114(12):1752-61.
8.Bakker SJ, IJzerman RG, Teerlink T, Westerhoff HV, Gans RO, Heine RJ. Cytosolic triglycerides and oxidative stress in central obesity: the missing link between excessive atherosclerosis, endothelial dysfunction, and β-cell failure? Atherosclerosis. 2000;148(1):17-21.
9.Inoguchi T, Li P, Umeda F, Yu HY, Kakimoto M, Imamura M, et al. High glucose level and free fatty acid stimulate reactive oxygen species production through protein kinase C--dependent activation of NAD (P) H oxidase in cultured vascular cells. Diabetes. 2000;49(11):1939-45.
10.Lee H, Lee YJ, Choi H, Ko EH, Kim J-w. Reactive oxygen species facilitate adipocyte differentiation by accelerating mitotic clonal expansion. J Biol Chem. 2009;284(16):10601-9.
11.Higuchi M, Dusting GJ, Peshavariya H, Jiang F, Hsiao ST-F, Chan EC, et al. Differentiation of human adipose-derived stem cells into fat involves reactive oxygen species and Forkhead box O1 mediated upregulation of antioxidant enzymes. Stem Cells Dev. 2013;22(6):878-88.
12.Horvath TL, Andrews ZB, Diano S. Fuel utilization by hypothalamic neurons: roles for ROS. Trends Endocrinol Metab. 2009;20(2):78-87.
13.Serra D, Mera P, Malandrino MI, Mir JF, Herrero L. Mitochondrial fatty acid oxidation in obesity. Antioxid Redox Signal. 2013;19(3):269-84.
14.Bournat JC, Brown CW. Mitochondrial dysfunction in obesity. Current opinion in endocrinology, diabetes, and obesity. 2010;17(5):446.
15.Mazidi M, Abbasi-Parizad P, Abdi H, Zhao B, Rahsepar A, Tavallaie S, et al. Thee 昀 fectofelectro-acupunctureonpro-oxidant antioxidantbalancevaluesinoverweightand obesesubjects: arandomizedcontrolledtrial study. J Complement Integr Med. 2017:20150081.
16.Hayes JD, McLELLAN LI. Glutathione and glutathione-dependent enzymes represent a co-ordinately regulated defence against oxidative stress. Free Radic Res. 1999;31(4):273-300.
17.Zitka O, Skalickova S, Gumulec J, Masarik M, Adam V, Hubalek J, et al. Redox status expressed as GSH: GSSG ratio as a marker for oxidative stress in paediatric tumour patients. Oncol Lett. 2012;4(6):1247-53.
18.MacPherson H, Altman DG, Hammerschlag R, Youping L, Taixiang W, White A, et al. Revised standards for reporting interventions in clinical trials of acupuncture (STRICTA): extending the CONSORT statement. J Evid -Based Integr Med. 2010;3(3):140-55.
19.Mazidi M, Abbasi-Parizad P, Abdi H, Zhao B, Rahsepar A, Tavallaie S, et al. The effect of electro-acupuncture on pro-oxidant antioxidant balance values in overweight and obese subjects: a randomized controlled trial study. J Complement Integr Med. 2017;15(2).
20.Jittiwat J. Laser Acupuncture at GV20 Improves Brain Damage and Oxidative Stress in Animal Model of Focal Ischemic Stroke. J Acupunct Meridian Stud. 2017;10(5):324-30.
21.Liu C-Z, Yu J-C, Zhang X-Z, Fu W-W, Wang T, Han J-X. Acupuncture prevents cognitive deficits and oxidative stress in cerebral multi-infarction rats. Neurosci Lett. 2006;393(1):45-50.
22.Siu FK, Lo SC, Leung MC. Electroacupuncture reduces the extent of lipid peroxidation by increasing superoxide dismutase and glutathione peroxidase activities in ischemic-reperfused rat brains. Neurosci Lett. 2004;354(2):158-62.
23.Yu Y-P, Ju W-P, Li Z-G, Wang D-Z, Wang Y-C, Xie A-M. Acupuncture inhibits oxidative stress and rotational behavior in 6-hydroxydopamine lesioned rat. Brain research. 2010;1336:58-65.
24.Zhang X, Wu B, Nie K, Jia Y, Yu J. Effects of acupuncture on declined cerebral blood flow, impaired mitochondrial respiratory function and oxidative stress in multi-infarct dementia rats.  Neurochem Int. 2014;65:23-9.
25.Wang H, Pan Y, Xue B, Wang X, Zhao F, Jia J, et al. The antioxidative effect of electro-acupuncture in a mouse model of Parkinson's disease. PLoS One. 2011;6(5):e19790.