Introduction: This study aims to elucidate the mechanisms underlying the efficacy of Quantitative Lifting And Inserting Acupuncture (QLIA) in treating simple obesity through integrated metabolomic and gut microbiota analyses. Methods: Thirty patients with obesity were randomized into treatment (QLIA), control (standard needle lifting), and healthy groups (standard needle lifting) (n=10 each). Acupuncture was administered three times per week for 8 weeks. 16S rRNA sequencing was performed on fecal samples, and serum samples were analyzed using ultra-high-performance liquid chromatography–tandem mass spectrometry (UHPLCMS/ MS) metabolomics. Results and Discussion: QLIA significantly altered gut microbiota α-diversity and β- diversity. The Firmicutes/Bacteroidetes ratio was significantly increased in the QLIAtreated group. The treatment group showed increased abundance of beneficial bacteria such as Bifidobacterium and Dialister, and decreased abundance of potentially harmful bacteria such as Escherichia–Shigella. KEGG pathway analysis revealed upregulation of amino acid biosynthesis and carbohydrate metabolism pathways and downregulation of nucleotide biosynthesis pathways in the gut microbiota. Metabolomic analysis showed significantly elevated levels of acetyl-Lcarnitine and decreased levels of N-acetylneuraminic acid in the treatment group after acupuncture. PICRUSt analysis primarily implicated amino acid metabolic pathways. Serum metabolite analysis identified lipid, carbohydrate, and amino acid metabolism pathways as key targets of acupuncture intervention. Comparative analysis of metabolic pathways revealed amino acid metabolism as a shared target in both gut microbiota and serum metabolite profiles. These findings suggest that QLIA exerts its weight-loss effects by reshaping the gut microbiota structure and modulating host metabolic profiles, thereby highlighting a synergistic mechanism involving the gut-host metabolic axis. Conclusion: QLIA significantly promoted weight loss in simple obesity by modulating key metabolic pathways and altering gut microbiota composition. The study provides insight into the mechanisms underlying acupuncture-induced weight loss and supports its potential as a therapeutic option for obesity.
Huo et al. (Wed,) studied this question.