Acupoint catgut embedding for improving HOMA-IR in patients with abdominal obesity and insulin resistance: a protocol for systematic review and network meta-analysis
Abstract
Objective: Acupoint catgut embedding (ACE) shows promise for improving insulin resistance in abdominal obesity, but its comparative efficacy against other interventions remains unclear due to a lack of head-to-head trials. This study aims to systematically evaluate the efficacy and safety of ACE for reducing HOMA-IR in this population and to compare different interventions via network meta-analysis.
Methods: We will conduct a systematic search of 13 electronic databases, covering the period from the inception of each database to March 2026. This study will include all randomized controlled trials evaluating acupoint catgut embedding for the treatment of abdominal obesity with concomitant insulin resistance. Two review authors will independently perform literature screening, data extraction, and assess the risk of bias of included studies using the revised Cochrane risk-of-bias tool (RoB 2). The primary outcome measure will be the homeostasis model assessment of insulin resistance (HOMA-IR) index. Secondary outcome measures will include fasting plasma glucose, fasting insulin, waist circumference, body mass index, lipid profile, inflammatory markers, and adverse events. Data synthesis will be performed using Stata 17.0 and R software. Conventional pairwise meta-analyses will be conducted using random-effects models. For network meta-analysis, we will adopt a frequentist framework using multivariate random-effects meta-analysis. The design-by-treatment interaction model will…
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