Efficacy of abdominal vibration technique in Tuina in reducing depression, anxiety, and stress in patients with prediabetes

Table 1 Baseline characteristics of study participants

Characteristic	Low-frequency group (n = 40)	Medium-frequency group (n = 40)	High-frequency group (n = 40)	P value
Demographic and clinical characteristics
Age (years)	52.4 ± 8.7	53.1 ± 9.2	51.8 ± 8.5	0.814
Sex (male/female)	18/22	19/21	17/23	0.925
Body mass index (kg/m²)	26.8 ± 3.6	27.1 ± 3.9	26.5 ± 3.4	0.763
Waist circumference (cm)	92.4 ± 10.2	93.1 ± 11.5	91.8 ± 9.8	0.842
Duration of prediabetes (months)	18.7 ± 10.3	19.5 ± 11.2	17.9 ± 9.5	0.789
Glycemic parameters
Fasting plasma glucose (mmol/L)	6.38 ± 0.42	6.41 ± 0.39	6.35 ± 0.41	0.810
2-hour postprandial glucose (mmol/L)	9.23 ± 1.15	9.17 ± 1.09	9.31 ± 1.18	0.847
Glycosylated hemoglobin (%)	6.14 ± 0.32	6.17 ± 0.29	6.11 ± 0.31	0.688
Insulin parameters
Fasting insulin (μIU/mL)	14.76 ± 5.21	14.92 ± 5.38	14.58 ± 5.12	0.957
2-hour postprandial insulin (μIU/mL)	78.45 ± 25.73	79.18 ± 26.41	77.69 ± 24.93	0.968
Homeostasis model assessment of insulin resistance	4.17 ± 1.48	4.23 ± 1.52	4.09 ± 1.43	0.910
Oxidative stress markers
Cysteine-C (mg/L)	0.92 ± 0.18	0.93 ± 0.19	0.91 ± 0.17	0.873
Beta-2-microglobulin (mg/L)	1.98 ± 0.41	2.01 ± 0.44	1.95 ± 0.39	0.804
Malondialdehyde (nmol/mL)	5.27 ± 1.23	5.34 ± 1.29	5.21 ± 1.18	0.886
Total antioxidant capacity (U/mL)	9.84 ± 2.63	9.78 ± 2.59	9.91 ± 2.68	0.975
Inflammatory markers
High-sensitivity C-reactive protein (mg/L)	3.14 ± 1.52	3.19 ± 1.57	3.08 ± 1.48	0.947
Tumor necrosis factor-alpha (pg/mL)	12.67 ± 3.98	12.78 ± 4.05	12.51 ± 3.89	0.953
Interleukin-6 (pg/mL)	3.28 ± 1.21	3.34 ± 1.25	3.22 ± 1.17	0.901
Psychological parameters
Beck Depression Inventory-II score	15.82 ± 5.73	16.04 ± 5.91	15.69 ± 5.62	0.959
STAI-State score	41.35 ± 8.67	41.73 ± 8.94	40.98 ± 8.42	0.928
STAI-Trait score	43.19 ± 9.25	43.58 ± 9.44	42.87 ± 9.13	0.952
Perceived Stress Scale score	19.85 ± 5.37	20.12 ± 5.49	19.67 ± 5.28	0.924

Values are presented as mean ± SD or frequencies. STAI: State-Trait Anxiety Inventory.

Table 2 Changes in psychological parameters from baseline to 12 months

Parameter	Group	Baseline	3 months	6 months	12 months	P value (within group)	P value (between groups)
Beck Depression Inventory-II	Low-frequency	15.82 ± 5.73	13.54 ± 5.12	10.98 ± 4.58	9.27 ± 4.11	< 0.001	< 0.001
	Medium-frequency	16.04 ± 5.91	12.87 ± 4.98	9.73 ± 4.21	7.82 ± 3.76	< 0.001
	High-frequency	15.69 ± 5.62	11.25 ± 4.65	8.17 ± 3.82	6.46 ± 3.42	< 0.001
STAI-State	Low-frequency	41.35 ± 8.67	37.62 ± 7.95	34.18 ± 7.32	31.94 ± 6.87	< 0.001	< 0.001
	Medium-frequency	41.73 ± 8.94	36.41 ± 7.73	32.29 ± 6.95	29.53 ± 6.41	< 0.001
	High-frequency	40.98 ± 8.42	34.75 ± 7.38	30.12 ± 6.51	27.24 ± 6.03	< 0.001
STAI-Trait	Low-frequency	43.19 ± 9.25	40.57 ± 8.81	37.84 ± 8.23	35.92 ± 7.94	< 0.001	< 0.001
	Medium-frequency	43.58 ± 9.44	39.82 ± 8.67	36.31 ± 7.89	33.75 ± 7.41	< 0.001
	High-frequency	42.87 ± 9.13	38.14 ± 8.32	34.52 ± 7.65	31.38 ± 7.12	< 0.001
Perceived Stress Scale	Low-frequency	19.85 ± 5.37	17.43 ± 4.98	14.89 ± 4.51	13.25 ± 4.18	< 0.001	< 0.001
	Medium-frequency	20.12 ± 5.49	16.78 ± 4.85	13.61 ± 4.32	11.84 ± 3.96	< 0.001
	High-frequency	19.67 ± 5.28	15.41 ± 4.63	11.92 ± 4.05	9.28 ± 3.72	< 0.001

Values are presented as mean ± SD. P value (within group): Repeated measures analysis of variance (ANOVA) comparing changes over time within each group. P value (between groups): One-way ANOVA comparing changes from baseline to 12 months between groups. STAI: State-Trait Anxiety Inventory.

Table 3 Changes in glycemic and insulin parameters from baseline to 12 months

Parameter	Group	Baseline	3 months	6 months	12 months	P value (within group)	P value (between groups)
Fasting plasma glucose (mmol/L)	Low-frequency	6.38 ± 0.42	6.19 ± 0.39	5.97 ± 0.36	5.82 ± 0.35	< 0.001	< 0.001
	Medium-frequency	6.41 ± 0.39	6.12 ± 0.37	5.84 ± 0.34	5.65 ± 0.32	< 0.001
	High-frequency	6.35 ± 0.41	5.98 ± 0.35	5.67 ± 0.31	5.43 ± 0.29	< 0.001
2-hour postprandial glucose (mmol/L)	Low-frequency	9.23 ± 1.15	8.87 ± 1.08	8.42 ± 0.98	8.12 ± 0.93	< 0.001	< 0.001
	Medium-frequency	9.17 ± 1.09	8.65 ± 1.02	8.09 ± 0.92	7.69 ± 0.86	< 0.001
	High-frequency	9.31 ± 1.18	8.43 ± 0.97	7.76 ± 0.85	7.44 ± 0.81	< 0.001
Glycosylated hemoglobin (%)	Low-frequency	6.14 ± 0.32	6.03 ± 0.30	5.89 ± 0.28	5.81 ± 0.27	< 0.001	< 0.001
	Medium-frequency	6.17 ± 0.29	5.98 ± 0.28	5.79 ± 0.26	5.69 ± 0.25	< 0.001
	High-frequency	6.11 ± 0.31	5.87 ± 0.27	5.67 ± 0.24	5.60 ± 0.23	< 0.001
Fasting insulin (μIU/mL)	Low-frequency	14.76 ± 5.21	13.92 ± 4.95	12.87 ± 4.63	12.15 ± 4.38	< 0.001	< 0.001
	Medium-frequency	14.92 ± 5.38	13.61 ± 4.87	12.32 ± 4.45	11.47 ± 4.12	< 0.001
	High-frequency	14.58 ± 5.12	12.93 ± 4.62	11.51 ± 4.18	10.68 ± 3.87	< 0.001
2-hour postprandial insulin (μIU/mL)	Low-frequency	78.45 ± 25.73	73.21 ± 24.15	67.14 ± 22.26	63.54 ± 21.08	< 0.001	< 0.001
	Medium-frequency	79.18 ± 26.41	71.47 ± 23.84	64.25 ± 21.58	59.46 ± 19.87	< 0.001
	High-frequency	77.69 ± 24.93	68.35 ± 22.31	60.42 ± 19.75	55.13 ± 18.02	< 0.001
Homeostasis model assessment of insulin resistance	Low-frequency	4.17 ± 1.48	3.82 ± 1.36	3.41 ± 1.22	3.14 ± 1.12	< 0.001	< 0.001
	Medium-frequency	4.23 ± 1.52	3.68 ± 1.33	3.19 ± 1.15	2.87 ± 1.03	< 0.001
	High-frequency	4.09 ± 1.43	3.42 ± 1.24	2.89 ± 1.05	2.57 ± 0.93	< 0.001

Values are presented as mean ± SD. P value (within group): Repeated measures analysis of variance (ANOVA) comparing changes over time within each group. P value (between groups): One-way ANOVA comparing changes from baseline to 12 months between groups.

Table 4 Changes in oxidative stress and inflammatory markers from baseline to 12 months

Parameter	Group	Baseline	6 months	12 months	P value (within group)	P value (between groups)
Cysteine-C (mg/L)	Low-frequency	0.92 ± 0.18	0.86 ± 0.16	0.81 ± 0.15	< 0.001	< 0.001
	Medium-frequency	0.93 ± 0.19	0.83 ± 0.15	0.76 ± 0.14	< 0.001
	High-frequency	0.91 ± 0.17	0.78 ± 0.14	0.70 ± 0.12	< 0.001
Beta-2-microglobulin (mg/L)	Low-frequency	1.98 ± 0.41	1.85 ± 0.38	1.76 ± 0.35	< 0.001	< 0.001
	Medium-frequency	2.01 ± 0.44	1.82 ± 0.36	1.69 ± 0.33	< 0.001
	High-frequency	1.95 ± 0.39	1.73 ± 0.34	1.58 ± 0.30	< 0.001
Malondialdehyde (nmol/mL)	Low-frequency	5.27 ± 1.23	4.82 ± 1.15	4.53 ± 1.07	< 0.001	< 0.001
	Medium-frequency	5.34 ± 1.29	4.67 ± 1.12	4.28 ± 1.03	< 0.001
	High-frequency	5.21 ± 1.18	4.38 ± 1.05	3.92 ± 0.94	< 0.001
Total antioxidant capacity (U/mL)	Low-frequency	9.84 ± 2.63	10.95 ± 2.84	11.68 ± 3.02	< 0.001	< 0.001
	Medium-frequency	9.78 ± 2.59	11.36 ± 2.92	12.47 ± 3.19	< 0.001
	High-frequency	9.91 ± 2.68	12.05 ± 3.13	13.85 ± 3.48	< 0.001
High-sensitivity C-reactive protein (mg/L)	Low-frequency	3.14 ± 1.52	2.78 ± 1.36	2.53 ± 1.25	< 0.001	< 0.001
	Medium-frequency	3.19 ± 1.57	2.65 ± 1.31	2.31 ± 1.18	< 0.001
	High-frequency	3.08 ± 1.48	2.42 ± 1.23	2.05 ± 1.09	< 0.001
Tumor necrosis factor-alpha (pg/mL)	Low-frequency	12.67 ± 3.98	11.34 ± 3.62	10.52 ± 3.41	< 0.001	< 0.001
	Medium-frequency	12.78 ± 4.05	10.89 ± 3.53	9.84 ± 3.26	< 0.001
	High-frequency	12.51 ± 3.89	10.12 ± 3.31	8.95 ± 3.05	< 0.001
Interleukin-6 (pg/mL)	Low-frequency	3.28 ± 1.21	2.87 ± 1.08	2.61 ± 0.98	< 0.001	< 0.001
	Medium-frequency	3.34 ± 1.25	2.75 ± 1.04	2.42 ± 0.92	< 0.001
	High-frequency	3.22 ± 1.17	2.54 ± 0.96	2.18 ± 0.83	< 0.001

Values are presented as mean ± SD. P value (within group): Repeated measures analysis of variance (ANOVA) comparing changes over time within each group. P value (between groups): One-way ANOVA comparing changes from baseline to 12 months between groups.

Table 5 Correlations between changes in psychological and metabolic parameters from baseline to 12 months

Parameter	Change in Beck Depression Inventory-II	Change in STAI-State	Change in STAI-Trait	Change in Perceived Stress Scale
Change in fasting plasma glucose	0.52	0.49	0.47	0.55
Change in 2-hour postprandial glucose	0.57	0.54	0.52	0.58
Change in glycosylated hemoglobin	0.49	0.46	0.44	0.51
Change in fasting insulin	0.54	0.52	0.49	0.56
Change in 2-hour postprandial insulin	0.58	0.56	0.53	0.59
Change in homeostasis model assessment of insulin resistance	0.63	0.61	0.57	0.65
Change in cysteine-C	0.48	0.45	0.43	0.50
Change in beta-2-microglobulin	0.47	0.45	0.42	0.49
Change in malondialdehyde	0.51	0.48	0.46	0.53
Change in total antioxidant capacity	-0.53	-0.50	-0.47	-0.54
Change in high-sensitivity C-reactive protein	0.62	0.59	0.56	0.64
Change in tumor necrosis factor-alpha	0.60	0.58	0.55	0.62
Change in interleukin-6	0.59	0.57	0.54	0.61

Values represent Pearson correlation coefficients (r). STAI: State-Trait Anxiety Inventory.