Possibilities of The Akabane Test to Monitor Excess Body Mass Index and Control Its Transformation into Type 2 Diabetes

Background : As you know, high BMI values often lead to type 2 diabetes (T2D). However, it is not clear what factors directly contribute to this transformation of one pathology into another, because many people with high BMI do not develop diabetes. In this regard, it is interesting to consider this pathology from the point of view of Traditional Chinese Medicine (TCM) based on the results of assessing the bioenergetics of such patients using the Akabane test. Methods / Design : In total, the Akabane test and BMI assessment was performed by 338 subjects of whom there were 139 men and 198 women who did not have any pronounced pathologies. The average age of thе participants was 43.52 + _13.26 years old. For comparison, a second group of 475 patients (men -160, women-315) of the same age with a verified diagnosis of T2D was taken, who also underwent this test. Results : The methods of correlation and regression analysis of the relationship of BMI with certain acupuncture channels (AC) were analyzed, as well as the features of the test profiles depending on the age and BMI values. It was found that the most informative in assessing high BMI values is the ratio of the right and left branches of the AC and the degree of symmetry breaking in them. A comparative analysis of different values of BMI and tests in 2 groups of subjects revealed those AC separately in men and women, whose changes against the background of BMI growth lead to the formation of T2D. The mechanisms and boundaries of transitions for such a transformation are identified. Conclusion : the capabilities of this test are shown for effective individual monitoring of BMI at the level of certain organs and body systems. This monitoring system, based on new physical principles, is especially useful for tracking the effect of various treatments, supplements and lifestyle factors on specific metabolic processes in the body. of The Akabane Test to Monitor Excess Body Mass Index and Control Its Transformation into Type 2 Diabetes. Biomed J Sci & Tech

the growth of BMI and its transition to T2D. Earlier it was shown that the AC system in the values of this test reflects the main physiological and biochemical parameters in the body at the level of individual organs and physiological systems [8][9][10][11][12]. Therefore, the use of this new tool in the assessment of metabolic disorders in the body opens up new opportunities in their early diagnosis and prevention of complications.
According to the main theoretical concepts of TCM, the work of all human organs and systems is controlled by the system of AC, which are represented on the human body by Acupuncture points, which, based on the connection with a certain organ or physiological system, are connected into an energy line that forms a specific AC. At the same time, various types of influence on such points lead to a change in the activity of the organs associated with them, which is used in reflexology. The quantitative assessment of AC activity is especially effective using the Akabane test, which has high correlations with various physiological and biochemical parameters of the body, which allows effective monitoring using this simple test. In TCM, it is customary to assess the activity of an AC by the amount of Chi (QI) energy in it, which from the point of view of modern physiology corresponds to the concept of "Functional activity" of a certain organ or system with which a particular AC is connected. In turn, the 12 main AC form the system of the 5 Elements Figure 1, which are responsible for the general balance of energy distribution in the body through stimulating and inhibiting interactions between the organs [13][14][15][16][17]. According to a number of researchers, in terms of its principles this five-point system of regulation is one of the most accomplished and wellknown in modern technology. Traditionally, the level of energy (activity) is characterised by two notions. These are "fullness", which corresponds to the hyperactivity of an organ corresponds to the Yan factor, and "emptiness", which corresponds to an organ's inactivation and corresponds to the Yin factor. According to TCM, the main flow of energy moves clockwise in a circle of circulation. However, as a result of various reasons, the uniform movement of energy at the level of certain AС and primary elements can be disturbed and lead to its local excess or deficiency. In this case, other regulatory mechanisms are manifested, associated with the depressing effect of one primary element on another.
For example, an excess of energy of the primary element Fireinhibits (melts) Metal. Metal destroys Wood, and it destroys the Earth. Water slows down (extinguishes) Fire, and the Earth blocks the path of Water. At present, a number of studies have appeared [18][19][20][21] in which the principle of operation of such a system at the mathematical level has been shown, which makes it possible to predict the occurrence of various diseases based on the individual state of this system. There are a number of modern studies showing that AС are real systems for transferring information between the environment and living organisms, including plants.
Wherever there is water, information transmission channels are spontaneously formed where there is a dynamic self-focused propagation of coherent radiation with its phase synchronization [8][9][10][11]. Such energy waves in the connective tissue can "capture" neighboring molecules, cells and biological units in their coherent vibrations. Thus, this optical waveguide in the form of an AС can provide a no dissipative flow of energy and information throughout the body [22].
To quantitatively evaluate a channel's activity level in TCM, the so-called "sacrificial stick" test was used in ancient times in China. This test involved a burning sandal stick that was brought in proximity to points at the tips of every finger and toe until the first sensation of pain. At each point, the pulse rate before pain was first felt, was measured. If the number of pulse beats was lower than the average one for all the channels, it proved the hyperactivity of an acupuncture channel and its corresponding organ. Conversely, when the rate was higher, it represented the inactivity of a channel and its corresponding organ. This test was described by the Japanese doctor Koben Akabane in 1956. Since then, the test has carried his name [23]. According to classical Oriental literature as well as according to our study results [24][25][26][27]  Each channel consists of the left (l) and the right (r) branch between which normal symmetrical activity balance is maintained.
TS is our bodies' basic reactive system; it is as significant as

Materials and Methods
In total, the Akabane test and BMI assessment was carried  [18][19]. Each impulse radiates 0.07 joules of thermal energy.
These measurements were carried out using a certified device -"Refleksomaster", invented by the author of this paper. The analysis of the relationship between biometrical indicators and AC was carried out using correlations (Pearson and Spearman coefficients) and multiple regression analysis. One-way MANOVA by LSD post hoc comparisons analysed the effect of sex on the AC data. Wilcoxon signed-rank test and the Mann-Whitney test were used for paired comparisons. Statistical decisions were made at the 5% significant level (р≤0.05). We used the SPSS software package version 15.

Results
According to the measurements, the BMI values in the groups  Figure 3 shows that throughout the entire age range, the BMI index is increasing for women, for men, the index also increases, and at the age of 40 it reaches almost a plateau.  Where: * -TS indicators of channel branches; r / l is the ratio of the TS indicators of the right and left branches of the AС.
To identify the relationships between the BMI parameters and the TS test values at the level of 24 channels, taking into account the influence of age, a correlation analysis was carried out. Table   1 shows only significant relationships (p< 0.05), and not only with individual AC, but also with the ratios of the values of their branches at the right / left level. Earlier it was shown that this indicator reflects the degree of asymmetry in the AC and it is one of the most important criteria in the diagnosis of various diseases (). Therefore, in Table 1 Table 2.
In men, according to these results of assessments of connections at the level of 24 branches of the AС, a new tendency was noted with the influence of the lung (p = ,053) and kidney (p = ,063) canals.
According to ТСМ, the kidneys contain a total energy reserve, which, from the point of view of modern concepts, corresponds to the volume of perirenal fatty tissue. In addition, the kidneys contain a reserve of "hereditary energy", which corresponds to the genetic characteristics of the organism. Where: * -TS indicators of channel branches; r / l is the ratio of the TS indicators of the right and left branches of the AC Thus, these results confirm the data on a genetic predisposition comes with a (+) sign. Therefore, the higher the right branch -which reflects blood oxygenation [28,29] -the higher the oxygen capacity of the blood. In women, as before, there was a pronounced significant relationship (p = ,007) with SPl. According to our data [18,20,21], the left SP branch is associated with the production of a counter insular hormone, which increases appetite. Therefore, the growth of BMI can be explained by bulimia. There is also a tendency (p =,087) in dependences with BL-which is associated with the peculiarities of the sex hormonal background. In general, in women compared to men, the regulation of metabolism is different. The SPl channel has the most pronounced effect. This dependence is also confirmed by significant connections (p =,008) with the primary element "Earth" at the level of 5 elements. Additional significant connections (p =,044) with the TE channel were also revealed, which reflect the influence of the thyroid gland and GB (p =,048), which reflect disorders in the nervous system [17,18], which is also very logical.
According to step-by-step regression analysis in men   Table 4. Of these, the most significant dependences with the SP -(p = .007), BL -(p = .01) channels), as well as, similarly to men, with the KI channel. An interesting trend (p =,09) was also noted in relation to the TE channel, which reflects the regulation of basal metabolism through the activity of the thyroid gland.
In general, this model also has a low percentage of explainable variance (R²= 0,10). R 2 (Adjusted) = 0.10. The following graphs show the profiles of the 24 AC test with BMI values less than and more than 25 in men and women Figure 4.   In both cases, a visual difference was noted mainly in the BL, SP and KI channel only in men. However, according to Multivariate Tests, (Wilks' Lambda, Males: p = .179; Females: p =, 569), these profiles do not differ significantly in general. Earlier it was shown that the assessment of the ratio of the right and left branches of the AС has the greatest diagnostic value [20][21][22][23][24][25]. Figure 5 shows the distribution profiles of these indicators' r/l in men and women.
The greatest differences in the profiles were noted in the lung canal.
According to the graph of differences from men, the indicators of the right branch of this channel are higher in women than on the left. In general, the profile of r / l values in women is higher in all channels, which reflects relative hypofunction in comparison with men at the level of major organs and systems, with the exception of the ACs of the heart and kidneys. The right branch according to the TCM characterizes accumulation and anabolic processes, and the left one -catabolic. The Woman is Yin, and the Man is Yang. Thus, on the whole, this graph confirms this classification of TCM. The female body tends to accumulate energy more, and the male to waste.
According to the t-test, M-W test Table 5, significant differences right and left branches of the AC occur in the AC of the lungs, small intestine, liver and stomach. To find the same changes in profiles, tests were compared for r / l ratios at different BMI values, as well as in patients with T2D separately in men and women. Figure 6 shows the profiles in men. With an increase in BMI above 25, an increase in LU, LI, ST and especially BL is noted. Such an increase in the latter is carried out mainly due to an increase in the indicator of its right branch. Earlier it was found [7,17,18], that this channel reflects the activity of the sex hormonal sphere.   Significance Levels p<0,05 branch of this channel should prevail. The sharp predominance of the right branch with a BMI of more than 25 reflects generally low sexual activity, since the supply of energy in this system sharply exceeds its expenditure [17,18]     which often leads to hyperphagia. At the same time, in the presence of T2D in men there is a sharp asymmetry in these AС due to the predominance of their right branches Figure 6, which is likely, based on previously obtained models, is accompanied by a high activity of the contra insular hormone against the background of insufficient insulin production and resistance to it [20][21][22].
This process is also largely controlled by the hormone Leptin, which is released from adiposities in proportion to the mass of adipose tissue. Its level increases with general obesity in proportion to excess body weight and also depends on the state of the intestinal micro biota. This creates a vicious circle of regulation.
One of the main functions of Leptin is the regulation of appetite by transmitting signals from fat stores by binding to Leptin receptors in the arcuate nucleus of the hypothalamus [30][31][32]. Consequently, the central nervous system is undoubtedly involved in these disorders. Such a pronounced asymmetry along the gastric canal in men, in turn, leads to an imbalance in BL, which controls the sex hormonal background, through "oppressive connections". Such links between ST and BL have previously been described as one of the causes of male disharmonosis and impotence [17,18,22]. There is also a well-known proverb "The way to a man's heart goes through the stomach", but excessive food consumption is harmful.
These changes are shown schematically in Figure 9. From the point of view of TCM, at the beginning of the movement of the system of five primary elements "along the vicious path", there may be changes in the canal of the large intestine, which reflects significant changes in its microbial flora [33]. The large intestine contains about ~ 100 trillion microbes, which create their own biofield, forming its activity. Through this AC, the effects on the body from food, water and other external factors are realized. There is even a bi-directional microbiota-gut-brain connection that modulates brain function that contributes to bulimia [34]. In this model, this channel has direct connections with both the stomach (ST) and BL, so it can play the role of the initiator of all violations.
According to mathematical modeling [13][14][15], the micro biota has a huge impact on our body as a whole and even forms the second regulatory system of the body. Its changes lead to a change in the overall pH of the body. Therefore, even the most insignificant deviations of it lead to a change in AC-LI, which are then transmitted to the hormonal AC-BL. As a result, there is a decrease in sexual activity, which according to the test in men is tracked by the presence of high indicators of its right branch [17,18,23]. In turn, such a transformation according to the "motherson" rules adopted in TCM leads to an increase in the values of the right branch of the gastric AC due to the influence of Leptin and pancreas, which is reflected in the test profiles in T2D Figure 6 as a key moment in the transition of a high indicator BMI in T2D.
As a result, a stable "Trigon" of pathological interrelations arises with the defeat of three of the 5 primary elements, which in such a vicious state support each other, which significantly complicates treatment. Women have a slightly different scenario, which is shown in Figure 10. The canal of the large intestine, according to Partial correlations Table 2, has no significant effect on the process.
The main influence from the point of view of TCM can be exerted by BL, where the profiles with BMI> 25 show signs of dyshormonosis.
Further from it there are 2 chains of influence: the first, through "oppressive connections", concerns the TE channel, which controls the basic metabolism in the body through the thyroid gland and is thus directly related to BMI. In addition, this channel controls the cardiovascular system, which is associated with the risk of various hemodynamic complications, which are much more common in women than in men [17,18]. According to the test profile in T2D, its changes are visually insignificant, however, according to paired comparisons, they are reliable (t-test; p <0.05). In this, an important role will be played by the assessment of test profiles, especially in terms of r /l ratios in the observation dynamics. Then we build an individual model of relationships at the level of 5 primary elements, which allows us to think over the tactics of treatment and take control of AC with high asymmetry.
Based on the obtained patterns, treatment with reflexology methods is also effective, because the key channels associated with the transformation of BMI in T2D are usually in the hypo, and their targeted stimulation at the level of individual branches of the AC by reflexotherapy methods, especially based on individual regression models, gives a good effect [17,18,23]. Of course, the therapeutic effect does not come immediately, because a significant restructuring at the level of bioenergetics is required under test control within 1-2 months. For correction, we use the Yang factor in the form of stimulating modulated IR radiation, with which we act on 2 points (Lo-point and Yuan) only on that branch of the AC, which is in the "Void" with an excess of Yin (www.chimaster. me) The impact is carried out in the "feedback" function until a painful response is achieved. The impact on each point lasts 2-3 minutes. In the course of 1 session, the correction is carried out on no more than three ACs. Then, after 20-30 minutes required for the completion of transient processes in the AC, a control test is carried out by which we evaluate the factor of reducing the level of asymmetry in the AC after exposure. After that, we put markers on the patient's body at points for self-correction at home using the method of acupressure or warming them with lighted sandalwood sticks in combination with a diet [17,18,21,22,35]. Approximately every week we conduct control tests for such patients to assess the effectiveness of treatment. At the same time, more attention is paid not even to the BMI index itself, but to those symptoms and diseases that accompany its high values. The purpose of such corrective actions is to bring the patient's existing profile closer to the norm profile under test control.
In addition to such reflexology, with high BMI rates, diet and drug therapy are prescribed, which is selected on the basis of the Akabane test using proven techniques [35]. Thus, such an integrated approach using metrology and mathematical modeling tools gives

Conclusions
The Akabane test can detect and control various metabolic disorders associated with BMI growth at the individual level.
With high BMI indices, it is possible to track the transformation of these changes in T2D. According to the test profile and the level of asymmetry between the branches of the AC during monitoring, it is possible to assess the dynamics and degree of disorders at the level of individual organs and physiological systems and thus control the effectiveness of treatment.