Abdominal massage improves intestinal barrier function via the TLR4/MyD88/NF-κB signaling pathway in obesity-associated T2DM rats.

Abdominal massage (AM), a traditional Chinese medicine treatment, is gradually being recognized in clinical practice for its ability to improve the symptoms of obesity and type 2 diabetes mellitus (T2DM) in clinical practice. This study aimed to investigate the effect of AM on an obesity-associated T2DM model induced by a high-fat diet (HFD) combined with a small dose of streptozotocin (STZ). Thirty male Sprague‒Dawley rats were randomly divided into three groups: control group (CON), the obesity-associated T2DM group (MOD), and AM group. After 4 weeks of HFD feeding and STZ injection, the rats received AM for 4 weeks. AM significantly improved glucose intolerance, obesity, and colonic inflammation and reduced fasting blood glucose and glycated serum protein levels. In addition, AM significantly ameliorated glucolipid metabolism abnormalities in obesity-associated T2DM rats, as evidenced by improved glucose tolerance and favorable alterations in lipid profiles. AM also attenuated both systemic and intestinal inflammation, accompanied by a marked reduction in circulating pro-inflammatory cytokines. In summary, our results suggest that AM exerts protective effects against obesity-associated T2DM by improving glucolipid metabolism, attenuating systemic and intestinal inflammation, and restoring intestinal barrier integrity via suppression of the TLR4/MyD88/NF-κB signaling pathway. Although long-term evaluations and multi-omics analyses are warranted to fully elucidate the underlying mechanisms, these results provide a solid theoretical basis for exploring AM as a potential barrier-protecting therapeutic strategy for obesity-related metabolic diseases.