Efficacy and safety of berberine alone or combined with statins for the treatment of hyperlipidemia: A systematic review and meta-analysis of randomized controlled clinical trials
Abstract
To systematically evaluate the efficacy and safety of berberine for the treatment of hyperlipidemia, six electronic literature databases including SinoMed, CNKI, WanFang Data, PubMed, Embase and The Cochrane Library were searched to collect clinical randomized controlled trials (RCTs) of berberine alone or combined with statins for the treatment of hyperlipidemia from the inception to 8 March 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included RCTs. Then, meta-analysis was performed by using RevMan 5.3 software. A total of 11 RCTs involving 1386 patients were finally included. The results of meta-analysis showed that compared with the placebo group, berberine could significantly reduce the total cholesterol and low-density lipoprotein levels and elevate the high density lipoprotein level ([Formula: see text]). Compared with the simvastatin group, berberine was effective only in reducing the level of triglyceride ([Formula: see text], 95% CI: [Formula: see text]0.66, [Formula: see text]0.07, [Formula: see text]). There, however, was no statistical significance between the BBR group and simvastatin group in the low density lipoprotein and high density lipoprotein levels. Compared with the simvastatin group, berberine plus simvastatin was more effective in reducing the level of triglyceride ([Formula: see text], 95% CI: [Formula: see text]0.46, [Formula: see text]0.20, [Formula: see text]) and total cholesterol ([Formula: see text], 95% CI: [Formula: see text]0.60, [Formula: see text]0.12, [Formula: see text]). In terms of adverse reactions, the incidence of adverse reactions including transaminase elevation and muscle aches was lower in the berberine alone or combined with simvastatin group than that in the control group, while the instance of constipation was higher. This study suggests that berberine is effective for hyperlipidemia. The quality and quantity of included studies, however, were dissatisfactory, which might decrease the reliability of the results. Higher quality studies are needed to provide more high quality evidence.
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Prior reviews of berberine have limitations including that they included studies that did not make comparisons to placebo, compared berberine to diverse controls, assessed extracts from the barberry plant, or defined the intervention as combination nutraceutical products containing berberine.
“Prior reviews of berberine have several limitations as they included studies that did not make comparisons to placebo, compared berberine to diverse controls (e.g., statins, oral hypoglycemics, lifestyle modification), assessed extracts from the barberry plant or defined the intervention as combination nutraceutical products containing berberine such as Armolipid Plus®.(7-13)”
From Overall and sex-specific effect of berberine for dyslipidemia: systematic review and meta-analysis of placebo-controlled trials (2022) · cites this paper as [11]
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References 21 · Cited by 50
- Authors
- Zhang, L.-S., Zhang, J.-H., Feng, R., Jin, X.-Y., Yang, F.-W., Ji, Z.-C., Zhao, M.-Y., Zhang, M.-Y., Zhang, B.-L., & Li, X.-M.
- Affiliations
- Tianjin University of Traditional Chinese Medicine (CN)
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China
- Baokang Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China
- ORCID
- Feng, Rui
- Venue
- The American Journal of Chinese Medicine
- Publisher
- World Scientific Pub Co Pte Ltd
- Published
- 2019-01
- Volume
- 47
- Issue
- 04
- Pages
- 751-767
- ISSN
- 0090-2942 (ISSN-L)
- 0192-415X
- 1793-6853
- OpenAlex
- W2945687754
- Cited by
- 50
- References
- 21
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 5 · 2023: 6 · 2022: 7 · 2021: 8 · 2020: 10
- FWCI
- 0.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Chinese Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Berberine and alkaloids research
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Natural Products and Biological Research
- Keywords
- berberine, hyperlipidemia, statins, simvastatin, combination therapy, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, adverse drug reactions, transaminase elevation, constipation
- MeSH terms
- Berberine, Cholesterol, Drug Therapy, Combination, Humans, Hyperlipidemias, Lipoproteins, HDL, Lipoproteins, LDL, Phytotherapy, Triglycerides, Randomized Controlled Trials as Topic, Databases, Bibliographic, Treatment Outcome, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Simvastatin
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