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Cited by 117Berberine and alkaloids researchNatural Antidiabetic Agents StudiesMetabolism, Diabetes, and Cancer

The DOI matches its Crossref record; 37 of the 38 references it cites were found in a registry or an index.

Efficacy and Safety of Berberine Alone for Several Metabolic Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

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Ye, Yu, Liu, Xiufen, Wu, Ninghua, Han, Yanqi, Wang, Jiawen, Yu, Yuandong, Chen, Qingjie·2021·Frontiers in Pharmacology
DOI 10.3389/fphar.2021.653887PMC PMC8107691
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Abstract

Background: Metabolic activity is the basic life activity of organisms and the fundamental for maintaining body functions. With the improvement of living standards, the incidence of metabolic disorder is also increasing. At present, most of the clinical treatment strategies and meta-analysis for metabolic disorder uncover that combined medicines with berberine ameliorate several metabolic disorders. However, evidence to disclose the therapeutic effect of berberine treatment alone and the possible factors affecting the efficacy is limited. Therefore, we have formulated strict inclusion criteria and selected more reliable data for meta-analysis through more refined screening strategies to provide evidence and guidance for clinical decision-making and understand the effect of berberine treatment alone and the factors affecting its efficacy. Methods and results: Using meta-analysis of “Cochrane Handbook for Systematic Reviews of Interventions” as guidelines, we searched PubMed, GeenMedical, Cochrane library, and china national knowledge infrastructure (CNKI) for trials reporting clinical treatment data of berberine. Another 417 trials were included through other sources to increase confidence in results. Among the 1,660 related documents retrieved from the four databases, 18 eligible documents were selected for analysis. Given the differences in trial design and measurement units, we used the standardized mean difference (SMD) method to eliminate the differences and then summarize the data for analysis. The main factors are triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), homeostasis model assessment-insulin resistance (HOMA-IR), and fasting plasma glucose (FPG). Random-effect model analysis was performed: TG (SMD: 0.94; 95%CI: 0.49,1.38; p = 0.00), TC (SMD: 1.06; 95%CI: 0.64, 1.48; p = 0.00), LDL (SMD: 1.77; 95%CI: 1.11,2.44; p = 0.00), HDL (SMD: −1.59; 95%CI: −2.32, −0.85; p = 0.00), HOMA-IR (SMD: 1.25; 95%CI: 0.25,2.24; p = 0.01), and FPG (SMD: 0.65; 95%CI: 0.28,1.03; p = 0.00). This study aimed to conduct a systematic review and meta-analysis of the literature to evaluate the therapeutic effect of berberine singly on metabolic diseases. Conclusion: Berberine can improve obesity and hyperlipidemia by reducing TG, TC, and LDL and increasing HDL; reduce insulin resistance to improve type Ⅱ diabetes; and prevent diabetic encephalopathy.

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Crossref · 10.3389/fphar.2021.653887

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FIGURE 1 Flow diagram.
FIGURE 1 Flow diagram.CC BY · PubMed Central
FIGURE 2 Risk of bias assessment. The details were related to the six domains that contained (1) random sequence generation (selection bias): the literature proclaims that the random sequence method is considered low risk. (2) Allocation concealment (selection bias): explain that allocation concealment or placebo-controlled experiments are considered low risk. (3) Blinding of participants and personnel (performance bias): the literature states that a double-blind study design is considered low risk. (4) Blinding of outcome assessment (detection bias): there is a return visit record or related explanation in the article that is considered low risk. (5) Incomplete outcome data (attrition bias): no outliers during the trial are considered low risk. (6) Selective reporting (reporting bias): no selective report treatment data are considered low risk.
FIGURE 2 Risk of bias assessment. The details were related to the six domains that contained (1) random sequence generation (selection bias): the literature proclaims that the random sequence method is considered low risk. (2) Allocation concealment (selection bias): explain that allocation concealment or placebo-controlled experiments are considered low risk. (3) Blinding of participants and personnel (performance bias): the literature states that a double-blind study design is considered low risk. (4) Blinding of outcome assessment (detection bias): there is a return visit record or related explanation in the article that is considered low risk. (5) Incomplete outcome data (attrition bias): no outliers during the trial are considered low risk. (6) Selective reporting (reporting bias): no selective report treatment data are considered low risk.CC BY · PubMed Central
FIGURE 3 Meta-analysis and migration analysis of the effect of berberine on triglyceride. Forest plot illustrates the differences in changes in triglyceride in adults with metabolic disease who did or did not receive berberine in 15 trials (n = 1,231). The mean difference (blue squares), 95% CI (horizontal lines through blue squares), and pooled-effect sizes (green diamonds) were presented using random-effect Hedges models.
FIGURE 3 Meta-analysis and migration analysis of the effect of berberine on triglyceride. Forest plot illustrates the differences in changes in triglyceride in adults with metabolic disease who did or did not receive berberine in 15 trials (n = 1,231). The mean difference (blue squares), 95% CI (horizontal lines through blue squares), and pooled-effect sizes (green diamonds) were presented using random-effect Hedges models.CC BY · PubMed Central
FIGURE 4 Meta-analysis and migration analysis of the effect of berberine on total cholesterol. Forest plot illustrates the differences in changes in total cholesterol in adults with metabolic disease who did or did not receive berberine in 15 trials (n = 1,297). The mean difference (blue squares), 95% CI (horizontal lines through blue squares), and pooled-effect sizes (green diamonds) were presented using random-effect Hedges models.
FIGURE 4 Meta-analysis and migration analysis of the effect of berberine on total cholesterol. Forest plot illustrates the differences in changes in total cholesterol in adults with metabolic disease who did or did not receive berberine in 15 trials (n = 1,297). The mean difference (blue squares), 95% CI (horizontal lines through blue squares), and pooled-effect sizes (green diamonds) were presented using random-effect Hedges models.CC BY · PubMed Central
FIGURE 5 Meta-analysis and migration analysis of the effect of berberine on low-density lipoprotein. Forest plot illustrates the differences in changes in low-density lipoprotein in adults with metabolic disease who did or did not receive berberine in 14 trials (n = 1,233). The mean difference (blue squares), 95% CI (horizontal lines through blue squares), and pooled-effect sizes (green diamonds) were presented using random-effect Hedges models.
FIGURE 5 Meta-analysis and migration analysis of the effect of berberine on low-density lipoprotein. Forest plot illustrates the differences in changes in low-density lipoprotein in adults with metabolic disease who did or did not receive berberine in 14 trials (n = 1,233). The mean difference (blue squares), 95% CI (horizontal lines through blue squares), and pooled-effect sizes (green diamonds) were presented using random-effect Hedges models.CC BY · PubMed Central
FIGURE 6 Meta-analysis and migration analysis of the effect of berberine on high-density lipoprotein. Forest plot illustrates the differences in changes in high-density lipoprotein in adults with metabolic disease who did or did not receive berberine in 13 trials (n = 1,133). The mean difference (blue squares), 95% CI (horizontal lines through blue squares), and pooled-effect sizes (green diamonds) were presented using random-effect Hedges models.
FIGURE 6 Meta-analysis and migration analysis of the effect of berberine on high-density lipoprotein. Forest plot illustrates the differences in changes in high-density lipoprotein in adults with metabolic disease who did or did not receive berberine in 13 trials (n = 1,133). The mean difference (blue squares), 95% CI (horizontal lines through blue squares), and pooled-effect sizes (green diamonds) were presented using random-effect Hedges models.CC BY · PubMed Central
FIGURE 7 Meta-analysis and migration analysis of the effect of berberine on homeostasis model assessment of insulin resistance. Forest plot illustrates the differences in changes in homeostasis model assessment of insulin resistance in adults with metabolic disease who did or did not receive berberine in 5 trials (n = 471). The mean difference (blue squares), 95% CI (horizontal lines through blue squares), and pooled-effect sizes (green diamonds) were presented using fixed-effects inverse-variance models.
FIGURE 7 Meta-analysis and migration analysis of the effect of berberine on homeostasis model assessment of insulin resistance. Forest plot illustrates the differences in changes in homeostasis model assessment of insulin resistance in adults with metabolic disease who did or did not receive berberine in 5 trials (n = 471). The mean difference (blue squares), 95% CI (horizontal lines through blue squares), and pooled-effect sizes (green diamonds) were presented using fixed-effects inverse-variance models.CC BY · PubMed Central
FIGURE 8 Meta-analysis and migration analysis of the effect of berberine on fasting plasma glucose. Forest plot illustrates the differences in changes in fasting plasma glucose in adults with metabolic disease who did or did not receive berberine in 13 trials (n = 1,052). The mean difference (blue squares), 95% CI (horizontal lines through blue squares), and pooled-effect sizes (green diamonds) were presented using random-effect Hedges models.
FIGURE 8 Meta-analysis and migration analysis of the effect of berberine on fasting plasma glucose. Forest plot illustrates the differences in changes in fasting plasma glucose in adults with metabolic disease who did or did not receive berberine in 13 trials (n = 1,052). The mean difference (blue squares), 95% CI (horizontal lines through blue squares), and pooled-effect sizes (green diamonds) were presented using random-effect Hedges models.CC BY · PubMed Central

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Citations

Cites

Show all 38 references

Research works printed but not linked: 6

  1. Cao, 2007, A Clinical Study of Multi-Factor Intervention to Improve Insulin Resistance in Type 2 Diabetes (Chinese). Master’s Degree
  2. Huang, 2011, Clinical Observation on 60 Cases of Hyperlipemia Treated by Berberine (Chinese), Chin. J. Clin. Rational Drug Use, 4, 76, 10.3969/j.issn.1674-3296.2011.22.058 · DOI
  3. Ju, 2007, Interventioal Effect of Berberine Liposome on Impaired Glucose Tolerance Accompanied with Hyperlipemia, J. Pract. Trad. Chin. Med., 23, 490
  4. Liu, 2015, Effect of Metabolic Diseases on Emotional and Cognitive Functions and its Potential Mechanisms: Research Progress, Chin. J. Pharmacol. Toxicol., 29, 847, 10.3867/j.issn.1000-3002.2015.05.063 · DOI
  5. Zhang, 2018, Clinical Study of Berberine Intervention in Patients with Impaired Fasting Blood Glucose (Chinese), Zhejiang J. Traditional Chin. Med., 53, 393, 10.3969/j.issn.0411-8421.2018.06.002 · DOI
  6. Zhao, 2018, Clinical Study of Berberine Intervention in Delaying the Development of Diabetes in Pre-diabetic Population (Chinese), J. Pract. Diabetol., 14, 31

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Metadata

Authors
Ye, Y., Liu, X., Wu, N., Han, Y., Wang, J., Yu, Y., & Chen, Q.
Affiliations
  • Hubei University of Science and Technology (CN)
  • Hubei University of Medicine (CN)
Corresponding author
  • Yu, Yuandong
  • Chen, Qingjie
ORCID
Venue
Frontiers in Pharmacology
Publisher
Frontiers Media SA
Published
2021-04-26
Volume
12
Pages
653887-653887
ISSN
1663-9812 (ISSN-L)
DOI
10.3389/fphar.2021.653887
PMC
PMC8107691
OpenAlex
W3160298538
Cited by
109
References
38
Citations by year
2026: 18 · 2025: 28 · 2024: 18 · 2023: 24 · 2022: 15 · 2021: 6
FWCI
1.99
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Pharmacology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Hubei Provincial Department of Education (BK202009, D20202803)
  • Natural Science Foundation of Hubei Province (2020CFB851)
  • Hubei University
  • Hubei University of Science and Technology
Topics
  • Health Sciences › Medicine › Pharmacology (medical) › Berberine and alkaloids research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Natural Antidiabetic Agents Studies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
Keywords
berberine, metabolic disorders, triglycerides, total cholesterol, LDL cholesterol, HDL cholesterol, insulin resistance, fasting blood glucose, serum lipids, treatment efficacy and safety

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