Aim : To assess the efficacy of berberine in the treatment of non alcoholic fatty liver disease through meta-analysis. Method. We searched Embase, Pubmed, Cochrane Library, and so forth, until March 2016 for randomized controlled trials using berberine to treat NAFLD. Result. Six randomized controlled trials involving 501 patients were included in this study.The results showed that the efficacy of reducing TC, LDL, ALT, 2hPG, and HbA1c in NAFLD patients of the berberine group were significantly higher than that of control group.The subgroupanalyses on TG, AST, and FBG indicated that treatment combined with berberine decreased TG level in NAFLD patients significantly. Compared with other drugs, berberine alone decreased TG level in NAFLD patients significantly. We also conducted a descriptive analysis on insulin resistance and radiography results that berberine can improve NAFLD patients’ insulin resistance and fatty liver. Conclusion. According to analysis result, berberine has positive efficacy on blood lipids, blood glucose, liver function, insulin resistance, and fatty liver condition of NAFLD patients. However, due to the limitation of number and quality of trials included, more clinical randomized controlled trials with high quality are needed for further verification of the efficacy of berberine on NAFLD patients.
The Therapeutic Effect of Berberine in the Treatment of Nonalcoholic Fatty Liver Disease: A Meta-Analysis - XiaoyunWei, ChunyanWang, Shijun Hao, Haiyan Song, and Lili Yang, Evidence-Based Complementary and Alternative Medicine Volume 2016, Article ID 3593951

The aim of this study is to assess the impact of a combination of berberine and silymarin on serum lipids and fasting plasma glucose (FPG) through a systematic review of literature and meta‐analysis of the available randomized, double‐blind, placebo‐controlled clinical trials (RCTs). A systematic literature search in SCOPUS, PubMed‐Medline, ISI Web of Science, and Google Scholar databases was conducted up to October 2, 2018, in order to identify RCTs assessing changes in plasma concentrations of total cholesterol (TC), triglycerides (TG), high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol (LDL‐C) and FPG during treatment with berberine and silymarin in combination. Two review authors independently extracted data on study characteristics, methods, and outcomes. Quantitative data synthesis was performed using a random‐effects model. We identified five eligible RCTs, with 497 subjects overall included. Berberine and silymarin combination treatment exerted a positive effect on TC (mean difference [MD]: −25.3, 95% CI [−39.2, −11.4] mg/dl; p max 0.001), TG (MD: −28, 95% CI [−35.3, −20.6] mg/dl; p max 0.001), HDL‐C [MD: 6, 95% CI [3.2, 8.8] mg/dl; p max 0.001), LDL‐C (MD: −29.1, 95% CI [−39.7, −18.6] mg/dl; p max 0.001), and FPG (MD: −7.5, 95% CI [−13, −1.9] mg/dl; p = 0.008). The present findings suggest that the coadministration of berberine and silymarin is associated with an advantageous improvement in lipid and glucose profile, suggesting the possible use of this nutraceutical combination in order to promote the cardiometabolic health.
KEYWORDS : berberine, cholesterol, fasting plasma glucose, meta analysis, nutraceutical, silymarin
Metabolic effect of berberine–silymarin association: A meta‐analysis of randomized, double‐blind, placebo‐controlled clinical trials - Federica Fogacci, Davide Grassi, Manfredi Rizzo, Arrigo F.G. Cicero

Abstract : Previous studies suggested that oxidative stress is related to the onset and development of osteoporosis. Moreover, it was demonstrated that berberine has a protective effect against oxidative stress‑induced injuries. In this study, we aimed to investigate the effect and mechanism of action of berberine on rats with induced osteoporosis. Sixty 8‑week‑old female Wistar rats were randomly divided into the following 6 groups: control saline‑treated, osteoporosis saline‑treated, 3 osteoporosis berberine‑treated groups (Ber 5, 10, and 20 mg/kg/body weight, respectively), and osteoporosis alendronate‑treated (ALD) group. Osteoporosis was induced by bilateral ovariectomy. All treatments were performed for 8 weeks. The bone mineral density (BMD), serum alkaline phosphatase (ALP), osteocalcin, calcium, phosphorus, superoxide dismutase (SOD), methylene dioxyamphetamine (MDA), and glutathione peroxidase (GSH‑Px) level was determined in the rat femur tissue. The gene and protein expression of osteoprotegerin (OPG) and receptor activator of nuclear factor kappa‑B ligand (RANKL) was analyzed by quantitative reverse transcription PCR and Western blot, respectively. The BMD, SOD and GSH-Px levels, and the expression of OPG were significantly lower in osteoporosis compared to control group (all P < 0.05). The serum levels of osteocalcin, ALP, and MDA, and the expression of RANKL were significantly higher in osteoporosis compared to control group (all P < 0.05). Berberine, especially the high doses of berberine, effectively increased SOD, GSH-Px, and OPG levels as well as decreased serum osteocalcin, ALP, MDA and RANKL levels in berberine‑treated osteoporosis groups (all P < 0.05). To conclude, oxidative stress may promote the development of osteoporosis in rats through the RANK/RANKL/ OPG pathway. The antioxidative effect of berberine reduces the development of osteoporosis in rats to some extent.
KEY WORDS: Osteoporosis; oxidative stress; Wistar rats; berberine; OPG; osteoprotegerin; RANK; RANKL; receptor activator of nuclear, factor kappa‑B ligand
Berberine alleviates oxidative stress in rats with osteoporosis through receptor activator of NF-kB/ receptor activator of NF-kB ligand/osteoprotegerin (RANK/RANKL/OPG) pathway - Bosn J Basic Med Sci. 2017, Xiao‑Feng He, Long Zhang, Chun‑Hua Zhang, Con‑Ran Zhao