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The clinical efficacy and safety of berberine in the treatment of non-alcoholic fatty liver disease: a meta-analysis and systematic review

Qi-Long Nie, Mingyang Li, Cai-Yang Huang, Yongwei Yuan, Qiu-Yan Liang, Xiaojun Ma, Teng-Yu Qiu, Jian-Hong Li

Journal of Translational Medicine, 2024

811 participants · 58 citations

Abstract

Non-alcoholic fatty liver disease (NAFLD) is becoming increasingly prevalent worldwide, emerging as a significant health issue on a global scale. Berberine exhibits potential for treating NAFLD, but clinical evidence remains inconclusive. This meta-analysis was conducted to assess the efficacy and safety of berberine for treating NAFLD. This study was registered with PROSPERO (No. CRD42023462338). Identification of randomized controlled trials (RCTs) involved searching 6 databases covering the period from their initiation to 9 September 2023. The primary outcomes comprised liver function markers such as glutamyl transpeptidase (GGT), alanine transaminase (ALT), aspartate transaminase (AST), lipid indices including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), homeostasis model assessment for insulin resistance (HOMA-IR) and body mass index (BMI). Review Manager 5.4 and STATA 17.0 were applied for analysis. Among 10 RCTs involving 811 patients, berberine demonstrated significant reductions in various parameters: ALT (standardized mean difference (SMD) = − 0.72), 95% confidence interval (Cl) [− 1.01, − 0.44], P < 0.00001), AST (SMD = − 0.79, 95% CI [− 1.17, − 0.40], P < 0.0001), GGT (SMD = − 0.62, 95% CI [− 0.95, − 0.29], P = 0.0002), TG (SMD = − 0.59, 95% CI [− 0.86, − 0.31], P < 0.0001), TC(SMD = − 0.74, 95% CI [− 1.00, − 0.49], P < 0.00001), LDL-C (SMD = − 0.53, 95% CI [− 0.88, −…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 811 participants or records.

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