Zhao Jie V, Huang Xin, Zhang Junmeng, Chan Yap-Hang, Tse Hung-Fat, Blais Joseph E
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
J Nutr. 2023 Oct;153(10):2939-2950. doi: 10.1016/j.tjnut.2023.08.016. Epub 2023 Aug 19.
Berberine is widely available as a nutraceutical supplement for improving glucose metabolism. Berberine affects sex hormones, raising the possibility that its effects on glycemic traits and insulin sensitivity have sex disparity which has been overlooked.
To assess the overall and sex-specific effects of berberine on glycemic- and insulin-related traits.
We identified randomized trials of berberine versus placebo from Medline, Embase, CNKI, clinical trial registries and previous systematic reviews. Mean differences were estimated using inverse-variance weighting with random effects models. Subgroup analyses were conducted by sex, diabetes diagnosis, trial duration, berberine dose and ethnicity.
We identified 20 eligible studies (n = 1761). Berberine lowered fasting glucose (-0.52 mmol/L, 95% CI -0.72 to -0.33; 18 studies, n = 1522), HbA1c (-4.48 mmol/mol, 95% CI -6.53 to -2.44, 7 studies, n = 756), fasting insulin (-2.36 mU/L, 95% CI -3.64 to -1.08, 11 studies, n = 966), HOMA-IR (-0.85, 95% CI -1.16 to -0.53,12 studies, n = 1065), and 2-h postprandial glucose (-1.81 mmol/L, 95% CI -2.37 to -1.24, 4 studies, n = 501). Effects on fasting glucose and HOMA-IR showed potential differences by sex, with larger reductions in women than in men. Comparing 4 studies conducted in women to one study conducted in men, the mean difference was -0.21 mmol/L (95% CI -0.41 to -0.00) for fasting glucose and -0.97 (95% CI -1.84 to -0.10) for HOMA-IR. We also found larger reductions in fasting glucose in participants with diabetes and in Asians.
Berberine is effective in improving glucose metabolism and may result in larger effects on fasting glucose in women, in people with diabetes and in Asians, but subgroup comparisons remain to be replicated given the limited number of studies. Berberine can be considered as a complementary intervention in individuals who may benefit from modest improvements in glucose metabolism and who prefer taking a nutraceutical.
PROSPERO (CRD42022345172).
小檗碱作为一种用于改善糖代谢的营养补充剂广泛可得。小檗碱会影响性激素，这增加了其对血糖特征和胰岛素敏感性的影响存在性别差异而被忽视的可能性。
评估小檗碱对血糖和胰岛素相关特征的总体及性别特异性影响。
我们从医学期刊数据库（Medline）、荷兰医学文摘数据库（Embase）、中国知网（CNKI）、临床试验注册库及既往系统评价中识别出小檗碱对比安慰剂的随机试验。使用随机效应模型的逆方差加权法估计平均差异。按性别、糖尿病诊断、试验持续时间、小檗碱剂量和种族进行亚组分析。
我们识别出20项符合条件的研究（n = 1761）。小檗碱降低了空腹血糖（-0.52 mmol/L，95%可信区间 -0.72至 -0.33；18项研究，n = 1522）、糖化血红蛋白（-4.48 mmol/mol，95%可信区间 -6.53至 -2.44，7项研究，n = 756）空腹胰岛素（-2.36 mU/L，95%可信区间 -3.64至 -1.08，11项研究，n = 966）、稳态模型评估的胰岛素抵抗（HOMA-IR）（-0.85，95%可信区间 -1.16至 -0.53，12项研究，n = 1065）以及餐后2小时血糖（-1.81 mmol/L，95%可信区间 -2.37至 -1.24，4项研究，n = 501）。对空腹血糖和HOMA-IR的影响显示出潜在的性别差异，女性的降低幅度大于男性。将在女性中进行的4项研究与在男性中进行的1项研究进行比较，空腹血糖的平均差异为 -0.21 mmol/L（95%可信区间 -0.41至 -
