Liu Dangzhen, Zhao Haiyan, Zhang Yiwen, Hu Jingqing, Xu Hong
School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
School of Third Clinical Medical, Nanjing University of Traditional Chinese Medicine, Nanjing, China.
Front Pharmacol. 2025 Jul 16;16:1572197. doi: 10.3389/fphar.2025.1572197. eCollection 2025.
Metabolic syndrome (MetS) is a prevalent metabolic disease that significantly increases the risk of type 2 diabetes, cardiovascular diseases, and overall mortality. Current medications have limited effects on the various components of MetS. Berberine has demonstrated unique comprehensive therapeutic benefits for MetS, but its efficacy remains uncertain.
To comprehensively evaluate the efficacy and safety of berberine on MetS indicators.
Our study provides a comprehensive evaluation of the efficacy and safety of berberine for MetS components through systematic review and meta-analysis, from the aspects of study characteristics, risk of bias, meta-analysis, sensitivity analysis, meta-regression, and publication bias.
The results indicate that berberine significantly reduces triglycerides (TG) (WMD: -0.367 mmol/L; 95% CI: -0.560 to -0.175; < 0.001), fasting plasma glucose (FPG) (WMD: -0.515 mmol/L; 95% CI: -0.847 to -0.183; = 0.002), and waist circumference (WC) (WMD: -3.270 cm; 95% CI: -4.818 to -1.722; < 0.001) among the components of MetS, but has no significant effect on high-density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), or diastolic blood pressure (DBP). Additionally, berberine also improves the secondary indicators of low-density lipoprotein cholesterol (LDL-C) (WMD: -0.495 mmol/L; 95% CI: -0.714 to -0.276; < 0.001), total cholesterol (TC) (WMD: -0.451 mmol/L; 95% CI: -0.631 to -0.271; < 0.001), body mass index (BMI) (WMD: -0.435 kg/m; 95% CI: -0.856 to -0.013; = 0.043), and 2-h oral glucose tolerance (2hOGTT) (WMD: -1.606 mmol/L; 95% CI: -1.891 to -1.321; < 0.001). Meta-regression and subgroup analyses indicate that short-term treatment (≤90 days) is more effective for HDL-C and LDL-C than long-term treatment. Regarding safety, no significant difference was observed between berberine and placebo.
Berberine significantly improves glucose and lipid metabolism and has notable effects on components of MetS, including TG, FPG, and WC, with a favorable safety profile. It may serve as a beneficial supplement. Meanwhile, more high-quality, rigorously designed randomized controlled trials are needed in the future to provide stronger evidence.
代谢综合征（MetS）是一种常见的代谢性疾病，显著增加了2型糖尿病、心血管疾病及全因死亡率的风险。目前的药物对代谢综合征的各个组分效果有限。黄连素已显示出对代谢综合征具有独特的综合治疗益处，但其疗效仍不确定。
全面评估黄连素对代谢综合征指标的疗效和安全性。
我们的研究通过系统评价和荟萃分析，从研究特征、偏倚风险、荟萃分析、敏感性分析、荟萃回归及发表偏倚等方面，对黄连素治疗代谢综合征各组分的疗效和安全性进行全面评估。
结果表明，黄连素能显著降低代谢综合征各组分中的甘油三酯（TG）（加权均数差：-0.367 mmol/L；95%置信区间：-0.560至-0.175；P<0.001）、空腹血糖（FPG）（加权均数差：-0.515 mmol/L；95%置信区间：-0.847至-0.183；P=0.002）和腰围（WC）（加权均数差：-3.270 cm；95%置信区间：-4.818至-1.722；P<0.001），但对高密度脂蛋白胆固醇（HDL-C）、收缩压（SBP）或舒张压（DBP）无显著影响。此外，黄连素还能改善低密度脂蛋白胆固醇（LDL-C）（加权均数差：-0.495 mmol/L；95%置信区间：-0.714至-0.276；P<0.001）、总胆固醇（TC）（加权均数差：-0.451 mmol/L；95%置信区间：-0.631至-0.271；P<0.001）、体重指数（BMI）（加权均数差：-0.435 kg/m²；95%置信区间：-0.856至-0.013；P=0.043）和口服葡萄糖耐量试验2小时血糖（2hOGTT）（加权均数差：-1.606 mmol/L；95%置信区间：-1.891至-1.321；P<0.001）等次要指标。荟萃回归和亚组分析表明，短期治疗（≤90天）对HDL-C和LDL-C的效果优于长期治疗。在安全性方面，黄连素与安慰剂之间未观察到显著差异。
黄连素能显著改善糖脂代谢，对代谢综合征的组分包括TG、FPG和WC有显著作用，且安全性良好。它可能是一种有益的补充剂。同时，未来需要更多高质量、设计严谨的随机对照试验来提供更有力的证据。
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