Zhu Wenyu, Yang Lele, Dai Yufan, Wang Hanyang, Zhou Jiaxuan, Xia Lina, Shen Tao
School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Front Pharmacol. 2025 Aug 29;16:1460643. doi: 10.3389/fphar.2025.1460643. eCollection 2025.
Non-alcoholic fatty liver disease (NAFLD) represents a global health challenge. Berberine, an isoquinoline alkaloid traditionally used for metabolic disorders, has garnered attention for its potential therapeutic interventions.
To comprehensively review and perform a meta-analysis of berberine's effects on NAFLD across clinical and preclinical studies.
A comprehensive literature search was conducted across five databases from their inception to May 2024. We included randomized controlled trials and animal studies that evaluated berberine's impact on NAFLD using specified biochemical markers.
Out of 487 screened studies, 22 (4 clinical and 18 preclinical) were included. Clinically, berberine significantly reduced fasting blood glucose (FBG) levels, with an effect size of 0.53 (95% CI: 0.04-1.01). In preclinical settings, berberine consistently demonstrated benefits across several markers, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lipid profiles, despite significant heterogeneity in some outcomes.
Berberine presents promising therapeutic avenues for NAFLD management, especially in terms of glucose metabolism. Further rigorous, well-designed trials are needed to substantiate these findings.
https://www.crd.york.ac.uk/prospero/, Identifier CRD42023459618.
非酒精性脂肪性肝病（NAFLD）是一项全球性的健康挑战。小檗碱是一种传统上用于治疗代谢紊乱的异喹啉生物碱，其潜在的治疗干预作用已引起关注。
全面综述并对小檗碱在临床和临床前研究中对NAFLD的影响进行荟萃分析。
对五个数据库从建库至2024年5月进行全面的文献检索。我们纳入了使用特定生化标志物评估小檗碱对NAFLD影响的随机对照试验和动物研究。
在筛选的487项研究中，纳入了22项（4项临床研究和18项临床前研究）。在临床上，小檗碱显著降低空腹血糖（FBG）水平，效应大小为0.53（95%CI：0.04 - 1.01）。在临床前研究中，尽管某些结果存在显著异质性，但小檗碱在包括丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）和血脂谱等多个指标上始终显示出有益作用。
小檗碱为NAFLD的管理提供了有前景的治疗途径，尤其是在葡萄糖代谢方面。需要进一步进行严格、设计良好的试验来证实这些发现。
