Efficacy and Safety of Safflower Yellow in Early Diabetic Nephropathy: A Meta-Analysis

Abstract

Background. Diabetic nephropathy (DN) is a major cause of end-stage renal disease. In order to palliate renal function impairment and reduce kidney related mortality, it is crucial to treating DN patients at the early stage. This study aims to assess the efficacy and safety of conventional therapy combined with safflower yellow versus conventional therapy alone in early DN patients. Methods. A meta-analysis of randomized controlled trials that compared safflower yellow plus conventional therapy with conventional therapy alone in early DN patients was conducted. Papers were searched using the electronic databases and reference lists. Two reviewers working independently extracted relevant data and carried out risk-of-bias assessments. Statistical analysis was undertaken in Review Manager 5.3. Results. Fourteen trials (1,072 patients) were included in the meta-analysis. Conventional therapy combined with safflower yellow was associated with a higher effective rate (RD, 0.24; 95% CI, 0.17 to 0.30) and a greater decline in urinary albumin excretion rates (SMD, -1.34; 95% CI, -1.77 to -0.92), fasting blood glucose (MD, -0.57; 95% CI, -0.98 to -0.16), serum creatinine (MD, -12.36; 95% CI, -14.66 to -10.06), and blood urea nitrogen (SMD, -0.93; 95% CI, -1.13 to -0.73) in the subgroup with a follow-up time > 15 days. The incidence of adverse events did not differ significantly between these two regimens (RD, -0.01; 95% CI, -0.03 to 0.01). Findings were similar in the subgroup with a follow-up time < 15 days. Conclusions. Conventional therapy combined with safflower yellow had a more beneficial effect than conventional therapy alone in early DN patients. There were significant differences in effective rate, urinary albumin excretion rates, fasting blood glucose, serum creatinine, and blood urea nitrogen between the two regimens and no significant difference in adverse events. More randomized controlled research using standardized protocols would be needed in the future to compare these two regimens.

Antioxidant and Anti-Inflammatory Properties of Hydroxyl Safflower Yellow a in Diabetic Nephropathy: A Meta-Analysis of Randomized Controlled Trials

“…The pooled results indicated that the intravenous infusion of HSYA can significantly improve oxidative stress and the inflammatory response and could produce a better therapeutic effect than conventional Western medicine alone. The results in this meta-analysis also showed that the effect of HSYA can significantly reduce the level of SCR and UAER, which is consistent with the results reported by other meta-analyses (Jin et al, 2019;Wang et al, 2019b). Moreover, no adverse effects occurring in these clinical trials were reported by researchers.…”

“…HSYA has been commonly used in treating cardiovascular and cerebrovascular diseases in China and to scavenge oxygen-free radicals, reduce inflammatory infiltration, and inhibit apoptosis ( Xue et al, 2021 ). Recently, several reviews and meta-analyses (SRs/MAs) have indicated that HSYA can significantly improve DKD by enhancing the total effective rate and reducing urinary albumin excretion rates (UAERs), serum creatinine (SCR), and blood urea nitrogen (BUN) levels ( Yang et al, 2018 ; Wang et al, 2019a ; Wang et al, 2019b ; Jin et al, 2019 ; Xu et al, 2019 ). However, the underlying mechanism implicated in the role of HSYA in DKD remains unclear.…”

Buyang Huanwu Decoction protects against STZ-induced diabetic nephropathy by inhibiting TGF-β/Smad3 signaling-mediated renal fibrosis and inflammation

“…Astragalus polysaccharides could protect against STZ-induced diabetic rats through inhibiting the TGF-β/Smad signaling pathway [ 43 ]. Ligustrazine and safflower yellow improve renal function and reduce urine protein excretion in diabetic nephropathy patients [ 41 , 42 ]. Thus, the anti-inflammation and anti-fibrosis for renoprotection could be attributed to the synergic effects of the multi-compounds from BHD, which should be further studied.…”

Pharmacological Activities of Safflower Yellow and Its Clinical Applications

“…Complications. Diabetic nephropathy (DN) is one of the major micro-vascular complications of diabetes mellitus (DM) disability and death [12,107]. SY can prolong PT.…”

“…Modern pharmacological studies show that SY has several pharmacological activities, which include but are not limited to improving cardiovascular and cerebrovascular diseases, abirritation [ 9 ], regulating lipids [ 10 ], and treating cancer [ 11 ] and diabetic complications [ 12 ]. SY is approved by the Food and Drug Administration of China.…”