The effects of berberine on inflammatory markers in Chinese patients with metabolic syndrome and related disorders: a meta‑analysis of randomized controlled trials

Abstract

Background A meta-analysis of randomized controlled trials (RCTs) was conducted to systematically evaluate the effects of berberine on the inflammatory markers of metabolic syndrome (MetS) and related disorders. Method Databases that were searched from inception to October 2020 included PubMed, Web of Science, the Cochrane Library, CNKI, VIP, WanFang Data, and ClinicalTrials.gov. Two reviewers independently selected articles and extracted data. The pooled evaluations were entered and analyzed in Review Manager 5.3. Results Of the 7387 publications screened, 52 studies were included, and the related trials involved 4616 patients. Pooled estimates showed that the use of berberine could significantly reduce the concentration level of C-reactive protein (CRP) [standardized mean difference (SMD) = − 1.54, 95% confidence intervals (CI) − 1.86, − 1.22, p < 0.05], tumor necrosis factor-α (TNF-α) [SMD = − 1.02, 95% CI − 1.27, − 0.77, p < 0.05], and interleukin 6 (IL-6) [SMD = − 1.17, 95% CI − 1.53, − 0.81, p < 0.05] among patients with MetS and related disorders. However, it did not affect the level of interleukin 1β (IL-1β) [SMD = − 0.81, 95% CI − 1.80, 0.17, p = 0.11]. Conclusion Overall, the use of berberine in patients with MetS and related disorders appeared to significantly decrease several inflammatory markers. Further multi-center and rigorous investigations with larger patient populations are encouraged to confirm the effect of berberine on MetS and related disorders.

The effects of berberine supplementation on cardiovascular risk factors in adults: A systematic review and dose-response meta-analysis

“…In addition, subgroup analysis showed that the significant results can be seen only in the subgroups with unhealthy metabolic status. This evidence can also be justified by the antiinflammatory properties of BBR (18,93,96). Moreover, risk of bias subgroup analysis has shown even in high risk of bias trials decreasing effect remained for all glycemic markers and even in most of them in moderate risk apart from HbA1c.…”

“…BBR was effective in reducing FBG only in the subgroup of FBG ≥100 which can be because of the induction of higher insulin secretion in hyperglycemia by BBR, as explained by a previous study (86). Another reason can be the anti-inflammatory properties of BBR (18,93,96) that result in FBG reduction only when it exceeds its normal range. Hyperglycemia induces oxidative stress (97) and BBR can act against the consequential inflammation.…”

“…All these conditions are linked to the secretion of inflammatory mediators and may benefit from antiinflammatory substances (102-104). As an anti-inflammatory agent, BBR is thought to inhibit the PI3K/AKT signaling pathway (93), suppress nuclear factor kappa B (NF-kB) signaling pathway (93, 96), and lower CRP, IL-6, and tumor necrosis factor-alpha (TNF-α) levels (18). Risk of bias subgroup analysis has shown that even in high and moderate risk of bias trials, the decreasing effect remained for all lipid profiles apart from HDL in moderate risk of bias.…”

“…Guo et al have done another meta-analysis of 46 studies in 2021 and have found an effective reduction in IL-6, TNF-α, and CRP following BBR intake (15). A metaanalysis of 52 RCTs by Lu et al (18) reported a significant BBRinduced reduction in these two inflammatory markers (CRP and IL-6). However, the participants of this study were only Chinese people, and the result should not be generalized (18).…”

“…BBR supplementation ameliorated MetS components (dyslipidemia, insulin resistance, hypertension, obesity) in previous meta-analyses (12)(13)(14)(15)(16). In addition, the effect of BBR supplementation on other CVD risk factors such as inflammatory markers and liver enzymes has been assessed by other meta-analyses (13,17,18). These metaanalyses have either assessed a single MetS component (12,17), showed null/inconclusive results at the end (13,14,19), or included a few studies in their meta-analysis (12,14).…”