PMID 34956436 The Effect of Berberine on Metabolic Profiles in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Systematic review and meta-analysis · Oxid Med Cell Longev, 2021 46 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s - berberineA yellow alkaloid found in the roots of plants like Coptis and barberry, studied as a metabolic agent that lowers glucose and lipids. (alone or added on) cut HbA1cGlycated hemoglobin, a blood marker reflecting average glucose over the past 2-3 months; used to gauge diabetes control. -0.73 pts, fasting glucose -0.86, post-meal -1.26, plus insulin resistanceA state in which cells respond poorly to insulin, so blood glucose does not fall as it should., triglycerideA type of fat in the blood; high levels raise cardiovascular risk.s, LDLLow-density lipoprotein cholesterol - the so-called "bad" cholesterol.; 'effective as adjunct' but China-database heavy.
Key summary
A meta-analysisA statistical synthesis combining results of multiple studies into one conclusion. of 46 randomized trials on berberineA yellow alkaloid found in the roots of plants like Coptis and barberry, studied as a metabolic agent that lowers glucose and lipids.'s metabolic effects in type 2 diabetes. Used alone or added to standard diabetes therapy, berberine significantly lowered HbA1cGlycated hemoglobin, a blood marker reflecting average glucose over the past 2-3 months; used to gauge diabetes control. by 0.73 percentage points, fasting glucose by 0.86 mmol/L, and 2-hour post-meal glucose by 1.26 mmol/L, and improved fasting insulin, HOMA-IR, and BMI. For lipids, triglycerideA type of fat in the blood; high levels raise cardiovascular risk.s, total cholesterol, and LDLLow-density lipoprotein cholesterol - the so-called "bad" cholesterol. fell and HDL rose slightly, with better inflammation markers. The authors concluded there is 'strong evidence supporting the clinical efficacy and safety of berberine,' especially as adjunctive therapy. But many included trials come from Chinese databases, so independence and quality warrant caution.
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OBJECTIVE: Rhizoma Coptidis is an herb that has been frequently used in many traditional formulas for the treatment of diabetic mellitus (DM) over thousands of years. Berberine, the main active component of Rhizoma Coptidis, has been demonstrated to have the potential effect of hypoglycemia. To determine the potential advantages of berberine for diabetic care, we conducted this systematic review and meta-analysis to examine the efficacy and safety of berberine in the treatment of patients with type 2 DM. METHODS: Eight databases including PubMed, Embase, Web of Science, the Cochrane library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (SinoMed), Wanfang Database, and Chinese VIP Information was searched for randomized controlled trials (RCTs) reporting clinical data regarding the use of berberine for the treatment of DM. Publication qualities were also considered to augment the credibility of the evidence. Glycemic metabolisms were the main factors studied, including glycosylated hemoglobin (HbA1c), fasting plasm glucose (FPG), and 2-hour postprandial blood glucose (2hPG). Insulin resistance was estimated by fasting blood insulin (FINS), homeostasis model assessment-insulin resistance (HOMA-IR), and body mass index (BMI). Lipid profiles were also assessed, including triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), along with inflammation factors such as C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). Serum creatinine (Scr), blood urea nitrogen (BUN), and adverse events were applied to evaluate the safety of berberine. RESULTS: Forty-six trials were assessed. Analysis of berberine applied alone or with standard diabetic therapies versus the control group revealed significant reductions in HbA1c (MD = -0.73; 95% CI (-0.97, -0.51)), FPG (MD = -0.86, 95% CI (-1.10, -0.62)), and 2hPG (MD = -1.26, 95% CI (-1.64, -0.89)). Improved insulin resistance was assessed by lowering FINS (MD = -2.05, 95% CI (-2.62, -1.48)), HOMA-IR (MD = -0.71, 95% CI (-1.03, -0.39)), and BMI (MD = -1.07, 95% CI (-1.76, -0.37)). Lipid metabolisms were also ameliorated via the reduction of TG (MD = -0.5, 95% CI (-0.61, -0.39)), TC (MD = 0.64, 95% CI (-0.78, -0.49)), and LDL (MD = 0.86, 95% CI (-1.06, -0.65)) and the upregulation of HDL (MD = 0.17, 95% CI (0.09, 0.25)). Additionally, berberine improved the inflammation factor. CONCLUSION: There is strong evidence supporting the clinical efficacy and safety of berberine in the treatment of DM, especially as an adjunctive therapy. In the future, this may be used to guide targeted clinical use of berberine and the development of medications seeking to treat patients with T2DM and dyslipidemia. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 23118793 Berberine in the treatment of type 2 diabetes mellitus: a systemic review and meta-analysis Systematic review and meta-analysis · Evid Based Complement Alternat Med, 2012 14 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s, 1,068 people - berberineA yellow alkaloid found in the roots of plants like Coptis and barberry, studied as a metabolic agent that lowers glucose and lipids. + lifestyle beat placeboAn inert dummy treatment used as the comparison baseline. on glucose/lipids but was not better than metformin alone; 'low quality, interpret carefully.'
Key summary
A meta-analysisA statistical synthesis combining results of multiple studies into one conclusion. of berberineA yellow alkaloid found in the roots of plants like Coptis and barberry, studied as a metabolic agent that lowers glucose and lipids.'s efficacy and safety in type 2 diabetes (14 randomized trials, 1,068 people). Methodological quality was generally low. Versus lifestyle modification (with or without placeboAn inert dummy treatment used as the comparison baseline.), adding berberine significantly lowered glucose and lipids, but compared with oral glucose-lowering drugs (metformin, glipizide, rosiglitazone) berberine alone did not achieve better glycemic control, only a mild lipid effect. Adding berberine on top of an oral drug gave better glycemic control. No serious adverse effects were reported. The authors concluded berberine appears efficacious for high glucose and dyslipidemiaBlood lipid levels (cholesterol, triglycerides) outside the normal range., but the evidence must be interpreted carefully due to low methodological quality, small samples, few trials, and unclear risk of bias.
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Objectives. To assess the efficacy and safety of berberine in the treatment of type 2 diabetes mellitus (T2DM). Methods. Randomized trials of berberine compared with lifestyle modification, placebo, and/or oral hypoglycaemics intervention on treating T2DM were included. Study population characteristics and outcome results were extracted independently by two reviewers. Meta-analyses were performed for data available. Results. Fourteen randomized trials, involving 1068 participants, were included in this study. Methodological quality was generally low. Compared with lifestyle modification with or without placebo, the cointervention of berberine and lifestyle modification showed significantly hypoglycaemic and antidyslipidemic response. Compared with oral hypoglycaemics including metformin, glipizide, or rosiglitazone, berberine did not demonstrate a significantly better glycaemic control but showed a mild antidyslipidemic effect. Compared with oral hypoglycaemic drugs, cointerventions with berberine and the same oral hypoglycaemics showed a better glycaemic control. No serious adverse effects from berberine were reported. Conclusions. Berberine appeared to be efficacious for treating hyperglycaemia and dyslipidemia in T2DM. However, the evidence of berberine for treating T2DM should be carefully interpreted due to the low methodological quality, small sample size, limited number of trials, and unidentified risks of bias. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 18442638 Efficacy of berberine in patients with type 2 diabetes mellitus Randomized pilot trial · Metabolism, 2008 Pilot RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects. (36+48 people) - berberineA yellow alkaloid found in the roots of plants like Coptis and barberry, studied as a metabolic agent that lowers glucose and lipids.'s glucose-lowering was similar to metformin (HbA1cGlycated hemoglobin, a blood marker reflecting average glucose over the past 2-3 months; used to gauge diabetes control. 9.5->7.5%), lipids fell too; but 34.5% had GI side effects.
Key summary
A pilot randomized trial of berberineA yellow alkaloid found in the roots of plants like Coptis and barberry, studied as a metabolic agent that lowers glucose and lipids.'s efficacy and safety in type 2 diabetes. In study A, 36 newly diagnosed patients were assigned to berberine or metformin (0.5 g three times daily) for 3 months, and berberine's glucose-lowering matched metformin (HbA1cGlycated hemoglobin, a blood marker reflecting average glucose over the past 2-3 months; used to gauge diabetes control. 9.5%->7.5%, with significant drops in fasting/post-meal glucose and triglycerideA type of fat in the blood; high levels raise cardiovascular risk.s). In study B, adding berberine in 48 poorly controlled patients lowered fasting and post-meal glucose from week 1, cut HbA1c from 8.1% to 7.3%, reduced fasting insulin and insulin-resistance index by 28.1% and 44.7%, and significantly lowered total cholesterol and LDLLow-density lipoprotein cholesterol - the so-called "bad" cholesterol.. However, 34.5% (20 patients) had transient gastrointestinal side effects, with no liver or kidney damage observed. The authors concluded berberine is a potent oral glucose-lowering agent with beneficial lipid effects.
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Berberine has been shown to regulate glucose and lipid metabolism in vitro and in vivo. This pilot study was to determine the efficacy and safety of berberine in the treatment of type 2 diabetes mellitus patients. In study A, 36 adults with newly diagnosed type 2 diabetes mellitus were randomly assigned to treatment with berberine or metformin (0.5 g 3 times a day) in a 3-month trial. The hypoglycemic effect of berberine was similar to that of metformin. Significant decreases in hemoglobin A1c (from 9.5%+/-0.5% to 7.5%+/-0.4%, P<.01), fasting blood glucose (from 10.6+/-0.9 mmol/L to 6.9+/-0.5 mmol/L, P<.01), postprandial blood glucose (from 19.8+/-1.7 to 11.1+/-0.9 mmol/L, P<.01), and plasma triglycerides (from 1.13+/-0.13 to 0.89+/-0.03 mmol/L, P<.05) were observed in the berberine group. In study B, 48 adults with poorly controlled type 2 diabetes mellitus were treated supplemented with berberine in a 3-month trial. Berberine acted by lowering fasting blood glucose and postprandial blood glucose from 1 week to the end of the trial. Hemoglobin A1c decreased from 8.1%+/-0.2% to 7.3%+/-0.3% (P<.001). Fasting plasma insulin and homeostasis model assessment of insulin resistance index were reduced by 28.1% and 44.7% (P<.001), respectively. Total cholesterol and low-density lipoprotein cholesterol were decreased significantly as well. During the trial, 20 (34.5%) patients experienced transient gastrointestinal adverse effects. Functional liver or kidney damages were not observed for all patients. In conclusion, this pilot study indicates that berberine is a potent oral hypoglycemic agent with beneficial effects on lipid metabolism. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 32690176 The effect of berberine supplementation on obesity parameters, inflammation and liver function enzymes: A systematic review and meta-analysis of randomized controlled trials Systematic review and meta-analysis · Clin Nutr ESPEN, 2020 12 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s - berberineA yellow alkaloid found in the roots of plants like Coptis and barberry, studied as a metabolic agent that lowers glucose and lipids. cut weight -2.07 kg, BMI -0.47, waist -1.08 cm, CRP, 'moderate but significant'; a different scale from GLP-1 injection weight loss.
Key summary
A meta-analysisA statistical synthesis combining results of multiple studies into one conclusion. of 12 randomized trials on berberineA yellow alkaloid found in the roots of plants like Coptis and barberry, studied as a metabolic agent that lowers glucose and lipids.'s effect on obesity markers, inflammation, and liver enzymes. Berberine significantly reduced body weight by 2.07 kg on average, BMI by 0.47 kg/m2, waist circumference by 1.08 cm, and C-reactive protein (CRP). It had no significant effect on liver enzymes (ALT, AST). The authors concluded berberine intake 'moderately but significantly' reduces weight, BMI, waist, and CRP. So the weight loss is real but about 2 kg over several months - a completely different scale from the dramatic loss implied by the 'natural Ozempic' nickname.
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INTRODUCTION: So far, no study has summarized the findings on the effects of berberine intake on anthropometric parameters, C-reactive protein (CRP) and liver enzymes. This systematic review and meta-analysis were done based upon randomized controlled trials (RCTs) to analyze the effects of berberine on anthropometric parameters, CRP and liver enzymes. METHOD: Following databases were searched for eligible studies published from inception to 30 July 2019: MEDLINE, EMBASE, Web of Science, Cochrane Library, PubMed and Google scholar. Necessary data were extracted. Data were pooled by the inverse variance method and expressed as mean difference with 95% Confidence Intervals (95% CI). RESULT: 12 studies were included. Berberine treatment moderately but significantly decreased body weight (WMD = -2.07 kg, 95% CI -3.09, -1.05, P < 0.001), body mass index (BMI) (WMD = -0.47 kg/m2, 95% CI -0.70, -0.23, P < 0.001), waist circumference (WC) (WMD = -1.08 cm, 95% CI -1.97, -0.19, P = 0.018) and C-reactive protein (CRP) concentrations (WMD = -0.42 mg/L, 95% CI -0.82, -0.03, P = 0.034). However, berberine intake did not affect liver enzymes, including alanine aminotransferase (ALT) (WMD = -1.66 I/U, 95% CI -3.98, 0.65, P = 0.160) and aspartate aminotransferase (AST) (WMD = -0.87 I/U, 95% CI -2.56, 0.82, P = 0.311). CONCLUSION: This meta-analysis found a significant reduction of body weight, BMI, WC and CRP levels associated with berberine intake which may have played an indirect role in improved clinical symptoms in diseases with metabolic disorders. Berberine administration had no significant effect on ALT and AST levels. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 39236662 Berberine as adjuvant therapy for treating reduced fertility potential in women with polycystic ovary syndrome: A meta-analysis of randomized controlled trials Meta-analysis · Explore (NY), 2024 10 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s, 713 women - adding berberineA yellow alkaloid found in the roots of plants like Coptis and barberry, studied as a metabolic agent that lowers glucose and lipids. to Western medicine raised ovulation RR 1.41, pregnancy RR 1.96, lowered testosterone; but adjuvant, China-heavy, 'more trials needed.'
Key summary
A meta-analysisA statistical synthesis combining results of multiple studies into one conclusion. of 10 randomized trials (713 women) using berberineA yellow alkaloid found in the roots of plants like Coptis and barberry, studied as a metabolic agent that lowers glucose and lipids. as adjuvant therapy for reduced fertility potential in PCOS. Adding berberine to Western medicine significantly increased endometrial thickness (weighted mean difference 1.62 mm), ovulation rate (risk ratio 1.41), and clinical pregnancy rate (risk ratio 1.96). It also lowered luteinizing hormone (-2.07 U/L) and total testosterone (standardized mean difference -0.70) but not follicle-stimulating hormone. The authors said berberine may serve as an adjuvant to enhance ovulation and pregnancy rates in PCOS, but that further clinical trials are needed to confirm the conclusions. A limitation is that most were combination trials from Chinese databases.
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OBJECTIVE: To evaluate the effect of berberine as adjuvant therapy for the treatment of reduced fertility potential in women with polycystic ovary syndrome (PCOS) through a meta-analysis. METHODS: We comprehensively searched CNKI, SinoMed, Wanfang, Cochrane Library, PubMed, Embase databases to identify randomized controlled trials (RCTs) evaluating the effect of berberine as adjuvant therapy for treating reduced fertility potential in women with PCOS. RESULTS: A total of 10 RCTs involving 713 patients were included. Berberine in combination with Western medicine significantly improved endometrial thickness (weight mean difference [WMD] 1.62 mm; 95 % confidence interval [CI] 1.39-1.85), ovulation rate (risk ratio [RR] 1.41; 95 % CI 1.26-1.60), and clinical pregnancy rate (RR 1.96; 95 % CI 1.59-2.41) compared to Western medicine alone. Moreover, berberine as adjuvant therapy also significantly reduced the blood levels of luteinizing hormone (WMD -2.07 U/L; 95 % CI -2.62 to -1.51) and total testosterone (standard mean difference -0.70; 95 % CI -1.02 to -0.39) but not the level of follicle-stimulating hormone level (WMD -0.23 IU/L; 95 % CI -0.52 to 0.06). CONCLUSIONS: Berberine may serve as an adjuvant therapy to enhance ovulation and increase clinical pregnancy rates in women with PCOS. The potential advantages of berberine may be linked to improvements in endometrial thickness, total testosterone, and luteinizing hormone level. However, further clinical trials are needed to confirm these findings and establish definitive conclusions. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 19370549 Effect of berberine on the pharmacokinetics of substrates of CYP3A and P-gp Animal pharmacokinetic study (rats) · Phytother Res, 2009 Rat study - berberineA yellow alkaloid found in the roots of plants like Coptis and barberry, studied as a metabolic agent that lowers glucose and lipids. blocked intestinal P-glycoproteinA transport protein (P-gp) that pumps drugs out of cells in the gut and liver; blocking it raises the blood level of that drug., raising digoxin exposure (AUC) up to 170% and cyclosporine significantly (interaction signal). No CYP3A change.
Key summary
A rat study of how berberineA yellow alkaloid found in the roots of plants like Coptis and barberry, studied as a metabolic agent that lowers glucose and lipids. affects the pharmacokinetics of CYP3A and P-glycoproteinA transport protein (P-gp) that pumps drugs out of cells in the gut and liver; blocking it raises the blood level of that drug. (P-gp) substrate drugs. After 2 weeks of berberine pretreatment, oral digoxin (a P-gp substrate) blood exposure (AUC) rose dose-dependently to up to about 170% of control, and cyclosporine A (a dual CYP3A/P-gp substrate) also had significantly higher AUC and peak concentration (e.g., +96% AUC at 100 mg/kg). By contrast, CYP3A activity (carbamazepine) was not clearly changed. The authors concluded berberine dose-dependently increases the bioavailabilityThe fraction of an ingested substance that actually reaches the blood and tissues to act. of digoxin and cyclosporine by blocking intestinal P-gp. Though animal data, it signals a possible clinical interaction when combined with drugs of narrow safety margin.
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The in vivo effects of berberine (BBR), the widely used bioactive herbal ingredient from many traditional Chinese medicinal herbs, on the pharmacokinetics of carbamazepine (CBZ, a substrate of CYP3A) and its metabolite carbamazepine 10,11-epoxide (ECBZ), digoxin (DIG, a substrate of P-gp) and cyclosporine A (CsA, a dual substrate of CYP3A and P-gp) were evaluated in rats. After a 2-week pretreatment with BBR, the pharmacokinetic parameters of i.g. administered CBZ and ECBZ were not significantly altered. The pharmacokinetics of i.v. administered DIG was not modified by single and 2-week pretreatments with BBR, but a dose-dependent increase in AUC and C(max) was observed in the i.g. administered DIG parameters in rats. The AUCs of DIG with BBR (30 mg/kg, 100 mg/kg) were 133%, 170% (single) and 123%, 169% (2-week) of control, respectively. The AUC and C(max) of i.g. administered CsA with a 2-week pretreatment with BBR increased by 62% and 43% (BBR 30 mg/kg, p < 0.05), 96% and 60% (BBR 100 mg/kg, p < 0.01), compared with the control. In conclusion, berberine produced a dose-dependent increased bioavailability of digoxin and cyclosporine A by inhibition of intestinal P-gp. No significant changes in CYP3A activity by berberine were observed. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
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