Journal of Korean Medicine for Obesity Research (한방비만학회지)

The Society of Korean Medicine for obesity Research (한방비만학회)
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Clinical Efficacy of Coptidis Rhizoma for Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

비알콜성 지방간 환자에 대한 베르베린 투여 치료의 임상적 효능 연구: 체계적 문헌 고찰과 메타분석

  • SongWon, Park (Department of Oriental Internal Medicine, Graduate School, Dongguk University) ;
  • MinJee, Kim (Department of Rehabilitation Medicine of Korean Medicine, Graduate School, Dongguk University) ;
  • Seong-Woo, Lim (Department of Oriental Internal Medicine, Graduate School, Dongguk University)
  • 박송원 (동국대학교 일반대학원 한의학과 한방내과학) ;
  • 김민지 (동국대학교 일반대학원 한의학과 한방재활의학) ;
  • 임성우 (동국대학교 일반대학원 한의학과 한방내과학)
  • Received : 2022.10.25
  • Accepted : 2022.11.30
  • Published : 2022.12.30
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Abstract

Objectives: The purpose of this meta-analysis was to evaluate the effects of berberine on non-alcoholic fatty liver disease (NAFLD) through a systematic review and meta-analysis. Methods: We searched seven electronic databases for studies through October 2022. All randomized controlled trials (RTCs) of berberine were included. Data extraction and risk of bias assessments were performed by two independent reviewers. The RevMan 5.4.1 program was used for meta-analysis. Results: A total of 279 relevant studies were identified, and 6 eligible RCTs were included to study the efficacy berberine on NAFLD. The six selected trials are studies on the effect between berberine and conventional treatment combined treatment versus conventional treatment. Liver function tests, blood lipid levels, and blood glucose levels were assessed. Combination treatment with berberine, ursodeoxycholate acid, metformin, and monascus purpureus showed statistically significant improvements in liver function levels, blood lipid levels, and blood glucose levels compared to conventional treatment alone. However, there was no significant efficacy of berberine combination dietary, exercise than control group on NAFLD. The meta-analysis results of examining 4 RCTs comparing the therapeutic efficacy of berberine showed statistically significant improvement in the liver function test, blood lipids levels, blood glucose levels. Conclusions: This study suggests that berberine has positive efficacy on blood lipids, blood glucose liver function, fatty liver condition of NAFLD. However, the level of evidence is low because of small effect size,so further investigation is needed.

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References

  1. Yan HM, Xia MF, Wang Y, Chang XX, Yao XZ, Rao SX, et al. Efficacy of berberine in patients with non-alcoholic fatty liver disease. PloS One. 2015 ; 10(8) : e0134172.
  2. Kim KM. Update of pharmacological therapy in non-alcoholic fatty liver disease. Korean Association for the Study of the Liver. 2018 ; (1) : 320-4.
  3. Cho YK. Screening, diagnosis and assessment of nonalcoholic fatty liver disease. Single Topic Symposium (STS). 2018 ; (2) : 25-30.
  4. Lee YR, Cho NK, Choi HS, Kim SM, Kim KS. A systematic review of Korean medicine for non-alcoholic fatty liver disease. The Journal of Internal Korean Medicine. 2019 ; 40(1) : 13-37.
  5. Ahn SH, Kim KB. The effect of coptidis rhizoma and glycyrrhiza uralensis on lipid deposition with nonalcoholic fatty liver disease (NAFLD). J Pediatric Korean Med. 2019 ; 33(2) : 12-21.
  6. Zhu X, Bian H, Gao X. The potential mechanisms of berberine in the treatment of nonalcoholic fatty liver disease. Molecules. 2016 ; 21(10) : 1336.
  7. Qin S, Tang H, Li W, Gong Y, Li S, Huang J, et al. AMPK and its activator berberine in the treatment of neurodegenerative diseases. Curr Pharm Des. 2020 ; 26 : 5054-66. https://doi.org/10.2174/1381612826666200523172334
  8. Liu R, Wu K, Li Y, Sun R, Li X. Human antigen R: a potential therapeutic target for liver diseases. Pharmacol Res. 2020 ; 155 : 104684.
  9. Li S, Xu Y, Guo W, Chen F, Zhang C, Tan HY, et al. The impacts of herbal medicines and natural products on regulating the hepatic lipid metabolism. Front Pharmacol. 2020 ; 11 : 351.
  10. Cao YF, Cai WW, Zhang LL, Fang Y. Clinical observation on the Berberine plus metformin in treatment of type 2 diabetes complicated by nonalcoholic fatty liver disease. Modern Preventive Medicine. 2012 ; 39(18) : 4885-7.
  11. Cicero A, Derosa G, Maffioli P, Reggi A, Parini A, Rosticci M, et al. Berberine induced improvement in hepatic steatosis index in overweight dyslipidaemic patients treated with lipid-lowering nutraceuticals. Current Topics in Nutraceutical Research. 2013 ; 11(1-2) : 41-6.
  12. Harrison SA, Gunn N, Neff GW, Kohli A, Liu L, Flyer A, et al. A phase 2, proof of concept, randomised controlled trial of berberine ursodeoxycholate in patients with presumed non-alcoholic steatohepatitis and type 2 diabetes. Nat Commun. 2021 ; 12(1) : 5503.
  13. Nejati L, Movahedi A, Salari G, Moeineddin R, Nejati P. The effect of berberine on lipid profile, liver enzymes, and fasting blood glucose in patients with nonalcoholic fatty liver disease (NAFLD): a randomized controlled trial. Med J Islam Repub Iran. 2022 ; 36 : 39.
  14. Song H, Zhang HT, Hwan S, Wang JH. Efficacy of berberine combined with metformin in the treatment of type 2 diabetes mellitus complicated with non-alcoholic fatty liver. Chin J Mod Drug. 2013 ; 7(23) : 155-6. (宁洁, 张海涛, 刘顶鼎, 王晓茜. 黄连素联合二甲双胍治疗2型糖尿病合并非酒精性脂肪肝的疗效探讨. Chin J Mod Drug. 2013 ; 7(23) : 155-6.)
  15. Cui JF. Efficacy and safety of berberine combined with metformin in treating non-alcoholic fatty liver with type II diabetes mellitus. Inner Mongolia Traditional Chinese Medicine. 2016 ;35(5) : 67-8. (崔俊峰. 黄连素与二甲双胍联合治疗对非酒精性脂肪肝伴II型糖尿病疗效及安全性的探讨. 内蒙古中医药. 2016 ; 35(5) : 67-8.)
  16. Jung SM, Kwon SE, Kang SY, Kim SJ, Jung HW, Park YK. Anti-obesity and anti-diabetic effects of a polyherbal extract consisting of Coptidis Rhizoma, Salviae Miltiorrhizae Radix, and Cinnamomi Cortex in high fat diet-induced obesity mice. Journal of Korean Medicine for Obesity Research. 2021 ; 21(2) : 59-68. https://doi.org/10.15429/jkomor.2021.21.2.59
  17. Cha JY, Ahn HY, Eom KE, Park BK, Jun BS, Park JC, et al. Effects of Monascus-fermented korean red ginseng powder on the contents of serum lipid and tissue lipid peroxidation in alcohol feeding rats. Journal of Life Science. 2009 ; 19(7) : 983-93.