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Efficacy and Safety of Berberine Alone or Combined with Statins for the Treatment of Hyperlipidemia: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials

Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China

Correspondence to: Dr. Jun-Hua Zhang, Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, No. 10 Poyang Lake Road, Jinghai District, Tianjin 301617, P. R. China. Tel: (+86) 22-5959-6152.

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Rui Feng

Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China

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Xin-Yao Jin

Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China

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Feng-Wen Yang

Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China

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Zhao-Chen Ji

Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China

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Meng-Yu Zhao

Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China

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Ming-Yan Zhang

Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China

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Bo-Li Zhang

Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China

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, and

Xue-Mei Li

Baokang Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China

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https://doi.org/10.1142/S0192415X19500393Cited by:36 (Source: Crossref)

Abstract

To systematically evaluate the efficacy and safety of berberine for the treatment of hyperlipidemia, six electronic literature databases including SinoMed, CNKI, WanFang Data, PubMed, Embase and The Cochrane Library were searched to collect clinical randomized controlled trials (RCTs) of berberine alone or combined with statins for the treatment of hyperlipidemia from the inception to 8 March 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included RCTs. Then, meta-analysis was performed by using RevMan 5.3 software. A total of 11 RCTs involving 1386 patients were finally included. The results of meta-analysis showed that compared with the placebo group, berberine could significantly reduce the total cholesterol and low-density lipoprotein levels and elevate the high density lipoprotein level ( $P < 0.05$ $P < 0.05$ ). Compared with the simvastatin group, berberine was effective only in reducing the level of triglyceride ( $MD = - 0.37$ $MD = - 0.37$ , 95% CI: $-$ $-$ 0.66, $-$ $-$ 0.07, $P = 0.02$ $P = 0.02$ ). There, however, was no statistical significance between the BBR group and simvastatin group in the low density lipoprotein and high density lipoprotein levels. Compared with the simvastatin group, berberine plus simvastatin was more effective in reducing the level of triglyceride ( $MD = - 0.33$ $MD = - 0.33$ , 95% CI: $-$ $-$ 0.46, $-$ $-$ 0.20, $P < 0.00001$ $P < 0.00001$ ) and total cholesterol ( $MD = - 0.36$ $MD = - 0.36$ , 95% CI: $-$ $-$ 0.60, $-$ $-$ 0.12, $P = 0.003$ $P = 0.003$ ). In terms of adverse reactions, the incidence of adverse reactions including transaminase elevation and muscle aches was lower in the berberine alone or combined with simvastatin group than that in the control group, while the instance of constipation was higher. This study suggests that berberine is effective for hyperlipidemia. The quality and quantity of included studies, however, were dissatisfactory, which might decrease the reliability of the results. Higher quality studies are needed to provide more high quality evidence.

Keywords:

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