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Paeoniflorin (PF), a bioactive compound from\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Paeonia lactiflora<\/jats:italic>\n                    <\/jats:styled-content>\n                    , has shown hepatometabolic effects in experimental studies, but its overall efficacy in NAFLD models remains unclear. We searched PubMed, Embase, Web of Science, the Cochrane Library, CNKI, Wanfang, VIP, and CBM from inception to January 2026 for controlled animal studies evaluating PF in diet\u2010induced NAFLD models. Two reviewers independently performed study selection, data extraction, and risk\u2010of\u2010bias assessment using SYRCLE's tool. Weighted mean differences or standardized mean differences with 95% confidence intervals were pooled using random\u2010effects models. Ten studies were included, all using diet\u2010induced models. PF treatment was associated with improvements in lipid metabolism, liver injury, glucose homeostasis, inflammation, and oxidative stress, including reductions in total cholesterol, triglycerides, low\u2010density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, body weight, fasting blood glucose, insulin resistance indices, tumor necrosis factor\u2010\u03b1, and malondialdehyde, together with increased superoxide dismutase activity. High\u2010density lipoprotein cholesterol showed no consistent improvement. Mechanistic findings suggested that PF may activate AMP\u2010activated protein kinase, inhibit sterol regulatory element\u2010binding protein\u20101c\/fatty acid synthase\u2010mediated lipogenesis, and modulate inflammatory and oxidative\u2010stress pathways. However, substantial heterogeneity and incomplete reporting of randomization, allocation concealment, and blinding limited confidence in the evidence. PF showed promising preclinical effects in NAFLD, but further well\u2010designed animal studies and clinical investigations are needed to clarify dose\u2013response relationships, safety, and translational relevance.\n                  <\/jats:p>","DOI":"10.1002\/fsn3.72192","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T07:25:06Z","timestamp":1785741906000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Paeoniflorin and\n                    <scp>NAFLD<\/scp>\n                    : A Systematic Review and Meta\u2010Analysis of Animal Studies With Mechanistic Insights"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8889-5253","authenticated-orcid":false,"given":"Dachuan","family":"Jin","sequence":"first","affiliation":[{"name":"Translational Medicine Research Center, Department of Liver Disease and Pharmacology Zhengzhou Sixth People's Hospital  Zhengzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunqin","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine The First Medical Center, Chinese PLA General Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine &amp; Laboratory of Gerontology and Anti\u2010Aging Research Qilu Hospital of Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6152-2967","authenticated-orcid":false,"given":"Guoping","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Key Laboratory of Artificial Organs and Computational Medicine in Zhejiang Province Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingfei","family":"Yao","sequence":"additional","affiliation":[{"name":"State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases The First Affiliated Hospital, College of Medicine, Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Gao","sequence":"additional","affiliation":[{"name":"Translational Medicine Research Center, Department of Liver Disease and Pharmacology Zhengzhou Sixth People's Hospital  Zhengzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangming","family":"Li","sequence":"additional","affiliation":[{"name":"Translational Medicine Research Center, Department of Liver Disease and Pharmacology Zhengzhou Sixth People's Hospital  Zhengzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan","family":"Qin","sequence":"additional","affiliation":[{"name":"Translational Medicine Research Center, Department of Liver Disease and Pharmacology Zhengzhou Sixth People's Hospital  Zhengzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcmed.2024.103043"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/foods12234214"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.23876"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050312120933804"},{"key":"e_1_2_12_6_1","first-page":"14651858","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Chandler J.","year":"2019"},{"issue":"5","key":"e_1_2_12_7_1","first-page":"1376","article-title":"Study on the 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