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Berberine exhibits potential for treating NAFLD, but clinical evidence remains inconclusive. This meta-analysis was conducted to assess the efficacy and safety of berberine for treating NAFLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was registered with PROSPERO (No. CRD42023462338). Identification of randomized controlled trials (RCTs) involved searching 6 databases covering the period from their initiation to 9 September 2023. The primary outcomes comprised liver function markers such as glutamyl transpeptidase (GGT), alanine transaminase (ALT), aspartate transaminase (AST), lipid indices including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), homeostasis model assessment for insulin resistance (HOMA-IR) and body mass index (BMI). Review Manager 5.4 and STATA 17.0 were applied for analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 10 RCTs involving 811 patients, berberine demonstrated significant reductions in various parameters: ALT (standardized mean difference (SMD)\u2009=\u2009\u2212\u20090.72), 95% confidence interval (Cl) [\u2212\u20091.01, \u2212\u20090.44],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.00001), AST (SMD\u2009=\u2009\u2212\u20090.79, 95% CI [\u2212\u20091.17, \u2212\u20090.40],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001), GGT (SMD\u2009=\u2009\u2212\u20090.62, 95% CI [\u2212\u20090.95, \u2212\u20090.29],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0002), TG (SMD\u2009=\u2009\u2212\u20090.59, 95% CI [\u2212\u20090.86, \u2212\u20090.31], P\u2009&lt;\u20090.0001), TC(SMD\u2009=\u2009\u2212\u20090.74, 95% CI [\u2212\u20091.00, \u2212\u20090.49],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.00001), LDL-C (SMD\u2009=\u2009\u2212\u20090.53, 95% CI [\u2212\u20090.88, \u2212\u20090.18],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003), HDL-C (SMD\u2009=\u2009\u2212\u20090.51, 95% CI [\u2212\u20090.12, 1.15],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.11), HOMA-IR (SMD\u2009=\u2009\u2212\u20091.56, 95% CI [\u2212\u20092.54, \u2212\u20090.58],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002), and BMI (SMD\u2009=\u2009\u2212\u20090.58, 95% CI [\u2212\u20090.77, \u2212\u20090.38],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.00001). Importantly, Berberine exhibited a favorable safety profile, with only mild gastrointestinal adverse events reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This meta-analysis demonstrates berberine's efficacy in improving liver enzymes, lipid profile, and insulin sensitivity in NAFLD patients. These results indicate that berberine shows promise as an adjunct therapy for NAFLD.<\/jats:p>\n                    <jats:p>\n                      <jats:italic>Trial registration<\/jats:italic>\n                      The protocol was registered with PROSPERO (No. CRD42023462338). Registered on September 27, 2023\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s12967-024-05011-2","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T14:03:06Z","timestamp":1709301786000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["The clinical efficacy and safety of berberine in the treatment of non-alcoholic fatty liver disease: a meta-analysis and systematic review"],"prefix":"10.1186","volume":"22","author":[{"given":"Qilong","family":"Nie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caiyang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongwei","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuyan","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojun","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tengyu","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8272-9246","authenticated-orcid":false,"given":"Jianhong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,1]]},"reference":[{"issue":"1","key":"5011_CR1","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1002\/hep.29367","volume":"67","author":"N Chalasani","year":"2018","unstructured":"Chalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, Harrison SA, Brunt EM, Sanyal AJ. 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