{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:41:02Z","timestamp":1760060462932,"version":"build-2065373602"},"reference-count":71,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Tungs\u2019 Taichung MetroHarbor Hospital","award":["TTMHH-R1140043"],"award-info":[{"award-number":["TTMHH-R1140043"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Metabolic syndrome refers to a group of conditions that commonly occur together, including abdominal obesity, high blood pressure, elevated blood sugar, high triglyceride levels, and low high-density lipoprotein cholesterol (HDL). These factors collectively increase the risk of cardiovascular disease, diabetes, and cognitive impairment. Recent research has identified a connection between metabolic syndrome and cognitive disorders such as mild cognitive impairment and vascular dementia (VaD). Mulberry (Morus alba L.) is a natural source of bioactive compounds with antioxidant, anti-inflammatory, and lipid-regulating properties. This meta-analysis assessed the potential of mulberry extract as an adjunctive treatment for metabolic risk factors linked to vascular dementia. We systematically reviewed randomized controlled trials (RCTs) published up to May 2025 that compared mulberry extract to placebo or standard care in adults with metabolic disorders. Fifteen trials including 1202 participants met the inclusion criteria. The primary outcomes were fasting glucose, fasting insulin, liver enzyme levels, lipid profiles, and inflammatory markers such as tumor necrosis factor-alpha (TNF-\u03b1), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP). The pooled results indicated that mulberry supplementation improved blood sugar control and lowered total cholesterol, low-density lipoprotein cholesterol (LDL), triglycerides, fasting blood glucose, glycosylated hemoglobin (HbA1c), homeostasis model assessment for insulin resistance (HOMA-IR), and inflammatory markers. Aspartate aminotransferase (AST) improved, whereas alanine aminotransferase (ALT) showed no significant change. Subgroup analyses revealed that greater benefits were associated with shorter treatment durations and doses below 500 milligrams per day. Furthermore, extracts from different parts of the mulberry plant showed varying effects on lipid and glucose metabolism. None of the included trials directly measured cognitive or neurovascular outcomes, so any potential neurovascular protection is inferred from changes in metabolic and inflammatory markers rather than demonstrated. In summary, these findings suggest that mulberry extract may be a promising complementary approach for managing metabolic risk factors in people at risk for VaD. However, further large-scale and rigorously designed studies are required to confirm its clinical benefits and to identify the most effective preparations.<\/jats:p>","DOI":"10.3390\/ijms26178380","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T08:01:01Z","timestamp":1756454461000},"page":"8380","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrative Evidence on Mulberry Extract for Modulating Metabolic Risk Factors Associated with Vascular Dementia"],"prefix":"10.3390","volume":"26","author":[{"given":"Jui-Ting","family":"Yu","sequence":"first","affiliation":[{"name":"Division of Hematology\/Medical Oncology, Department of Medicine, Tung\u2019s Taichung MetroHarbor Hospital, Taichung 43503, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen-Pi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nursing, Tung\u2019s Taichung MetroHarbor Hospital, Taichung 43503, Taiwan"},{"name":"Department of Nursing, National Taichung University of Science and Technology, Taichung 40343, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Hsiao","sequence":"additional","affiliation":[{"name":"School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8079-0090","authenticated-orcid":false,"given":"Kuan-Po","family":"Cheng","sequence":"additional","affiliation":[{"name":"School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9556-8907","authenticated-orcid":false,"given":"Ru-Yin","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan"},{"name":"Department of Medical Education, Chung Shan Medical University Hospital, Taichung 40201, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.jagp.2019.01.214","article-title":"Metabolic Syndrome, Mild Cognitive Impairment, and Dementia: A Meta-Analysis of Longitudinal Studies","volume":"27","author":"Atti","year":"2019","journal-title":"Am. J. Geriatr. Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity","volume":"120","author":"Alberti","year":"2009","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1212\/WNL.0b013e318217e7a4","article-title":"Vascular risk factors promote conversion from mild cognitive impairment to Alzheimer disease","volume":"76","author":"Li","year":"2011","journal-title":"Neurology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1698","DOI":"10.1016\/S0140-6736(15)00463-8","article-title":"Vascular dementia","volume":"386","author":"Thomas","year":"2015","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1159\/000536643","article-title":"Potentially Modifiable Risk Factors for Dementia and Mild Cognitive Impairment: An Umbrella Review and Meta-Analysis","volume":"53","author":"Jones","year":"2024","journal-title":"Dement. Geriatr. Cogn. Disord."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Rodrigues, E.L., Marcelino, G., Silva, G.T., Figueiredo, P.S., Garcez, W.S., Corsino, J., Guimar\u00e3es, R.D.C.A., and Freitas, K.D.C. (2019). Nutraceutical and Medicinal Potential of the Morus Species in Metabolic Dysfunctions. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20020301"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Chen, C., Razali, U.H.M., Saikim, F.H., Mahyudin, A., and Noor, N.Q.I.M. (2021). Morus alba L. Plant: Bioactive Compounds and Potential as a Functional Food Ingredient. Foods, 10.","DOI":"10.3390\/foods10030689"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Yu, J.S., Lim, S.H., Lee, S.R., Choi, C.I., and Kim, K.H. (2021). Antioxidant and Anti-Inflammatory Effects of White Mulberry (Morus alba L.) Fruits on Lipopolysaccharide-Stimulated RAW 264.7 Macrophages. Molecules, 26.","DOI":"10.3390\/molecules26040920"},{"key":"ref_9","first-page":"791","article-title":"Control of hyperglycemia and retardation of cataract by mulberry (Morus indica L.) leaves in streptozotocin diabetic rats","volume":"40","author":"Andallu","year":"2002","journal-title":"Indian. J. Exp. Biol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Parklak, W., Chottidao, M., Munkong, N., Komindr, S., Monkhai, S., Wanikorn, B., Makaje, N., Kulprachakarn, K., Chuljerm, H., and Somnuk, S. (2024). Nutraceutical Properties of Thai Mulberry (Morus alba L.) and Their Effects on Metabolic and Cardiovascular Risk Factors in Individuals with Obesity: A Randomized, Single-Blind Crossover Trial. Nutrients, 16.","DOI":"10.3390\/nu16244336"},{"key":"ref_11","first-page":"6123759","article-title":"Effect of Single Administration of Mulberry Milk on the Cognitive Function of 6-12-Year-Old Children: Results from a Randomized, Placebo-Controlled, Crossover Study","volume":"2020","author":"Wattanathorn","year":"2020","journal-title":"Oxid. Med. Cell Longev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/1745-6215-12-38","article-title":"The efficacy and safety study of dietary supplement PURIAM110 on non-insulin taking Korean adults in the stage of pre-diabetes and diabetes mellitus: Protocol for a randomized, double-blind, placebo-controlled, and multicenter trial-pilot study","volume":"12","author":"Park","year":"2011","journal-title":"Trials"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Kuwahara, M., Kim, H.K., Ozaki, M., Nanba, T., Chijiki, H., Fukazawa, M., Okubo, J., Mineshita, Y., Takahashi, M., and Shibata, S. (2020). Consumption of Biscuits with a Beverage of Mulberry or Barley Leaves in the Afternoon Prevents Dinner-Induced High, but Not Low, Increases in Blood Glucose among Young Adults. Nutrients, 12.","DOI":"10.3390\/nu12061580"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"5520059","DOI":"10.1155\/2021\/5520059","article-title":"The Positive Modulation Effect of a 6-Week Consumption of an Anthocyanin-Rich Mulberry Milk on Working Memory, Cholinergic, and Monoaminergic Functions in Healthy Working-Age Adults","volume":"2021","author":"Wattanathorn","year":"2021","journal-title":"Oxid. Med. Cell Longev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e11996","DOI":"10.1097\/MD.0000000000011996","article-title":"Mulberry leaf extract reduces the glycemic indexes of four common dietary carbohydrates","volume":"97","author":"Wang","year":"2018","journal-title":"Medicine"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1089\/acm.2016.0425","article-title":"Effectiveness of Black Mulberry Molasses in Prevention of Radiotherapy-Induced Oral Mucositis: A Randomized Controlled Study in Head and Neck Cancer Patients","volume":"23","author":"Can","year":"2017","journal-title":"J. Altern. Complement. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"4893104","DOI":"10.1155\/2017\/4893104","article-title":"The Effects of Morus alba and Acacia catechu on Quality of Life and Overall Function in Adults with Osteoarthritis of the Knee","volume":"2017","author":"Kalman","year":"2017","journal-title":"J. Nutr. Metab."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1002\/ijgo.13057","article-title":"Randomized double-blind placebo-controlled trial of the effect of Morus nigra L. (black mulberry) leaf powder on symptoms and quality of life among climacteric women","volume":"148","author":"Costa","year":"2020","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.sjbs.2014.04.005","article-title":"Reduction of post-prandial hyperglycemia by mulberry tea in type-2 diabetes patients","volume":"22","author":"Banu","year":"2015","journal-title":"Saudi J. Biol. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1002\/ptr.6611","article-title":"Ilex paraguariensis, white mulberry and chromium picolinate in patients with pre-diabetes","volume":"34","author":"Derosa","year":"2020","journal-title":"Phytother. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"365742","DOI":"10.1155\/2014\/365742","article-title":"Evaluation of a crataegus-based multiherb formula for dyslipidemia: A randomized, double-blind, placebo-controlled clinical trial","volume":"2014","author":"Hu","year":"2014","journal-title":"Evid.-Based Complement. Altern. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"735191","DOI":"10.1155\/2012\/735191","article-title":"A six-month supplementation of mulberry, korean red ginseng, and banaba decreases biomarkers of systemic low-grade inflammation in subjects with impaired glucose tolerance and type 2 diabetes","volume":"2012","author":"Kim","year":"2012","journal-title":"Evid.-Based Complement. Altern. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s40292-015-0087-2","article-title":"Effects of a new combination of nutraceuticals with Morus alba on lipid profile, insulin sensitivity and endotelial function in dyslipidemic subjects. A cross-over, randomized, double-blind trial","volume":"22","author":"Trimarco","year":"2015","journal-title":"High Blood Press. Cardiovasc. Prev."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Aramwit, P., Supasyndh, O., Siritienthong, T., and Bang, N. (2013). Mulberry leaf reduces oxidation and C-reactive protein level in patients with mild dyslipidemia. BioMed Res. Int., 2013.","DOI":"10.1155\/2013\/787981"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1002\/ptr.3270","article-title":"Efficacy of mulberry leaf tablets in patients with mild dyslipidemia","volume":"25","author":"Aramwit","year":"2011","journal-title":"Phytother. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"7","DOI":"10.6000\/1927-5951.2016.06.01.2","article-title":"The effect of mulberry fruits consumption on lipid profiles in hypercholesterolemic subjects: A randomized controlled trial","volume":"6","author":"Sirikanchanarod","year":"2016","journal-title":"J. Pharm. Nutr. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1272112","DOI":"10.3389\/fendo.2023.1272112","article-title":"Effects of mulberry twig alkaloids (Sangzhi alkaloids) and metformin on blood glucose fluctuations in combination with premixed insulin-treated patients with type 2 diabetes","volume":"14","author":"Meng","year":"2023","journal-title":"Front Endocrinol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/S0009-8981(01)00632-5","article-title":"Effect of mulberry (Morus indica L.) therapy on plasma and erythrocyte membrane lipids in patients with type 2 diabetes","volume":"314","author":"Andallu","year":"2001","journal-title":"Clin. Chim. Acta"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"5869","DOI":"10.1021\/jf062680g","article-title":"Food-grade mulberry powder enriched with 1-deoxynojirimycin suppresses the elevation of postprandial blood glucose in humans","volume":"55","author":"Kimura","year":"2007","journal-title":"J. Agric. Food Chem."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1111\/j.2040-1124.2011.00101.x","article-title":"Effect of mulberry leaf extract with enriched 1-deoxynojirimycin content on postprandial glycemic control in subjects with impaired glucose metabolism","volume":"2","author":"Asai","year":"2011","journal-title":"J. Diabetes Investig."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"7121356","DOI":"10.1155\/2016\/7121356","article-title":"Randomized, double-blinded, double-dummy, active-controlled, and multiple-dose clinical study comparing the efficacy and safety of mulberry twig (Ramulus Mori, Sangzhi) alkaloid tablet and acarbose in individuals with type 2 diabetes mellitus","volume":"2016","author":"Li","year":"2016","journal-title":"Evid.-Based Complement. Altern. Med."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Ma, Y., Lv, W., Gu, Y., and Yu, S. (2019). 1-deoxynojirimycin in mulberry (Morus indica L.) leaves ameliorates stable angina pectoris in patients with coronary heart disease by improving antioxidant and anti-inflammatory capacities. Front. Pharmacol., 10.","DOI":"10.3389\/fphar.2019.00569"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.2337\/dc20-2109","article-title":"Efficacy and Safety of Mulberry Twig Alkaloids Tablet for the Treatment of Type 2 Diabetes: A Multicenter, Randomized, Double-Blind, Double-Dummy, and Parallel Controlled Clinical Trial","volume":"44","author":"Qu","year":"2021","journal-title":"Diabetes Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.ctim.2017.04.006","article-title":"Impact of mulberry leaf extract on type 2 diabetes (Mul-DM): A randomized, placebo-controlled pilot study","volume":"32","author":"Riche","year":"2017","journal-title":"Complement. Ther. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"102292","DOI":"10.1016\/j.ctim.2019.102292","article-title":"A randomized controlled study of dose-finding, efficacy, and safety of mulberry leaves on glycemic profiles in obese persons with borderline diabetes","volume":"49","author":"Thaipitakwong","year":"2020","journal-title":"Complement. Ther. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.clnesp.2022.03.027","article-title":"Morus alba leaf extract affects metabolic profiles, biomarkers inflammation and oxidative stress in patients with type 2 diabetes mellitus: A double-blind clinical trial","volume":"49","author":"Taghizadeh","year":"2022","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Wang, Y., Yu, Z., Jiang, J., Li, Y., and Yu, S. (2021). Mulberry leaf attenuates atherosclerotic lesions in patients with coronary heart disease possibly via 1-Deoxynojirimycin: A placebo-controlled, double-blind clinical trial. J. Food Biochem., 45.","DOI":"10.1111\/jfbc.13573"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1093\/bbb\/zbac011","article-title":"Safety evaluation of a beverage containing mulberry leaf extract","volume":"86","author":"Yasumoto","year":"2022","journal-title":"Biosci. Biotechnol. Biochem."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1089\/jmf.2014.3160","article-title":"Mulberry leaf extract improves postprandial glucose response in prediabetic subjects: A randomized, double-blind placebo-controlled trial","volume":"18","author":"Kim","year":"2015","journal-title":"J. Med. Food"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1982","DOI":"10.1111\/jcpt.13822","article-title":"Impact of mulberry consumption on cardiometabolic risk factors: A systematic review and meta-analysis of randomized-controlled trials","volume":"47","author":"Chen","year":"2022","journal-title":"J. Clin. Pharm. Ther."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Zhao, Y., Wang, H., Tang, G., Wang, L., Tian, X., and Li, R. (2025). Risk factors for mild cognitive impairment in type 2 diabetes: A systematic review and meta-analysis. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1617248"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"100944","DOI":"10.1016\/j.arr.2019.100944","article-title":"Diabetes mellitus and risks of cognitive impairment and dementia: A systematic review and meta-analysis of 144 prospective studies","volume":"55","author":"Xue","year":"2019","journal-title":"Ageing Res. Rev."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Guo, D., Yuan, Y., Huang, R., Tian, S., Wang, J., Lin, H., An, K., Han, J., and Wang, S. (2019). Association between plasma adipsin level and mild cognitive impairment in Chinese patients with type 2 diabetes: A cross-sectional study. BMC Endocr. Disord., 19.","DOI":"10.1186\/s12902-019-0431-y"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1879","DOI":"10.1016\/j.clnu.2020.10.015","article-title":"Impact of specialized oral nutritional supplement on clinical, nutritional, and functional outcomes: A randomized, placebo-controlled trial in community-dwelling older adults at risk of malnutrition","volume":"40","author":"Chew","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Li, C.P., Huang, S.C., Hsiao, Y., and Tsai, R.Y. (2024). Evaluating the Role of Vitamin D in Alleviating Chronic Pruritus: A Meta-Analysis. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25189983"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Blumberg, J.B., Frei, B.B., Fulgoni, V.L., Weaver, C.M., and Zeisel, S.H. (2017). Impact of Frequency of Multi-Vitamin\/Multi-Mineral Supplement Intake on Nutritional Adequacy and Nutrient Deficiencies in U.S. Adults. Nutrients, 9.","DOI":"10.3390\/nu9080849"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"117962","DOI":"10.1016\/j.lfs.2020.117962","article-title":"Oral resveratrol supplementation improves Metabolic Syndrome features in obese patients submitted to a lifestyle-changing program","volume":"256","author":"Silveira","year":"2020","journal-title":"Life Sci."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1024\/0300-9831\/a000528","article-title":"No beneficial effects of resveratrol supplementation on atherogenic risk factors in patients with nonalcoholic fatty liver disease","volume":"90","author":"Farzin","year":"2020","journal-title":"Int. J. Vitam. Nutr. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1007\/s10238-025-01809-6","article-title":"Anti-inflammatory mechanism of resveratrol\u2019s Triglyceride-lowering effect in hyperlipidemia: A meta-analysis integrated network pharmacology and molecular dynamics simulation","volume":"25","author":"Shao","year":"2025","journal-title":"Clin. Exp. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11883-022-01075-x","article-title":"Role of Omega-3 Fatty Acids in Cardiovascular Disease: The Debate Continues","volume":"25","author":"Sherratt","year":"2023","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.amjms.2024.11.004","article-title":"The relationship between dietary niacin intake and the incidence of all-cause and cardiovascular mortality among chronic kidney disease patients","volume":"369","author":"Chen","year":"2025","journal-title":"Am. J. Med. Sci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"6","DOI":"10.21037\/jlpm-20-93","article-title":"Aspartate aminotransferase and cardiovascular disease\u2014A narrative review","volume":"6","author":"Ndrepepa","year":"2021","journal-title":"J. Lab. Precis. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.1093\/clinchem\/46.12.2050","article-title":"Diagnosis and monitoring of hepatic injury. II. Recommendations for use of laboratory tests in screening, diagnosis, and monitoring","volume":"46","author":"Dufour","year":"2000","journal-title":"Clin. Chem."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"100554","DOI":"10.1016\/j.obmed.2024.100554","article-title":"Effects of black mulberry leaf extract on liver health and metabolic parameters in rats with high-fat diet-induced liver changes","volume":"50","author":"Ghandi","year":"2024","journal-title":"Obes. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1039\/D2FO02645G","article-title":"Effect of mulberry leaf or mulberry leaf extract on glycemic traits: A systematic review and meta-analysis","volume":"14","author":"Cui","year":"2023","journal-title":"Food Funct."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"106029","DOI":"10.1016\/j.phrs.2021.106029","article-title":"Mulberry leaf (Morus alba L.): A review of its potential influences in mechanisms of action on metabolic diseases","volume":"175","author":"Zhang","year":"2022","journal-title":"Pharmacol. Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.mpmed.2014.11.006","article-title":"Metabolic syndrome","volume":"43","author":"Han","year":"2015","journal-title":"Medicine"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.12669\/pjms.37.5.3854","article-title":"Levels of anti-oxidative molecules and inflammatory factors in patients with vascular dementia and their clinical significance","volume":"37","author":"Qi","year":"2021","journal-title":"Pak. J. Med. Sci."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s12031-017-0917-x","article-title":"Regulation of Human Brain Microvascular Endothelial Cell Adhesion and Barrier Functions by Memantine","volume":"62","author":"Wang","year":"2017","journal-title":"J. Mol. Neurosci."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Zhang, H., Ma, Z.F., Luo, X., and Li, X. (2018). Effects of Mulberry Fruit (Morus alba L.) Consumption on Health Outcomes: A Mini-Review. Antioxidants, 7.","DOI":"10.3390\/antiox7050069"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Borda, M.G., Ram\u00edrez-V\u00e9lez, R., Botero-Rodriguez, F., Patricio-Baldera, J., de Lucia, C., Pola, I., Barreto, G.E., Khalifa, K., Bergland, A.K., and Kivipelto, M. (2025). Anthocyanin supplementation in adults at risk for dementia: A randomized controlled trial on its cardiometabolic and anti-inflammatory biomarker effects. GeroScience, 1\u201314.","DOI":"10.1007\/s11357-025-01669-8"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1007\/s11357-024-01308-8","article-title":"Senolytic intervention improves cognition, metabolism, and adiposity in female APP(NL)(-F\/NL-F) mice","volume":"47","author":"Fang","year":"2025","journal-title":"Geroscience"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2785","DOI":"10.1007\/s11357-023-00830-5","article-title":"Long-term dasatinib plus quercetin effects on aging outcomes and inflammation in nonhuman primates: Implications for senolytic clinical trial design","volume":"45","author":"Ruggiero","year":"2023","journal-title":"Geroscience"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"3149","DOI":"10.1007\/s11357-024-01068-5","article-title":"Eliminating senescent cells by white adipose tissue-targeted senotherapy alleviates age-related hepatic steatosis through decreasing lipolysis","volume":"46","author":"Tang","year":"2024","journal-title":"Geroscience"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"9140","DOI":"10.1021\/jf403136w","article-title":"Varietal differences in the flavonol content of mulberry (Morus spp.) leaves and genetic analysis of quercetin 3-(6-malonylglucoside) for component breeding","volume":"61","author":"Sugiyama","year":"2013","journal-title":"J. Agric. Food Chem."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"5061","DOI":"10.1007\/s11357-024-01235-8","article-title":"The neurovascular unit and its correlation with cognitive performance in patients with cerebral small vessel disease: A canonical correlation analysis approach","volume":"46","author":"Voorter","year":"2024","journal-title":"Geroscience"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"5103","DOI":"10.1007\/s11357-024-01139-7","article-title":"Atherosclerotic burden and cerebral small vessel disease: Exploring the link through microvascular aging and cerebral microhemorrhages","volume":"46","author":"Csiszar","year":"2024","journal-title":"Geroscience"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"3307","DOI":"10.1007\/s11357-023-00927-x","article-title":"Vascular senescence and leak are features of the early breakdown of the blood-brain barrier in Alzheimer\u2019s disease models","volume":"45","author":"Ting","year":"2023","journal-title":"Geroscience"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1007\/s11357-022-00693-2","article-title":"Morusin and mulberrin extend the lifespans of yeast and C. elegans via suppressing nutrient-sensing pathways","volume":"45","author":"Xu","year":"2023","journal-title":"Geroscience"},{"key":"ref_70","unstructured":"Higgins, J.P.T., and Cochrane Collaboration (2019). Cochrane Handbook for Systematic Reviews of Interventions, Wiley-Blackwell. [2nd ed.]."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/17\/8380\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:34:53Z","timestamp":1760034893000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/17\/8380"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,28]]},"references-count":71,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["ijms26178380"],"URL":"https:\/\/doi.org\/10.3390\/ijms26178380","relation":{},"ISSN":["1422-0067"],"issn-type":[{"type":"electronic","value":"1422-0067"}],"subject":[],"published":{"date-parts":[[2025,8,28]]}}}