Efficacy and safety of berberine on metabolic abnormalities in women with polycystic ovary syndrome by systematic review and Meta-analysis

doi:10.3969/j.issn.1006-7795.2021.04.013

Abstract

Abstract: Objectives To evaluate the efficacy and safety of berberine on polycystic ovary syndrome(PCOS)patients with metabolic abnormalities. Methods CNKI, Wanfang Data, VIP, PubMed, ELSEVIER and Cochrane Library were searched for randomized controlled trials in human beings, till June 2020. Relevant indicators were collected and the data were analyzed by using RevMan 5.0 software. Results A total of 11 studies, 2 English articles and 9 Chinese articles were included. Our study showed that berberine (BBR) improved better than metformin (MET) on waist-hip ratio(WHR)(MD=-0.03,95%CI:-0.04--0.01), fasting insulin(FIN)(MD=-1.91,95%CI:-3.56--0.25),total cholesterol(TC)((MD=-0.37,95%CI:-0.68--0.06),high density lipoprotein cholesterol(HDL-C)( MD=-0.15,95%CI:-0.31-0.00) and low density lipoprotein cholesterol (LDL-C)( MD=-0.34,95%CI:-0.56--0.13), but not on body mass index(BMI)(MD=-0.09,95%CI:-0.97-0.80),fasting plasma glucose (FPG)(MD=0.09,95%CI:-0.03-0.21),homeostasis model assessment of insulin resistance(HOMA-IR)(MD=-0.25,95%CI:-0.58-0.07),total testosterone (TT) (MD=-0.13,95%CI:-0.26-0.01), and worse on triglyceride (TG) (MD=0.11,95%CI:0.02-0.20). Compared with COC alone, BBR combined with COC improved better on WHR(MD=-0.03,95%CI:-0.04--0.03), FPG(MD=-0.34,95%CI:-0.57--0.11),FIN(MD=-3.39,95%CI:-5.16--1.62),HOMA-IR(MD=-1.12,95%CI:-1.73--0.51),TC(MD=-0.50,95%CI:-0.58--0.42),TG(MD=-0.23,95%CI:-0.36--0.11),HDL-C(MD=0.11,95%CI:0.09-0.14),LDL-C(MD=-0.43,95%CI:-0.53--0.33)和TT(MD=-0.14,95%CI:-0.25--0.03),but not on BMI(MD=-0.41,95%CI:-1.07-0.24). There was no statistically significant difference on the incidence of adverse reactions between BBR and MET (RR=0.58,95%CI:0.32-1.07),and BBR combined with COC and COC alone(RR=1.85,95%CI:0.77-4.46). Conclusion BBR could improve clinical outcomes on metabolic abnormalities in women with PCOS. However, the effectiveness and safety need to be further verified by high-quality, large-sample, multi-center RCTs.

Key words: berberine, polycystic ovary syndrome(PCOS), abnormal metabolism, metabolic syndrome, hyperandrogenemia

CLC Number:

R711.75

Liu Zhen, Yin Dongmei, Zhan Sien, Ruan Xiangyan. Efficacy and safety of berberine on metabolic abnormalities in women with polycystic ovary syndrome by systematic review and Meta-analysis[J]. Journal of Capital Medical University, 2021, 42(4): 588-595.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2021.04.013

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2021/V42/I4/588

References

[1] 中华医学会妇产科学分会内分泌学组及指南专家组.多囊卵巢综合征中国诊疗指南[J]. 中华妇产科杂志,2018,53(1):2-6.
[2] Ruan X Y,Kubba A,Aguilard A,et al. Use of cyproterone acetate/ethinylestradiol in polycystic ovary syndrome: rationale and practical aspects[J]. Eur J Contracept Reprod Health Care,2017,22(3):183-190.
[3] Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group.Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome(PCOS) [J].Hum Reprod,2004,19(1):41-47.
[4] An Y, Sun Z Z,Zhang Y J,et al. The use of berberine for women with polycystic ovary syndrome undergoing IVF treatment[J]. Clinical Endocrinol,2014,80(3):425-431.
[5] 陈晓,刘素,韩鲜梅. 小檗碱治疗多囊卵巢综合征合并胰岛素抵抗疗效探讨[J]. 中国医药科学,2016,6(4):64-66.
[6] 邝姮.黄连素治疗多囊卵巢综合征胰岛素抵抗的临床研究[D]. 广州:广州中医药大学,2014.
[7] 黎小斌,邝姮,骆赟韵,等. 黄连素干预多囊卵巢综合征患者胰岛素抵抗的临床观察[J]. 广州中医药大学学报,2017,34(2):172-177.
[8] 李甜甜. 小檗碱治疗胰岛素抵抗型多囊卵巢综合征的临床与基础研究[D]. 广州:广州医科大学,2017.
[9] 李勇峰,林彦杰,王小青,等. 小檗碱对多囊卵巢综合征患者对血糖、血脂及胰岛素抵抗的影响[J].慢性病学杂志,2018,19(S1):125-126.
[10] 李思敏,刘博,李海燕. 小檗碱联合达英-35改善PCOS脂代谢的疗效研究[J].饮食保健,2019,6(23):46-47.
[11] 马玉琨,杨军光,隋明,等. 小檗碱治疗多囊卵巢综合征合并胰岛素抵抗疗效研究[J].中国实用妇科与产科杂志,2011,27(9):684-687.
[12] 桑敏,陈敏. 小檗碱联合优思明对青春期多囊卵巢综合征患者内分泌及临床症状的影响[J].哈尔滨医科大学学报,2019,53(3):317-320.
[13] Wei W, Zhao H M, Wang A L, et al. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome[J].Eur J Endocrinol,2012,166:99-105.
[14] 朱秋艳,胡望琦,戴丛伟.小檗碱联合炔雌醇环丙孕酮治疗肥胖型多囊卵巢综合征疗效观察[J].中国基层医药,2016,23(6):837-840.
[15] Sun Y,Xia M,Yan H,et al. Berberine attenuates hepatic steatosis and enhances energy expenditure in mice by inducing autophagy and fibroblast growth factor 21 [J]. Br J Pharmacol,2018,175(2):374-387.
[16] Wu H, Ruan X, Jin J,et al. Metabolic profile of diane-35 versus diane-35 plus metformin in Chinese PCOS women under standardized life-style changes[J]. Gynecol Endocrinol,2015,31: 548-551.
[17] 马毅,吴效科,侯丽辉,等.中药小檗碱、薯芋皂苷对滋养细胞内糖代谢分子表达的调控[J].中华中医药杂志,2009,24(2) :144-148.
[18] 魏敬,蒋建东,吴锦丹,等. 盐酸小檗碱的调脂作用的研究[J]. 中华糖尿病杂志,2005,13(1):49-51.
[18] 林金芳. 多囊卵巢综合征患者高雄激素血症的诊治[J]. 中国实用妇科与产科杂志 2013,29(11):860-863.
[19] Ruan X,Song J,Gu M,et al. Effect of Diane-35, alone or in combination with orlistat or metformin in Chinese polycystic ovary syndrome patients[J]. Arch Gynecol Obst, 2018, 297(6):1557-1563.
[20] 李旸. 盐酸小檗碱对血脂异常伴动脉粥样硬化患者的疗效及安全性观察[D]. 长春:吉林大学,2019.