The clinical efficacy and safety of berberine in the treatment of non-alcoholic fatty liver disease: a meta-analysis and systematic review.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is becoming increasingly prevalent worldwide, emerging as a significant health issue on a global scale. 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. METHODS: 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. RESULTS: Among 10 RCTs involving 811 patients, berberine demonstrated significant reductions in various parameters: ALT (standardized mean difference (SMD) = - 0.72), 95% confidence interval (Cl) [- 1.01, - 0.44], P < 0.00001), AST (SMD = - 0.79, 95% CI [- 1.17, - 0.40], P < 0.0001), GGT (SMD = - 0.62, 95% CI [- 0.95, - 0.29], P = 0.0002), TG (SMD = - 0.59, 95% CI [- 0.86, - 0.31], P < 0.0001), TC(SMD = - 0.74, 95% CI [- 1.00, - 0.49], P < 0.00001), LDL-C (SMD = - 0.53, 95% CI [- 0.88, - 0.18], P = 0.003), HDL-C (SMD = - 0.51, 95% CI [- 0.12, 1.15], P = 0.11), HOMA-IR (SMD = - 1.56, 95% CI [- 2.54, - 0.58], P = 0.002), and BMI (SMD = - 0.58, 95% CI [- 0.77, - 0.38], P < 0.00001). Importantly, Berberine exhibited a favorable safety profile, with only mild gastrointestinal adverse events reported. CONCLUSION: 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. Trial registration The protocol was registered with PROSPERO (No. CRD42023462338). Registered on September 27, 2023.

Prevalence of scoliosis in children and adolescents: a systematic review and meta-analysis.

Background: The understanding of the prevalence and early predictive factors of scoliosis in children and adolescents is limited, which poses challenges to developing preventative strategies. This systematic review and meta-analysis aimed to clarify the prevalence and predictors of scoliosis among children and adolescents. Methods: We conducted a comprehensive search in PubMed, Cochrane, Embase, and Web of Science through October 2023. The quality of included studies was evaluated using the Joanna Briggs Institute scale or the Newcastle-Ottawa Scale. Subgroup analyses were performed to examine different types of scoliosis and specific demographic groups. Results: From 32 studies encompassing 55,635,351 children and adolescents, we identified 284,114 cases of scoliosis, resulting in a prevalence rate of 3.1% (95% CI: 1.5%-5.2%). This rate varied by gender, degrees of scoliosis severity, and between idiopathic vs. congenital forms. Notable predictors included gender, age, Body Mass Index (BMI), race, environmental factors, and lifestyle choices. Conclusion: Scoliosis is a significant condition affecting a minority of children and adolescents, particularly adolescent girls and individuals who are overweight. It is recommended that guardians and schools enhance educational efforts towards its prevention. Systematic Review Registration: https://www.crd.york.ac.uk/, Identifier CRD42023476498.