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.

Development and characterization of pectin and chitosan films incorporated with a new cross-linking agent.

BACKGROUND: In this study, a new crosslinking agent (CA) containing whey protein, papin, glycerin, and epigallocatechin gallate (EGCG), was prepared. The effects of CA content (0, 10, 20, 30, and 40%, v/v) on food packaging properties, crystallinity, microstructure, and antioxidant properties of pectin-CA and chitosan-CA composite films were analyzed. The results of this research offer a theoretical basis for engineering improved films for food packing. RESULTS: Pectin-CA (30%) and chitosan-CA (40%) composite films showed the best light transmission, water retention, breathability, plasticity, and antioxidant activity. Scanning electron microscopy revealed that these composite films exhibited a uniform and homogeneous structure without obvious pores. Fourier-transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) indicated that the amino acids and EGCG in CA were bonded to the film substrate (pectin/chitosan) via electrostatic interactions, hydrogen bonding, and covalent bonding, which led to an improvement in the film's properties. CONCLUSION: The CA has broad application prospects in food packaging as a cross-linking agent and antioxidant. © 2022 Society of Chemical Industry.