ABSTRACT
Objectives: Despite controversies, no study has systematically
summarized findings from earlier studies on the effect of berberine( BBR)–silymarin on liver enzymes. Therefore, the current
systematic review and meta-analysis aimed to investigate the effect of
berberis aristate and silybum marianum on alanine aminotransferase (ALT)
and aspartate aminotransferase (AST) in adults.
Methods : Relevant studies, published up to June 2020, were
searched through PubMed/Medline, Scopus, ISI Web of Science, EMBASE. The
mean differences and standard deviations were pooled using a Fixed
effect model. The studies’ quality was evaluated using Cochrane Risk of
Bias Tool. Out of 80 citations, 5 trials that enrolled 549 participants
were included.
Results : Berberis aristate and silybum marianum resulted in no
statistically significant change in ALT (weighted mean differences
(WMD): −0.39 mg/dl; 95% CI: −1.67 to 0.89, P=0.55), and AST (WMD: −0.44
mg/dl; 95% CI: −2.02 to 1.14, P=0.58). We did not find any significant
reduction in liver enzymes following BBR–silymarin consumption in
adults.
Conclusion : Further clinical trials with high quality seem to
be helpful to use BBR–silymarin as a supplement for improving liver
function.
Keywords: Berberis aristate, Silybum marianum, ALT, AST,
Meta-analysis
Review Criteria: Randomised clinical trials were identified
using prespecified search terms in PubMed/Medline, Scopus, ISI Web of
Science, EMBASE electronic databases with English language restriction.
Message for the Clinic: The decision to include
berberine( BBR)–silymarin on the list of complementary medicines
recommended for Fatty liver disease, is not evidence based. Patients who
are using (or considering using) berberine ( BBR)–silymarin for
management of these symptoms should be provided with current evidence of
effectiveness. Whilst a lack of evidence does not mean that berberine( BBR)–silymarin isn’t ineffective, further clinical trials
with high quality seem to be helpful to use BBR–silymarin as a
supplement for improving liver function.