Effects berberine–silymarin on liver enzymes: A systematic review and
meta-analysis of randomized controlled trials
Abstract
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 and Google Scholar. The mean differences and
standard deviations were pooled using a random-effects 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 according
to challenges mentioned seem to be helpful to use BBR–silymarin as a
supplement for improving liver function. Keywords: Berberis aristate,
Silybum marianum, ALT, AST, Meta-analysis