Barberry in the treatment of obesity and metabolic syndrome: possible mechanisms of action

Figures & data

Figure 1 Chemical structure of berberine.

Table 1 Glycemic control mechanisms of berberine

Upregulation of GLUT-4

Activation of AMPK

Suppression of adipogenesis by inhibiting PPARγ and C/EBPα function

Stimulation of GLP-1

Suppression of human protein tyrosine phosphatase 1B

Stimulation of the pancreatic GPR40

Reduction of intestinal glucose absorption by inhibiting α-glucosidase activity

Abbreviations: AMPK, 5′ adenosine monophosphate-activated protein kinase; GLP-1, glucagon-like peptide-1; GLUT-4, glucose transporter type 4; GPR40, G protein-coupled receptor 40.

Table 2 Clinical efficacy of barberry

Author (publication year) Country	Patient (number)	Study design	Intervention	Duration	Results Significant reduction (P<0.05)
Lazavi et al (2018)^Citation43 Iran	Patients with type 2 diabetes (n=45)	Randomized clinical trial	200 mL of barberry juice/day	8 weeks	FBG, TC, blood pressure: both systolic and diastolic, TGs
Zilaee et al (2015)^Citation48 Iran	Subjects with metabolic syndrome (n=106)	Double-blind controlled trial	200 mg (capsule) three times per day	6 weeks	FBG, BMI, blood pressure: both systolic and diastolic
Iloon Kashkooli et al (2015)^Citation54 Iran	Patients with NAFLD (n=80), including 32 males and 48 females	Case and control	Case group received two capsules (750 mg) every day	3 months	Weight, TGs and TC
Li et al (2015)^Citation55 China	Rat model of metabolic syndrome (n=20)	Randomized clinical trial	Case group received 50 mg/kg/day berberine	16 weeks	p38 MAPK, ATF-2 and MMP-2
Moazezi and Qujeq (2014)^Citation56 Iran	Patients with type 2 diabetes (n=30)	Double-blind controlled trial	1 mg barberry extracts (capsule) two times per day	8 weeks	FBG, HbA1c
Pérez-Rubio et al (2013)^Citation57 USA	Patients with a diagnosis of metabolic syndrome (n=24)	Double-blind controlled clinical trial	Twelve patients received 500 mg berberine three times daily and 12 patients received placebo	3 months	Waist circumference, SBP, TGs and total insulin secretion
di Pierro et al (2012)^Citation18 Italy	Patients with suboptimal glycemic control (n=22)	Pilot clinical trial	An oral tablet containing 588 mg of Berberis aristata extract titered as 85% berberine and 105 mg of Silybum marianum extract titered as 60% flavonolignans	90 days	HbA1c, TC, LDL-C, TGs, basal insulin, HOMA-R
Hu and Davies (2010)^Citation26 USA	Nine-week-old C57BL/6J male mice (n=36)	Randomized clinical trial	Group1: normal diet with 3 mg/kg/day berberine Group 2: subgroup 1: high-fat diet; subgroups 2–4: high-fat diet mice treated with 0.75, 1.5, 3 mg/kg/day berberine, respectively	36 days	Weight gain and food intake, serum glucose, TG and TC. Also, downregulation of PPAR-γ expression and upregulation of GATA-3 expression
Ebrahimi-Mamaghani et al (2009)^Citation58 Iran	Patients with type 2 diabetes (n=57)	Randomized controlled clinical trial	–	8 weeks	LDL-c and TC/HDL-c ratio
Yin et al (2009)^Citation34 China	Patients with type 2 diabetes (n=36)	Randomized clinical trial	500 mg berberine three times daily	3 months	HbA1c, FBG, postprandial blood glucose and TGs

Abbreviations: ATF-2, activating transcription factor 2; BMI, body mass index; FBG, fasting blood glucose; HbA1c, hemoglobin A1c; HDL-c, high-density lipoprotein-cholesterol; HOMA-R: homeostatic model assessment-insulin resistance; LDL-c, low-density lipoprotein-cholesterol; MMP-2, matrix metalloproteinase 2; NAFLD, nonalcoholic fatty liver disease; TC, total cholesterol; TGs, triglycerides.

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