{"title":"小檗和水飞蓟固定剂量组合对成人血糖和胰岛素抵抗参数的疗效评估:随机对照试验的系统回顾和荟萃分析","authors":"Vishal Dubey, Jignesh Kansagra, Varun Sureja, Dharmeshkumar Kheni","doi":"10.1186/s43094-024-00603-7","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Diabetes is one of the most prevalent metabolic diseases with high rate of morbidity and mortality. The increased level of blood glucose level and increased insulin resistance is the hallmark of diabetes. Currently, various non-pharmacological and pharmacological therapeutic options are used for lowering the glucose level and improving the insulin activity. The current systematic review and meta-analysis study was conducted to evaluate the efficacy of <i>Berberis aristata</i> and <i>Silybum marianum</i> fixed dose nutraceutical combination on serum glucose and glycated haemoglobin level and insulin resistance parameters.</p><h3>Main Body</h3><p>Randomized controlled trials, identified from three online databases, evaluating the efficacy of <i>Berberis aristata</i> and <i>Silybum marianum</i> fixed dose combination were identified and evaluated as per pre-defined protocol. Quality of studies was evaluated using PEDro scale, and risk of bias was assessed using Cochrane Risk of Bias Tool. Pooled effect was reported as mean difference (MD) and 95% confidence interval, while the complete study was conducted as per PRISMA and Cochrane guidelines. After complete literature screening and evaluation process, seven studies were included in the final analysis. Data of 825 participants (active group: 416 participants and control group: 409 participants) were utilized for the statistical analysis. All included studies (except one) were of good quality. Supplementation of fixed dose combination significantly reduced glucose level (MD: − 5.26 mg/dl; <i>p</i> = 0.02) and glycated haemoglobin (HbA1c) level (MD: − 0.69%; <i>p</i> < 0.0001) as compared to control therapy, while greater insulin resistance reduction was observed in active group and the difference approached significance (MD: − 0.64 HOMA-IR score; <i>p</i> = 0.08). Risk of bias analysis revealed some concerns regarding biasness (mainly due to randomization, outcome measurement and selected reporting biasness). All included studies had moderate risk of biasness. Sensitivity analysis revealed effect of particular study on overall heterogeneity observed, while neither significant publication bias nor any missing study was observed.</p><h3>Conclusion</h3><p>The results of current study suggest that <i>B. aristata</i> and <i>S. marianum</i> fixed dose combination is effective in improving glycaemic and insulin parameters and can be effective in diabetic population. The observed sensitivity of certain studies on overall heterogeneity and the moderate risk of biasness warrants further well-designed clinical studies to strengthen the results of current study.</p></div>","PeriodicalId":577,"journal":{"name":"Future Journal of Pharmaceutical Sciences","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://fjps.springeropen.com/counter/pdf/10.1186/s43094-024-00603-7","citationCount":"0","resultStr":"{\"title\":\"Efficacy evaluation of Berberis aristata and Silybum marianum fixed dose combination on glycaemic and insulin resistance parameters in adult population: a systematic review and meta-analysis of randomized controlled trials\",\"authors\":\"Vishal Dubey, Jignesh Kansagra, Varun Sureja, Dharmeshkumar Kheni\",\"doi\":\"10.1186/s43094-024-00603-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Diabetes is one of the most prevalent metabolic diseases with high rate of morbidity and mortality. The increased level of blood glucose level and increased insulin resistance is the hallmark of diabetes. Currently, various non-pharmacological and pharmacological therapeutic options are used for lowering the glucose level and improving the insulin activity. The current systematic review and meta-analysis study was conducted to evaluate the efficacy of <i>Berberis aristata</i> and <i>Silybum marianum</i> fixed dose nutraceutical combination on serum glucose and glycated haemoglobin level and insulin resistance parameters.</p><h3>Main Body</h3><p>Randomized controlled trials, identified from three online databases, evaluating the efficacy of <i>Berberis aristata</i> and <i>Silybum marianum</i> fixed dose combination were identified and evaluated as per pre-defined protocol. Quality of studies was evaluated using PEDro scale, and risk of bias was assessed using Cochrane Risk of Bias Tool. Pooled effect was reported as mean difference (MD) and 95% confidence interval, while the complete study was conducted as per PRISMA and Cochrane guidelines. After complete literature screening and evaluation process, seven studies were included in the final analysis. Data of 825 participants (active group: 416 participants and control group: 409 participants) were utilized for the statistical analysis. All included studies (except one) were of good quality. Supplementation of fixed dose combination significantly reduced glucose level (MD: − 5.26 mg/dl; <i>p</i> = 0.02) and glycated haemoglobin (HbA1c) level (MD: − 0.69%; <i>p</i> < 0.0001) as compared to control therapy, while greater insulin resistance reduction was observed in active group and the difference approached significance (MD: − 0.64 HOMA-IR score; <i>p</i> = 0.08). Risk of bias analysis revealed some concerns regarding biasness (mainly due to randomization, outcome measurement and selected reporting biasness). All included studies had moderate risk of biasness. Sensitivity analysis revealed effect of particular study on overall heterogeneity observed, while neither significant publication bias nor any missing study was observed.</p><h3>Conclusion</h3><p>The results of current study suggest that <i>B. aristata</i> and <i>S. marianum</i> fixed dose combination is effective in improving glycaemic and insulin parameters and can be effective in diabetic population. The observed sensitivity of certain studies on overall heterogeneity and the moderate risk of biasness warrants further well-designed clinical studies to strengthen the results of current study.</p></div>\",\"PeriodicalId\":577,\"journal\":{\"name\":\"Future Journal of Pharmaceutical Sciences\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-02-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://fjps.springeropen.com/counter/pdf/10.1186/s43094-024-00603-7\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Future Journal of Pharmaceutical Sciences\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://link.springer.com/article/10.1186/s43094-024-00603-7\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Future Journal of Pharmaceutical Sciences","FirstCategoryId":"1085","ListUrlMain":"https://link.springer.com/article/10.1186/s43094-024-00603-7","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
Efficacy evaluation of Berberis aristata and Silybum marianum fixed dose combination on glycaemic and insulin resistance parameters in adult population: a systematic review and meta-analysis of randomized controlled trials
Background
Diabetes is one of the most prevalent metabolic diseases with high rate of morbidity and mortality. The increased level of blood glucose level and increased insulin resistance is the hallmark of diabetes. Currently, various non-pharmacological and pharmacological therapeutic options are used for lowering the glucose level and improving the insulin activity. The current systematic review and meta-analysis study was conducted to evaluate the efficacy of Berberis aristata and Silybum marianum fixed dose nutraceutical combination on serum glucose and glycated haemoglobin level and insulin resistance parameters.
Main Body
Randomized controlled trials, identified from three online databases, evaluating the efficacy of Berberis aristata and Silybum marianum fixed dose combination were identified and evaluated as per pre-defined protocol. Quality of studies was evaluated using PEDro scale, and risk of bias was assessed using Cochrane Risk of Bias Tool. Pooled effect was reported as mean difference (MD) and 95% confidence interval, while the complete study was conducted as per PRISMA and Cochrane guidelines. After complete literature screening and evaluation process, seven studies were included in the final analysis. Data of 825 participants (active group: 416 participants and control group: 409 participants) were utilized for the statistical analysis. All included studies (except one) were of good quality. Supplementation of fixed dose combination significantly reduced glucose level (MD: − 5.26 mg/dl; p = 0.02) and glycated haemoglobin (HbA1c) level (MD: − 0.69%; p < 0.0001) as compared to control therapy, while greater insulin resistance reduction was observed in active group and the difference approached significance (MD: − 0.64 HOMA-IR score; p = 0.08). Risk of bias analysis revealed some concerns regarding biasness (mainly due to randomization, outcome measurement and selected reporting biasness). All included studies had moderate risk of biasness. Sensitivity analysis revealed effect of particular study on overall heterogeneity observed, while neither significant publication bias nor any missing study was observed.
Conclusion
The results of current study suggest that B. aristata and S. marianum fixed dose combination is effective in improving glycaemic and insulin parameters and can be effective in diabetic population. The observed sensitivity of certain studies on overall heterogeneity and the moderate risk of biasness warrants further well-designed clinical studies to strengthen the results of current study.
期刊介绍:
Future Journal of Pharmaceutical Sciences (FJPS) is the official journal of the Future University in Egypt. It is a peer-reviewed, open access journal which publishes original research articles, review articles and case studies on all aspects of pharmaceutical sciences and technologies, pharmacy practice and related clinical aspects, and pharmacy education. The journal publishes articles covering developments in drug absorption and metabolism, pharmacokinetics and dynamics, drug delivery systems, drug targeting and nano-technology. It also covers development of new systems, methods and techniques in pharmacy education and practice. The scope of the journal also extends to cover advancements in toxicology, cell and molecular biology, biomedical research, clinical and pharmaceutical microbiology, pharmaceutical biotechnology, medicinal chemistry, phytochemistry and nutraceuticals.