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Chinese Herbal Medicine for Type 2 Diabetes Mellitus With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

Objectives: To evaluate the efficacy and safety of Chinese herbal medicine (CHM) for type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD) with current evidence. Methods: This study was registered in PROSPERO as CRD42021271488. A literature search was conducted in eight elect...

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Autores principales: Peng, Sihan, Liu, Lu, Xie, Ziyan, Zhang, Xiyu, Xie, Chunguang, Ye, Sha, Zhang, Xiangeng, Liang, Xiaoli, Wang, Hongyan, Liu, Ya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9271569/
https://www.ncbi.nlm.nih.gov/pubmed/35833030
http://dx.doi.org/10.3389/fphar.2022.863839
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author Peng, Sihan
Liu, Lu
Xie, Ziyan
Zhang, Xiyu
Xie, Chunguang
Ye, Sha
Zhang, Xiangeng
Liang, Xiaoli
Wang, Hongyan
Liu, Ya
author_facet Peng, Sihan
Liu, Lu
Xie, Ziyan
Zhang, Xiyu
Xie, Chunguang
Ye, Sha
Zhang, Xiangeng
Liang, Xiaoli
Wang, Hongyan
Liu, Ya
author_sort Peng, Sihan
collection PubMed
description Objectives: To evaluate the efficacy and safety of Chinese herbal medicine (CHM) for type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD) with current evidence. Methods: This study was registered in PROSPERO as CRD42021271488. A literature search was conducted in eight electronic databases from inception to December 2021. The primary outcomes were lipid indices and liver functions, including triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), alanine transaminase (ALT), and aspartate transaminase (AST). Review Manager 5.2 and Stata v14.0 were applied for analysis. Results: The research enrolled 18 RCTs with 1,463 participants. Results showed CHM combined with western medicine (WM) was more effective than WM alone in TG (weighted mean differences (WMD) = −0.35.95% confidence interval (CI) [−0.51, −0.19], p < 0.0001), TC (WMD = −0.58.95%CI [−0.80, −0.36], p < 0.00001), LDL-C (WMD = −0.37, 95%CI [−0.47, −0.26], p < 0.00001), HDL-C (WMD = 0.20, 95%CI [0.10, 0.29], p < 0.0001), ALT (WMD = −4.99, 95%CI [−6.64, −3.33], p < 0.00001), AST (WMD = −4.76, 95%CI [−6.35, −3.16], p < 0.00001), homeostatic model assessment of insulin resistance (WMD = −1.01, 95%CI [−1.22, −0.79], p < 0.00001), fasting blood glucose (WMD = −0.87, 95%CI [−1.13, −0.61], p < 0.00001), 2-h postprandial glucose (WMD = −1.45.95%CI [−2.00, −0.91], p < 0.00001), body mass index (WMD = −0.73.95%CI [−1.35, −0.12], p = 0.02), and overall effective rate (risk ratio (RR) = 1.37.95%CI [1.29, 1.46], p < 0.00001). Conclusion: The CHM in combination with WM seems to be more beneficial in T2DM with NAFLD patients in improving lipid and glucose metabolism, liver function, and insulin resistance as well as improving overall efficiency and reducing body weight. Given the poor quality of reports from these studies and uncertain evidence, these findings should be interpreted cautiously. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021271488, identifier CRD42021271488.
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spelling pubmed-92715692022-07-12 Chinese Herbal Medicine for Type 2 Diabetes Mellitus With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis Peng, Sihan Liu, Lu Xie, Ziyan Zhang, Xiyu Xie, Chunguang Ye, Sha Zhang, Xiangeng Liang, Xiaoli Wang, Hongyan Liu, Ya Front Pharmacol Pharmacology Objectives: To evaluate the efficacy and safety of Chinese herbal medicine (CHM) for type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD) with current evidence. Methods: This study was registered in PROSPERO as CRD42021271488. A literature search was conducted in eight electronic databases from inception to December 2021. The primary outcomes were lipid indices and liver functions, including triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), alanine transaminase (ALT), and aspartate transaminase (AST). Review Manager 5.2 and Stata v14.0 were applied for analysis. Results: The research enrolled 18 RCTs with 1,463 participants. Results showed CHM combined with western medicine (WM) was more effective than WM alone in TG (weighted mean differences (WMD) = −0.35.95% confidence interval (CI) [−0.51, −0.19], p < 0.0001), TC (WMD = −0.58.95%CI [−0.80, −0.36], p < 0.00001), LDL-C (WMD = −0.37, 95%CI [−0.47, −0.26], p < 0.00001), HDL-C (WMD = 0.20, 95%CI [0.10, 0.29], p < 0.0001), ALT (WMD = −4.99, 95%CI [−6.64, −3.33], p < 0.00001), AST (WMD = −4.76, 95%CI [−6.35, −3.16], p < 0.00001), homeostatic model assessment of insulin resistance (WMD = −1.01, 95%CI [−1.22, −0.79], p < 0.00001), fasting blood glucose (WMD = −0.87, 95%CI [−1.13, −0.61], p < 0.00001), 2-h postprandial glucose (WMD = −1.45.95%CI [−2.00, −0.91], p < 0.00001), body mass index (WMD = −0.73.95%CI [−1.35, −0.12], p = 0.02), and overall effective rate (risk ratio (RR) = 1.37.95%CI [1.29, 1.46], p < 0.00001). Conclusion: The CHM in combination with WM seems to be more beneficial in T2DM with NAFLD patients in improving lipid and glucose metabolism, liver function, and insulin resistance as well as improving overall efficiency and reducing body weight. Given the poor quality of reports from these studies and uncertain evidence, these findings should be interpreted cautiously. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021271488, identifier CRD42021271488. Frontiers Media S.A. 2022-06-27 /pmc/articles/PMC9271569/ /pubmed/35833030 http://dx.doi.org/10.3389/fphar.2022.863839 Text en Copyright © 2022 Peng, Liu, Xie, Zhang, Xie, Ye, Zhang, Liang, Wang and Liu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Peng, Sihan
Liu, Lu
Xie, Ziyan
Zhang, Xiyu
Xie, Chunguang
Ye, Sha
Zhang, Xiangeng
Liang, Xiaoli
Wang, Hongyan
Liu, Ya
Chinese Herbal Medicine for Type 2 Diabetes Mellitus With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis
title Chinese Herbal Medicine for Type 2 Diabetes Mellitus With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis
title_full Chinese Herbal Medicine for Type 2 Diabetes Mellitus With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis
title_fullStr Chinese Herbal Medicine for Type 2 Diabetes Mellitus With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis
title_full_unstemmed Chinese Herbal Medicine for Type 2 Diabetes Mellitus With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis
title_short Chinese Herbal Medicine for Type 2 Diabetes Mellitus With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis
title_sort chinese herbal medicine for type 2 diabetes mellitus with nonalcoholic fatty liver disease: a systematic review and meta-analysis
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9271569/
https://www.ncbi.nlm.nih.gov/pubmed/35833030
http://dx.doi.org/10.3389/fphar.2022.863839
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