Abstract
Berberine (BBR) exhibits significant anti-diabetic effects by enhancing insulin sensitivity, promoting glycolysis, and inhibiting gluconeogenesis. It also shows promise in treating non-alcoholic fatty liver disease (NAFLD) by reducing hepatic fat content and improving liver enzyme levels, lipid profiles, and insulin sensitivity. Studies show that BBR inhibits tumor growth, metastasis, and cell proliferation while inducing apoptosis and cell cycle arrest. Additionally, it enhances autophagy, regulates gut microbiota, and boosts the effectiveness of other anti-tumor drugs. Clinical trials indicate that BBR reduces the recurrence of colorectal adenomas and offers radioprotective benefits, although mild side effects such as constipation have been noted. Additionally, BBR's cardiovascular benefits include lowering cholesterol, improving lipid metabolism, and reducing inflammation, thus potentially attenuating the progression of atherosclerosis. Numerous randomized clinical trials have demonstrated BBR's therapeutic efficacy, suggesting that it may be a safe and useful adjuvant treatment for diabetes, NAFLD, cancer, and cardiovascular disease (CVD). However, we need to acknowledge limitations like low bioavailability and trial heterogeneity, which could affect how well the findings apply more broadly. Notwithstanding these encouraging results, more investigation is required to develop uniform treatment regimens and to completely comprehend the processes underlying the benefits of BBR.