Clinical Efficacy of Curcumin, Resveratrol, Silymarin, and Berberine on Cardio-Metabolic Risk Factors Among Patients With Type 2 Diabetes Mellitus: A Systemic Review and Bayesian Network Meta-Analysis

Miao et al., 2025 | Phytother Res | Systematic Review

Citation

Miao Runyu, Zhang Boxun, ... Tong Xiaolin. Clinical Efficacy of Curcumin, Resveratrol, Silymarin, and Berberine on Cardio-Metabolic Risk Factors Among Patients With Type 2 Diabetes Mellitus: A Systemic Review and Bayesian Network Meta-Analysis. Phytother Res. 2025-Dec;39(12):5617-5633. doi:10.1002/ptr.8431

Abstract

The comprehensive management of cardiovascular risk factors, including blood glucose, blood lipids, and blood pressure in type 2 diabetes mellitus (T2DM), is essential to prevent cardiovascular complications. Consequently, there is an urgent need to explore improved clinical treatment strategies by comparing the efficacy of various interventions. To assess the efficacy of herbal phytochemicals in regulating cardio-metabolic risk factors among patients with T2DM. A systematic literature review of the English language literature from inception to March 31, 2024, was conducted using PubMed, Embase, and Cochrane Library databases. The included literature focused on treating patients with T2DM using herbal phytochemicals. ADDIS and Revman were used to conduct Bayesian network and pairwise meta-analyses, respectively, and the surface under the cumulative ranking curve was used to obtain the ranking order of different herbal phytochemicals. This study included 17 studies involving 1,337 participants. Resveratrol was generally the most effective, followed by silymarin. Compared with the placebo, resveratrol significantly improved HOMA-IR, total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), systolic blood pressure (SBP), and diastolic blood pressure (DBP) (P < 0.05); silymarin significantly improved fasting plasma glucose (FPG), HOMA-IR, and hemoglobin A1c (HbA1c) (P < 0.05). For HbA1c, silymarin was more effective than resveratrol (MD -2.08, 95%Cl -3.50 to -0.72) (P < 0.05). For body mass index (BMI), curcumin was more effective than resveratrol (MD -1.27, 95%Cl -2.43 to -0.03) (P < 0.05). Curcumin, resveratrol, silymarin, and berberine can effectively improve cardio-metabolic risk factors in T2DM, and different herbal phytochemicals have different clinical advantages. The therapeutic potential of resveratrol is significant in the regulation of blood glucose, blood lipids, and body weight, silymarin exhibited the best effect in reducing blood glucose, berberine could lower blood glucose and regulate blood lipids, and curcumin had a definite therapeutic effect on weight loss. However, further validation of these findings is necessary through extensive clinical studies with larger sample sizes.

Key Findings

However, further validation of these findings is necessary through extensive clinical studies with larger sample sizes.

Outcomes Measured

  • blood pressure
  • systolic blood pressure
  • diastolic blood pressure

Population

Field Value
Population t2dm
Sample Size 1337
Age Range See abstract
Condition blood pressure

MeSH Terms

  • Humans
  • Diabetes Mellitus, Type 2
  • Curcumin
  • Resveratrol
  • Bayes Theorem
  • Berberine
  • Silymarin
  • Blood Pressure
  • Blood Glucose
  • Cardiometabolic Risk Factors
  • Cardiovascular Diseases
  • Risk Factors

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review, Network Meta-Analysis
  • Vertical: berberine

Provenance


Source extracted via PubMed E-utilities API on 2026-04-09