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Effects of Berberine in Reducing Abdominal Visceral Adipose Tissue Among Individuals with Obesity and NAFLD

Phase 4
Completed
Conditions
Obesity, Abdominal
NAFLD
Obesity
Interventions
Behavioral: Placebo plus lifestyle intervention
Registration Number
NCT05647915
Lead Sponsor
China National Center for Cardiovascular Diseases
Brief Summary

This multicenter, double-blinded, randomized controlled trial aims to evaluate the effect of berberine in reducing visceral and liver adipose tissue among individuals with obesity and non-alcoholic fatty liver disease (NAFLD) in China.

Detailed Description

The trial aims to evaluate the efficacy and safety of berberine treatment for obesity and NAFLD. Potential eligible patients will be recruited from 10-20 medical centers in China. After a 4-week run-in period with berberine, all the eligible participants will be randomized (1:1) to berberine 1.0 g per day plus lifestyle intervention (Arm A) or placebo plus lifestyle intervention (Arm B). The participants will be asked to attend the visit at least once every 2 months, and be followed up for 6 months.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
337
Inclusion Criteria
  • Participants aged ≥18 years
  • Participants with obesity (i.e., BMI ≥ 28 kg/m2) and abdominal obesity (i.e., waist circumference ≥85 cm in female or waist circumference ≥90 cm in male)
  • Participants with NAFLD diagnosed by ultrasound, computed tomography or magnetic resonance imaging
Exclusion Criteria
  • Patients with established coronary heart disease, stroke, or peripheral arterial disease
  • Patients diagnosed with diabetes or taking oral glucose-lowering drugs
  • Patients with severely uncontrolled hypertension (i.e., SBP≥180mmHg and/or DBP ≥110mmHg)
  • Excess alcohol consumption (i.e., alcohol ≥ 20 g/day in female or alcohol ≥ 30 g/day in male)
  • Other causes of fatty liver disease, including alcohol or drug abuse, hepatitis B or C, autoimmune, hepatolenticular degeneration, total parenteral nutrition, inflammatory bowel disease, celiac disease, hypothyroidism, Cushing syndrome, β -lipoprotein deficiency, lipid atrophy diabetes, Mauriac syndrome, etc.
  • Patients with thyroid disease, including hyperthyroidism or hypothyroidism
  • Patients with cardiac insufficiency
  • ALT or AST ≥ 3 times upper limit of normal, liver cirrhosis or hepatic insufficiency
  • Patients with renal insufficiency: estimated glomerular filtration rate (eGFR) < 60 ml/(min×1.73m2)
  • Patients who had weight loss surgery, or are currently taking drugs for weight loss, or plan to have weight loss surgery or drugs in the following 6 months
  • Patients diagnosed with glucose-6-phosphate dehydrogenase (G6PD) deficiency
  • Taking berberine or drug containing berberine in the past 1 month
  • Any adverse reaction to berberine
  • Severe constipation, diarrhea, and/or severe chronic intestinal diseases (e.g., ulcerative colitis, Crohn's disease, irritable bowel syndrome, etc.)
  • Patients who had to use long-term or intermittent corticosteroids, immunosuppressants, antibiotics, or other drugs that affect inflammatory biomarkers
  • Women who are pregnant or breastfeeding, or those who plan to be pregnant during the trial
  • Patients with malignant tumors
  • Patients with mental disorders, cognitive disorders, and/or other serious diseases
  • Those who participated or have been participating other trials during the last 3 months
  • Any other conditions that may hinder the compliance to the study intervention or follow-up visit

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
placebo groupPlacebo plus lifestyle interventionPlacebo plus lifestyle intervention
berberine groupBerberine plus lifestyle interventionBerberine hydrochloride plus lifestyle intervention
Primary Outcome Measures
NameTimeMethod
Change of visceral fat content6 months

Measurement of visceral fat by computed tomography

Change of liver fat content6 months

Measurement of liver fat content by computed tomography

Secondary Outcome Measures
NameTimeMethod
Change of low-density lipoprotein cholesterol6 months

Measurement of low-density lipoprotein cholesterol

Change of serum triglyceride6 months

Measurement of serum triglyceride (TG)

Change of fasting plasma glucose6 months

Measurement of fasting plasma glucose (FPG)

Change of HbA1c6 months

Measurement of HbA1c

Change of 2-hour postprandial blood glucose6 months

Measurement of 2-hour postprandial blood glucose (2hPG)

Change of homeostatic model assessment-insulin resistance6 months

Homeostatic model assessment-insulin resistance (HOMA-IR)= (fasting insulin (mIU/L) \* FPG (mmol/L)) / 22.5

Change of homeostasis model assessment-insulin sensitivity6 months

Homeostatic model assessment-insulin sensitivity (HOMA-IS)= 1/ HOMA-IR

Change of high-density lipoprotein cholesterol6 months

Measurement of high-density lipoprotein cholesterol

Change of total cholesterol6 months

Measurement of total cholesterol

Change of lipoprotein (a)6 months

Measurement of lipoprotein (a)

Change of apolipoprotein6 months

Measurement of apolipoprotein

Change of metabolic syndrome z-score6 months

Metabolic syndrome z-score calculated by the five components, including waist circumference, HDL-C, blood pressure, TG and FPG. Higher score indicates greater severity of metabolic syndrome

Change of fat liver index6 months

Fat liver index (FLI) calculated by TG, body mass index, gamma-glutamyltransferase (γ-GGT), waist circumference. Higher index indicates higher content of liver fat

Change of body mass index6 months

Weight and height will be combined to report BMI in kg/m\^2

Change of waist-hip ratio6 months

Waist circumference and hip circumference will be combined to report waist-hip ratio.

Change of systolic blood pressure6 months

Measurement of systolic blood pressure (SBP)

Change of diastolic blood pressure6 months

Measurement of diastolic blood pressure (DBP)

Change of homeostasis model assessment-β cell6 months

Homeostatic model assessment (HOMA-β) = (20 x fasting insulin (mIU/L)) / (FPG (mmol/L) - 3.5)

Change of serum homocysteine6 months

Measurement of serum homocysteine

Change of body weight6 months

Measurement of body weight in kg

Change of waist-height ratio6 months

Waist circumference and height will be combined to report waist-height ratio.

Change of visceral fat index6 months

Visceral fat index calculated by waist circumference, body mass index, TG, HDL-C. Higher index indicates higher content of visceral fat

Change of triglyceride glucose index6 months

Triglyceride glucose index (TyG) calculated by TG and FPG. Higher index indicates higher insulin resistance

Change of serum urine acid6 months

Measurement of serum urine acid

Normalization of glucose parameters among participants with prediabetes6 months

Meeting all three criteria: 1) FPG\<6.1 mmol/L; 2) 2hPG\<7.8 mmol/L; 3) HbA1c\<5.7%

Change of waist circumference6 months

Measurement of waist circumference in cm

Trial Locations

Locations (1)

Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases

🇨🇳

Beijing, China

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