3.2. | Characteristics of included studies
The characteristics of included studies were abstracted in Table
2 . Selected eligible trials enrolled 549 participants with age ranging
from 30.7 to 59.4 years old and were conducted on both genders. All
trials were conducted in Italy, which involved 549 patients with
dyslipidemic patients and overweight [5] euglycemic with statins at
high doses and overweight [7] dyslipidemic and euglycemic with
statins at high doses and overweight [6], type 2 diabetes mellitus
[9], type 1 diabetic [42]. Publication dates ranged from 2013
and 2016. All of the included studies had parallel designs. The
participants of all studies were of both genders. All studies used
berberis aristata/silybum marianum for intervention. The cases received
a daily dose of berberis aristata
from 1176 mg/day plus silybum marianum from 210 mg/day except Guarino
study with dose of BBR-aristata from 1000 mg/day plus silybum marianum
from 300 mg/day [9] and the control group received a placebo. The
intervention duration was from 12 to 24 weeks.
3.3. | Effect of BBR and silymarin on liver enzymes The effect of BBR-silymarin on serum
ALT and AST was reported in all
studies. The combined supplementation was found to not significantly
reduce in ALT (WMD: −0.39 mg/dl;
95% CI: −1.67 to 0.89, P=0.55) (I2=39.3%,
P<0.001) (Figure 2) and AST (WMD: −0.44 mg/dl; 95%
CI: −2.02 to 1.14, P=0.58) (I2=35.9%,
P<0.001) (Figure 3).