Berberine 1 g a Day for 6 Months Did Not Reduce Liver Fat or Visceral Fat: 337-Person Trial

Berberine, an alkaloid found in medicinal plants such as Coptis and Phellodendron, has drawn attention as an ingredient for improving metabolic disease, but randomised trial results published in JAMA Network Open show it did not reduce visceral fat or liver fat in people with obesity and metabolic dysfunction-associated steatotic liver disease (MASLD). The trial, called BRAVO, was led by the National Clinical Research Center for Cardiovascular Diseases at Fuwai Hospital in China.

No difference in CT-measured visceral fat or liver fat

At 11 hospitals in China, 337 adults with obesity and MASLD but without diabetes (average age 41.8) were split into a berberine 1 g/day group (169) and a placebo group (168) and compared double-blind for 6 months. Medication adherence was about 90% in both groups. There were no significant differences between the groups in the relative change in visceral fat area or the change in liver fat content measured by computed tomography (CT).

Among secondary measures, LDL cholesterol fell about 0.2 mmol/L (7.7 mg/dL) more and apolipoprotein B about 3.4 mg/dL more in the berberine group than in the placebo group, and the inflammation marker hs-CRP also fell slightly. The rate of adverse events was similar in the two groups.

The trial included only Chinese participants and lasted 6 months, and the abstract does not state the clinical trial phase. The lipid improvements are secondary measure results and need separate verification.