Effects of berberine on the serum cystatin C levels and urine albumin/creatine ratio in patients with type 2 diabetes mellitus

Abstract

Objective: To investigate the effects of berberine on urine albumin/creatine ratio (UACR) and serum cystatin C (Cys C) in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 114 T2DM inpatients or outpatients, including 46 males and 68 females aged (55±14) years between January 2015 and January 2016 were randomly divided into two groups: the control group (n=57) only with hypoglycemic agents, and the intervention group (n=57) with berberine (0.4 g, 3 times a day) on the basis of treatment from the control group. Both groups were treated and followed up for six months. All the clinical and biochemical parameters were routinely evaluated before and after treatment. And the safety of berberine was assessed. Results: After the treatment, the improvement of glycosylated hemoglobin (HbA1c), blood urea nitrogen (BUN), systolic pressure (SP), high sensitive C-reactive protein (hs-CRP), rythrocyte sedimentation rate (ESR), estimated glomerular filtration rate (eGFR) in the intervention group were significantly better than those in the control group (all P<0.05), as well as the UACR[47(26, 120) mg/g vs 103(42, 267) mg/g, P<0.001]and serum Cys C[(0.83±0.30) mg/L vs (0.98±0.25) mg/L, P=0.031]. However, there was no statistically significant difference of UACR and Cys C between before and after treatment in the control group (all P>0.05). Compared to the control group, the patients in the intervention group had lesser UACR[47(26, 120) mg/g vs 68(28, 158) mg/g, P=0.039], and lower serum Cys C[(0.83±0.30) mg/L vs (0.96±0.30)mg/L, P=0.041]. Berberine had no obvious adverse effects. Multiple linear regression analysis revealed that the berberine administration was independently associated with the reduction of UACR (β=-0.051, P=0.041) and Cys C (β=-0.068, P=0.033) in T2DM patients. Conclusion: Berberine improves diabetic kidney disease by reducing UACR and serum Cys C in T2DM patients, and it was safe.