A Berberine-containing combination preparation and ultrasound-derived fat fraction in hepatic steatosis: a single-center observational case series

Background

Hepatic steatosis is the most common chronic liver disease, but pharmacologic options remain limited. Berberine reduces hepatic fat in randomized trials, but has very low oral bioavailability and has been studied almost exclusively as high-dose (1.0–1.5 g/day) capsules. Case Presentation: We report a single-center, retrospective, uncontrolled before–after case series of 25 adults with ultrasound-defined hepatic steatosis who used a liquid berberine-containing combination preparation during routine care, without a prescribed lifestyle intervention or control group. Twenty patients (16 men; mean age 57 years) had paired UDFF measurements and were included in the complete-case analysis; five lacked follow-up measurements. After a median of 7 weeks, UDFF decreased from 18.2 ± 6.3% to 11.2 ± 4.8% among complete cases (mean change −7.1 percentage points; 95% CI −9.1 to −5.0; p < 0.001). All 20 complete cases had a lower follow-up value, and 12 (60%) had a ≥30% relative reduction. In a conservative sensitivity analysis assigning zero change to the five patients without follow-up, the mean change was −5.6 percentage points and 12 of 25 (48%) met the ≥30% threshold. No adverse events were documented in the available routine-care records.