FIGURE 3.

Efficacy and underlying mechanisms of berberine against lipid metabolic diseases. The liver and intestine are important organs for endogenous and exogenous lipid production, respectively, and regulate the body’s lipid levels. Cluster of differentiation 36 (CD36), acetyl-CoA carboxylase (ACC), and microsomal triglyceride transfer protein (MTTP) are the liver targets for lipid production. At the same time, ATP-binding cassette transporter A1 (ABCA1), scavenger receptor class B type 1 (SR-BI), and low-density lipoprotein receptor (LDLR) are the liver targets for lipid clearance. Risk factors such as irrational diet and disease promote lipogenesis and inhibit lipid clearance by up-regulating CD36, ACC, and MTTP and down-regulating SR-BI, LDLR, and ABCA1, elevating circulating lipid levels and exacerbating hepatic fat accumulation. Intestinal flora is an important micro-ecosystem of the intestine, which is greatly influenced by diet. High-fat diet aggravates the body’s lipid burden by altering the intestinal flora’s composition and its metabolites’ production. Elevated circulating lipid levels lead to vascular endothelial dysfunction, macrophage foam cell formation, and vascular smooth muscle cell hyperproliferation, accelerating the formation of atherosclerosis. Berberine works against lipid metabolic diseases by synergistically regulating multiple lipid metabolism-related targets in the liver, gut, and blood vessels.