Table 5.

The role of silybin in metabolic syndrome.

Diseases	Key associated effect	Regulated factors	Reference
Diabetes mellitus and its complications	↑ Activate the PI3K-Akt signaling pathway, stabilize ERα/ERβ expression, induce protective autophagy; ↓ mTOR signaling pathway, and protect pancreatic islet β-cells	↑PI3K-Akt signaling pathway, ↓ mTOR signaling pathway	(17)
	↓ pro-inflammatory cytokine levels;↑ AMPK signaling pathway; ↓TGF-β1/Smad pro-fibrotic signaling pathway	↓ TNF-α,IL-1β,IL-6,↑ AMPK signaling pathway; ↓ TGF-β1/Smad pro-fibrotic signaling pathway	(66)
	↓miR-122 regulates key enzymes in lipid metabolism	↓ miR-122, ↓ FAS, ↓ ACC, ↑ CPT1A	(72)
	↑ PI3K/AKT/GSK-3β signaling pathway; ↑ Nrf2 nuclear translocation; ↑ Erα; ↑ GLP-1 secretion	↑ PI3K/AKT/GSK-3β signaling pathway, ↑ Nrf2 nuclear translocation, ↑ GLP-1	(73)
Abnormal lipid metabolism/fatty liver disease	↓ NF-κB signaling pathway; ↓ adipose tissue inflammation; ↑ Nrf2 antioxidant pathway, restore adiponectin; ↓ lipid uptake and synthesis; ↑ glucose and lipid metabolism	↓ NF-κB signaling pathway, ↑ Nrf2 antioxidant pathway,↓ CD36, ↓ FAS, ↓ ACC	(74)
	↓ phosphorylation of the Erk signaling pathway, block obesity-associated liver carcinogenesis	↓ phosphorylation of the Erk signaling pathway,↓ FASN, ↓ IL-6, ↓ IL-1β	(75)
	↑ lipid class switching, regulates triglyceride and phospholipid metabolism		(76)
MASLD	target FXR, regulate gut microbiota and 7-KDCA production, and negatively regulate the FXR pathway		(77)
NASH	↓ NETs formation, macrophage inflammation	↓ NETs	(78)

“↑” represents silybin’s promoting effect. “↓” represents silybin’s inhibiting effect.