Coptidis Rhizoma for Obesity, Diabetes, and Dyslipidemia: An Integrated Meta-Analysis and In Silico Study

Obesity, diabetes, and dyslipidemia form an interconnected metabolic disease cluster driven by insulin resistance and chronic inflammation. This study evaluated the clinical efficacy and multi-target mechanisms of Coptidis Rhizoma for these metabolic disorders through an integrated systematic review, meta-analysis of randomized controlled trials (RCTs), network pharmacology, and molecular docking. Meta-analysis of 19 RCTs (n = 1718) demonstrated that Coptidis-containing formulations, primarily as adjunctive therapy, significantly improved primary clinical endpoints across all three metabolic conditions: body mass index (BMI: SMD = -0.72, 95% CI [-1.00, -0.44], p < 0.00001), glycated hemoglobin (HbA1c: SMD = -0.77, 95% CI [-1.07, -0.47], p < 0.00001), and low-density lipoprotein cholesterol (LDL-C: SMD = -1.10, 95% CI [-1.57, -0.62], p < 0.00001). Network analysis revealed shared targets enriched in lipid metabolism, inflammatory signaling, and PI3K-Akt/MAPK cascades. Molecular docking demonstrated favorable structural compatibility and predicted docking scores (ranging from -7.1 to -9.5 kcal/mol) of berberine toward key hub proteins, including PIK3CA, JAK2, MAOA, and PARP1. Consequently, Coptidis Rhizoma provides tangible clinical benefits across interconnected metabolic outcomes via the multi-target regulation of inflammatory and insulin signaling pathways. Clinically, Coptidis-containing formulations show promise as a complementary adjunct to conventional metabolic therapies, though future large-scale, standardized RCTs remain necessary to confirm long-term safety and optimize dosing regimens.