AUTHOR=Li Wei , Zhang Zechen , Li Yuyi , Wu Zhenyu , Wang Chengjie , Huang Zhen , Ye Baisheng , Jiang Xin , Yang Xiaolong , Shi Xiaolin 

TITLE=Effects of total flavonoids of Rhizoma Drynariae on biochemical indicators of bone metabolism: a systematic review and meta-analysis

JOURNAL=Frontiers in Pharmacology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1443235

DOI=10.3389/fphar.2024.1443235

ISSN=1663-9812

ABSTRACT=<sec><title>Background</title><p>Evidence shows that the total flavonoids of Rhizoma Drynariae (TFRD) can improve bone mineral density (BMD). However, there is no evidence to summarize the improvement of biochemical indicators of bone metabolism (BIBM).</p></sec><sec><title>Methods</title><p>The PubMed, Web of Science, Cochrane Library, Embase, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, Chongqing VIP Information Database (VIP) and SinoMed were searched from inception to 6 May 2024. The final included studies performed meta-analyses using RevMan 5.3.</p></sec><sec><title>Results</title><p>Nine randomized controlled trials (RCTs) were ultimately included. The TFRD group had higher bone gla protein (BGP) and type I procollagen-N-propeptide (PINP) compared to the Other therapies (WMD: 5.11; 95% CI: 3.37, 6.84; <italic>p</italic> &lt; 0.00001; WMD: 13.89; 95% CI: 11.81, 15.97; <italic>p</italic> &lt; 0.00001). The tartrate-resistant acid phosphatase (TRACP) decreased significantly (WMD: −1.34; 95% CI: −1.62, −1.06; <italic>p</italic> &lt; 0.00001). The alkaline phosphatase (ALP) increased significantly (WMD: 7.47; 95% CI: 6.29, 8.66; <italic>p</italic> &lt; 0.00001). There were no significant differences in serum calcium (SC) or serum phosphorus (SP) levels between the TFRD and control groups (WMD: 0.08; 95% CI: −0.04, 0.20; <italic>p</italic> = 0.17; WMD: 0.02; 95% CI: −0.02, 0.05; <italic>p</italic> = 0.36).</p></sec><sec><title>Conclusion</title><p>TFRD can stimulate bone formation and prevent bone resorption in osteoporosis (OP) patients, but it has no effect on SC and SP.</p></sec><sec><title>Systematic Review Registration</title><p><ext-link ext-link-type="uri" xlink:href="https://www.crd.york.ac.uk/PROSPERO/" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.crd.york.ac.uk/PROSPERO/</ext-link>.</p></sec>