Antioxidant and Anti-Inflammatory Properties of Hydroxyl Safflower Yellow a in Diabetic Nephropathy: A Meta-Analysis of Randomized Controlled Trials

Systematic review and meta-analysis of 31 randomized controlled trial groups involving 2487 participants with diabetic nephropathy. All included populations were Chinese and received HSYA in addition to conventional treatment.

Hydroxyl safflower yellow A (HSYA) was given intravenously, typically as an add-on to conventional therapy. The review did not provide a consistent per-arm dose or duration for individual trials, although subgroup analyses referenced doses of ≤100 mg versus >100 mg.

HSYA showed overall benefit for diabetic nephropathy, with improvements in glycemic control, insulin resistance, lipids, inflammation, and oxidative stress, alongside better renal function indices. Pooled effects favored HSYA for FBG (SMD = -0.63, 95% CI -1.05 to -0.21), PBG (SMD = -0.51, 95% CI -0.98 to -0.03), HOMA-IR (SMD = -1.35, 95% CI -2.06 to -0.65), TC (SMD = -1.03, 95% CI -1.25 to -0.80), TG (SMD = -1.05, 95% CI -1.28 to -0.82), hsCRP (SMD = -1.96, 95% CI -2.55 to -1.38), IL-6 (SMD = -1.94, 95% CI -2.79 to -1.10), TNF-α (SMD = -1.32, 95% CI -1.96 to -0.67), MDA (SMD = -1.63, 95% CI -2.69 to -0.57), and GSH-Px (SMD = 0.88, 95% CI 0.57 to 1.19). HbA1C was borderline significant (SMD = -0.55, 95% CI -1.11 to -0.00; p = 0.05), and the review reported no adverse effects in the included clinical trials.

Evidence is limited by low study quality, small sample sizes, and substantial heterogeneity across outcomes, with I2 values often above 85%. All participants were Chinese, so generalizability is limited, and dosing details were inconsistently reported. Safety evidence is weak because adverse events were not systematically reported, and oral HSYA remains untested in this evidence base.