Moringa oleifera on hyperglycemia and hypertension in metabolic diseases: Systematic review, exploratory meta-analysis and meta-regression

Background Moringa oleifera ( M. oleifera ) has shown potential efficacy in animal models of metabolic disorders treatment; however, clinical evidence has been obtained from small sample sizes, and the findings remain contradictory. This study aims to evaluate the effects of M . oleifera on hypertension and hyperglycemia in individuals with metabolic disorders. Method This was a registered meta-analysis (CRD420251184037) that employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search was conducted on PubMed, Scopus, Web of Science, Cochrane Library, ScienceDirect, and ResearchGate. The umbrella terms moringa oleifera Lam , moringa oleifera, and metabolic diseases were used, along with Boolean operators (OR, AND), and each database was adjusted accordingly. A meta-analysis web tool and JAMOVI version 2.6.44.0 were used to analyze the data, with results reported as mean differences (MD) or standardized mean differences (SMDs) and 95% confidence intervals (CI). Results Twenty clinical studies, conducted in patients with metabolic diseases, were analyzed. The pooled estimates suggest a modest association between M. oleifera and fasting blood glucose, SMD = -0.70, 95% CI (-1.06, -0.34), p = 0.0002, and glycated hemoglobin, MD = -0.62%, 95% CI (-0.99, -0.25), p = 0.0009. Furthermore, M. oleifera was associated with reduced diastolic blood pressure, MD = -6.82 mmHg, 95% CI (-7.84, -5.80), p < 0.0001, and systolic blood pressure, MD = -7.50 mmHg, 95% CI (-10.96, -4.03), p < 0.0001. Meta-regression showed that patients' conditions and the continent where the study was conducted were significant moderators of the effect sizes, especially for FBG and SBP. Conclusion The evidence gathered in this study suggests that M. oleifera may have potential in patients with metabolic disorders. However, due to heterogeneity and limitations in the study quality, these findings must be considered preliminary and hypothesis-generating and thus highlight the need for future powered condition-specific trials.