A meta-analysis and systematic review on the association between air pollution and chronic liver diseases.

IF 3.4 3区医学 Q3 NANOSCIENCE & NANOTECHNOLOGY

Nanotoxicology Pub Date : 2025-09-29 DOI:10.1080/17435390.2025.2565212

Sibo Gao, Li Tian, Yao Zeng, Huili Wang, Yang Yu

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引用次数: 0

Abstract

Background and aims: Air pollution represents the second most significant global health burden, and existing epidemiological studies have reported that air pollution is harmful to the liver. To comprehensively understand the relationship between air pollution and liver health, this study quantitatively assessed the effects of air pollutants on liver diseases based on published population studies.

Methods and results: 46 papers from PubMed, Cochrane Library, and Web of Science were included in this study. The study we included covered Asia, Europe, and the Americas, mainly from China (23/46), the United States (7/46), and the United Kingdom (3/46). This study has been registered on PROSPERO (CRD42024515689). A WHO-approved risk of bias (ROB) assessment tool specialized for air quality research was applied to evaluate the bias in the included studies. Statistical analyses were performed in R 4.3.2 with fixed/random-effects models (threshold: I²>50%). Effect values (odds ratio [ORs]/weighted mean differences [WMDs]) were standardized per 10 μg/m³ increment, with sensitivity analysis (leave-one-out), and publication bias tests (Begg/Egger) at P < 0.05. The results indicated that each 10 μg/m³ increment in particulate matter 2.5 mum (PM_2.5) was associated with increased levels of aspartate aminotransferase (AST) (3.25%, 95% CI: 0.87-5.68), alanine aminotransferase (ALT) (1.82%, 95% CI: 0.60-3.04), and gamma-glutamyl transferase (GGT) (1.86%, 95% CI: 0.70-3.01); as well as increased risk of metabolic dysfunction-associated fatty liver disease (MAFLD) (OR = 1.32, 95% CI: 1.21-1.44), liver cancer incidence (OR = 1.22, 95% CI: 1.11-1.35), and liver cancer mortality (OR = 1.47, 95% CI: 1.14-1.90). Particulate matter 10 mum (PM₁₀) and nitrogen dioxide (NO₂) exposure also correlated with elevated liver enzymes. The present study has demonstrated that long-term exposure to air pollutants was associated with a higher risk of developing liver diseases in comparison to short-term exposure. The cohort study yielded more statistically significant findings than the cross-sectional study.

Conclusion: The evidence presented in this study suggested that air pollution was associated with an increased risk of liver enzyme abnormality, incidence of MAFLD, as well as incidence and mortality of liver cancer, reminding the public, environmental and clinical experts, to pay attention to the liver health associated with air pollution.

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空气污染与慢性肝病相关性的meta分析与系统综述。

背景和目的：空气污染是全球第二大健康负担，现有的流行病学研究报告称，空气污染对肝脏有害。为了全面了解空气污染与肝脏健康之间的关系，本研究基于已发表的人口研究，定量评估了空气污染物对肝脏疾病的影响。方法与结果：本研究从PubMed、Cochrane Library和Web of Science中纳入46篇论文。我们纳入的研究覆盖了亚洲、欧洲和美洲，主要来自中国（23/46）、美国（7/46）和英国（3/46）。本研究已在PROSPERO注册（CRD42024515689）。应用世卫组织批准的专门用于空气质量研究的偏倚风险评估工具来评估纳入研究的偏倚。采用r4.3.2进行统计分析，采用固定/随机效应模型（阈值：I2 bb0 50%）。效应值（优势比[ORs]/加权平均差异[wmd]）每增加10 μg/m³进行标准化，并进行敏感性分析（留一），发表偏倚试验（Begg/Egger）在PM2.5中增加3时，与天冬氨酸转氨酶（AST）（3.25%, 95% CI: 0.87-5.68）、丙氨酸转氨酶（ALT）（1.82%, 95% CI: 0.60-3.04）和γ -谷氨酰转移酶（GGT）（1.86%, 95% CI: 0.70-3.01）水平升高相关；以及代谢功能障碍相关脂肪性肝病（MAFLD）（OR = 1.32, 95% CI: 1.21-1.44）、肝癌发病率（OR = 1.22, 95% CI: 1.11-1.35）和肝癌死亡率（OR = 1.47, 95% CI: 1.14-1.90）的风险增加。颗粒物（PM10）和二氧化氮（NO2）暴露也与肝酶升高相关。目前的研究表明，与短期接触空气污染物相比，长期接触空气污染物与患肝脏疾病的风险更高有关。队列研究比横断面研究产生了更有统计学意义的结果。结论：本研究证据提示空气污染与肝酶异常、mald发病率、肝癌发病率和死亡率增加相关，提醒公众、环境和临床专家关注空气污染对肝脏健康的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nanotoxicology 医学-毒理学

CiteScore

10.10

自引率

4.00%

发文量

审稿时长

3.5 months

期刊介绍： Nanotoxicology invites contributions addressing research relating to the potential for human and environmental exposure, hazard and risk associated with the use and development of nano-structured materials. In this context, the term nano-structured materials has a broad definition, including ‘materials with at least one dimension in the nanometer size range’. These nanomaterials range from nanoparticles and nanomedicines, to nano-surfaces of larger materials and composite materials. The range of nanomaterials in use and under development is extremely diverse, so this journal includes a range of materials generated for purposeful delivery into the body (food, medicines, diagnostics and prosthetics), to consumer products (e.g. paints, cosmetics, electronics and clothing), and particles designed for environmental applications (e.g. remediation). It is the nano-size range if these materials which unifies them and defines the scope of Nanotoxicology . While the term ‘toxicology’ indicates risk, the journal Nanotoxicology also aims to encompass studies that enhance safety during the production, use and disposal of nanomaterials. Well-controlled studies demonstrating a lack of exposure, hazard or risk associated with nanomaterials, or studies aiming to improve biocompatibility are welcomed and encouraged, as such studies will lead to an advancement of nanotechnology. Furthermore, many nanoparticles are developed with the intention to improve human health (e.g. antimicrobial agents), and again, such articles are encouraged. In order to promote quality, Nanotoxicology will prioritise publications that have demonstrated characterisation of the nanomaterials investigated.