Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Eur J Nutr. 2019 Aug;58(5):1759-1769. doi: 10.1007/s00394-018-1711-4. Epub 2018 May 14.
The relationship between consumption of sugar sweetened beverages (SSB) and NAFLD has been reported in several epidemiological studies, but the results are inconsistent. The present systematic review and meta-analysis of observational studies was carried out to assess the relationship between sugar sweetened beverages consumption and NAFLD.
Online databases were searched systematically through December, 2016 for studies investigating association between SSB consumption and NAFLD but limited to observational studies in human. Pooled odds ratio (OR) and 95% confidence intervals were calculated using Der-Simonian and Laird method while random effects meta-analysis was used, taking into account conceptual heterogeneity. Heterogeneity was assessed with the Cochran Q statistic and quantified with the I statistic.
Of the 1015 identified articles, 42 were reviewed in depth and six studies (four cross-sectional, one case-control, and one cohort) met the criteria for inclusion in our systematic review with 6326 participants and 1361 cases of NAFLD in both men and women. Finally, four cross-sectional studies were included in the meta-analysis. Higher intake of SSBs (highest compared to lowest categories) was significantly associated with NAFLD, with a 40% increased Odds of NAFLD after adjusting for important potential confounders (pooled odds ratio 1.40; 95% CI 1.07, 1.82). There was no evidence for significant heterogeneity across studies [P = 0.226 (Q statistics), I = 31.0%]. A significant positive association between SSB consumption and NAFLD was observed consistently in a sensitivity analysis [range of summary ORs 1.39-1.49]. There was no evidence of publication bias for the association between SSB and NAFLD.
This meta-analysis supports a positive significant association between higher consumption of SSB and NAFLD in both men and women. These findings strengthen the evidence that intake of SSBs should be limited to reduce fatty liver disease.
已有几项流行病学研究报道了糖饮料（SSB）的消费与非酒精性脂肪性肝病（NAFLD）之间的关系，但结果并不一致。本系统评价和观察性研究的荟萃分析旨在评估糖饮料消费与 NAFLD 之间的关系。
通过在线数据库检索，系统地搜索了截至 2016 年 12 月调查 SSB 消费与 NAFLD 之间关系的研究，但仅限于人类的观察性研究。使用 Der-Simonian 和 Laird 方法计算汇总优势比（OR）和 95％置信区间，同时考虑到概念异质性，采用随机效应荟萃分析。使用 Cochran Q 统计量评估异质性，并使用 I 统计量量化异质性。
在 1015 篇确定的文章中，有 42 篇进行了深入审查，有 6 项研究（4 项横断面研究、1 项病例对照研究和 1 项队列研究）符合我们的系统评价标准，共有 6326 名参与者，其中男性和女性均有 1361 例 NAFLD。最后，有 4 项横断面研究纳入荟萃分析。调整了重要的潜在混杂因素后，SSB 摄入量较高（最高与最低类别相比）与 NAFLD 显著相关，NAFLD 的发生几率增加了 40％（汇总 OR 1.40；95％CI 1.07，1.82）。研究之间没有显著的异质性[P=0.226（Q 统计量），I=31.0％]。在敏感性分析中，观察到 SSB 消耗与 NAFLD 之间存在显著的正相关[汇总 OR 范围为 1.39-1.49]。SSB 与 NAFLD 之间的关联不存在发表偏倚的证据。
这项荟萃分析支持 SSB 消耗与男性和女性 NAFLD 之间存在显著正相关。这些发现加强了摄入 SSB 应受到限制以减少脂肪肝疾病的证据。
