Research Institute for Environment and Health, Nanjing University of Information Science and Technology, Nanjing 210044, China.
Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China.
Int J Environ Res Public Health. 2023 Feb 4;20(4):2803. doi: 10.3390/ijerph20042803.
Although previous studies have presented that fine particulate matter (PM2.5) regulates liver enzyme levels in the development of liver diseases, the evidence regarding the relationship between PM2.5 exposure and liver enzyme is not robust. We further aimed to conduct a systematic review and meta-analysis of observational studies to summarize the recent evidence on the effects of PM2.5 on liver enzyme in humans. In the meta-analysis, we retrieved online databases including PubMed and Web of Science database from 1982 up to 2022. A random-effects model was applied to evaluate the correlation between PM2.5 and liver enzyme level. A total of 10 studies fulfilled the inclusion criteria, including five prospective cohort studies, two cross-sectional studies, two longitudinal studies, and one time-series analysis. Each 10 μg/m increase in PM2.5 concentration was significantly correlated with a 4.45% increase in alanine aminotransferase (ALT) level (95% CI: 0.51-8.38%, = 0.03), a 3.99% increase in aspartate transferase (AST) level (95% CI: 0.88-7.10%, = 0.01), and a 2.91% increase in gamma-glutamyl transferase (GGT) level (95% CI: 1.18-4.64%, < 0.001), but this significant association was not observed in alkaline phosphatase (ALP). Subgroup analysis revealed that PM2.5 has a significant correlation with ALT (5.07%, 95% CI: 0.81-9.33%), AST (4.11%, 95% CI: 0.74-7.48%), and GGT (2.74%, 95% CI: 1.09-4.38%) in Asia. Our meta-analysis showed that increments in PM2.5 exposure were significantly associated with a higher level of ALT, AST, and GGT. In addition, investigations into liver enzyme subtypes and specific chemical components of PM2.5 are important directions for future research.
虽然先前的研究表明，细颗粒物（PM2.5）在肝病的发展过程中调节肝脏酶水平，但关于 PM2.5 暴露与肝脏酶之间关系的证据并不充分。我们进一步旨在进行系统评价和荟萃分析观察性研究，以总结 PM2.5 对人类肝脏酶影响的最新证据。在荟萃分析中，我们从 1982 年到 2022 年检索了在线数据库，包括 PubMed 和 Web of Science 数据库。应用随机效应模型评估 PM2.5 与肝脏酶水平之间的相关性。共有 10 项研究符合纳入标准，包括 5 项前瞻性队列研究、2 项横断面研究、2 项纵向研究和 1 项时间序列分析。PM2.5 浓度每增加 10 μg/m3，丙氨酸氨基转移酶（ALT）水平显著升高 4.45%（95%CI：0.51-8.38%， = 0.03），天冬氨酸氨基转移酶（AST）水平升高 3.99%（95%CI：0.88-7.10%， = 0.01），γ-谷氨酰转移酶（GGT）水平升高 2.91%（95%CI：1.18-4.64%，<0.001），但碱性磷酸酶（ALP）未见显著相关性。亚组分析表明，PM2.5 与 ALT（5.07%，95%CI：0.81-9.33%）、AST（4.11%，95%CI：0.74-7.48%）和 GGT（2.74%，95%CI：1.09-4.38%）在亚洲显著相关。我们的荟萃分析表明，PM2.5 暴露增加与 ALT、AST 和 GGT 水平升高显著相关。此外，对肝脏酶亚型和 PM2.5 的特定化学组分的研究是未来研究的重要方向。
