Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, PR China.
Research Institute for Environment and Health, Nanjing University of Information Science and Technology, Nanjing, Jiangsu, 210044, China.
Food Funct. 2024 Sep 30;15(19):9813-9832. doi: 10.1039/d4fo03082f.
: due to the high incidence of liver disease and the severity of adverse outcomes, liver disease has become a serious public health problem, bringing a huge disease burden to individuals, families, and society. Most studies have shown significant differences in serum carotenoid content and dietary carotenoid intake between liver disease patients and non-liver disease patients, but some studies have reported contrary results. This paper aimed to systematically review and analyze all published epidemiological studies on carotenoids and liver disease to quantitatively assess the relationship between serum and dietary carotenoid concentrations and liver disease. : by systematically searching PubMed, Web of Science, Scopus, Embase, and Cochrane databases according to pre-combined search terms from inception to July 23, 2024, 30 studies were found to meet the exclusion criteria. Finally, 3 RCT studies, 6 cohort studies, 11 case-control studies, 9 cross-sectional studies, and 1 RCT-combined cross-sectional study were included in the further analysis. Two reviewers independently scored the literature quality and extracted data, and the results were represented by the standard mean difference (SMD) with a 95% confidence interval. Cochran statistics and statistics were used to evaluate statistical heterogeneity (defined as significant when < 0.05 or > 50%). When there was insignificant heterogeneity, a fixed effects model was selected; otherwise a random effects model was used. Publication bias was assessed by the Egger test. : pooled meta-analysis showed that serum α-carotene (SMD = -0.58, 95% CI (-0.83, -0.32), < 0.001), β-carotene (SMD = -0.81, 95% CI (-1.13, -0.49), < 0.001), and lycopene (SMD = -1.06, 95% CI (-1.74, -0.38), < 0.001) were negatively correlated with the risk and severity of liver disease. However, no significant difference was observed between serum β-cryptoxanthin (SMD = 0.02, 95% CI (-0.41, 0.45), = 0.92) and lutein/zeaxanthin (SMD = 0.62, 95% CI (-1.20, 2.45), = 0.502). Dietary β-carotene intake (SMD = -0.22, 95% CI (-0.31, -0.13), < 0.001) was negatively associated with the risk of liver disease. The Egger test showed no publication bias ( > 0.05). An intake of more than 6 mg of carotenoids on an energy-restricted diet can effectively alleviate the symptoms of NAFLD. : lower serum concentrations of α-carotene, β-carotene, and lycopene were associated with a higher risk of liver disease. Meanwhile, dietary intake of β-carotene could reduce the incidence of liver disease. However, for malignant diseases such as liver cancer, it did not show the significant effects of carotenoid supplementation.
由于肝病发病率高，不良预后严重，肝病已成为严重的公共卫生问题，给个人、家庭和社会带来了巨大的疾病负担。大多数研究表明，肝病患者和非肝病患者的血清类胡萝卜素含量和饮食类胡萝卜素摄入存在显著差异，但也有一些研究报告了相反的结果。本研究旨在系统地回顾和分析所有已发表的关于类胡萝卜素与肝病的流行病学研究，以定量评估血清和饮食类胡萝卜素浓度与肝病之间的关系。
通过系统检索 PubMed、Web of Science、Scopus、Embase 和 Cochrane 数据库，根据预先组合的检索词，从成立到 2024 年 7 月 23 日进行搜索，共发现 30 项研究符合排除标准。最终，纳入了 3 项 RCT 研究、6 项队列研究、11 项病例对照研究、9 项横断面研究和 1 项 RCT 与横断面研究的组合。两名评审员独立对文献质量进行评分并提取数据，结果用标准均数差（SMD）表示，置信区间为 95%。Cochran 统计量和 I 2 统计量用于评估统计学异质性（当 < 0.05 或 > 50%时定义为显著）。当异质性不显著时，选择固定效应模型；否则，选择随机效应模型。采用 Egger 检验评估发表偏倚。
汇总分析显示，血清 α-胡萝卜素（SMD = -0.58，95%CI（-0.83，-0.32）， < 0.001）、β-胡萝卜素（SMD = -0.81，95%CI（-1.13，-0.49）， < 0.001）和番茄红素（SMD = -1.06，95%CI（-1.74，-0.38）， < 0.001）与肝病的风险和严重程度呈负相关。然而，血清 β-隐黄质（SMD = 0.02，95%CI（-0.41，0.45）， = 0.92）和叶黄素/玉米黄质（SMD = 0.62，95%CI（-1.20，2.45）， = 0.502）之间无显著差异。饮食中 β-胡萝卜素的摄入（SMD = -0.22，95%CI（-0.31，-0.13）， < 0.001）与肝病的风险呈负相关。Egger 检验显示无发表偏倚（ > 0.05）。在限制能量的饮食中摄入超过 6 毫克的类胡萝卜素可以有效缓解非酒精性脂肪性肝病的症状。
血清中 α-胡萝卜素、β-胡萝卜素和番茄红素浓度较低与肝病风险增加有关。同时，β-胡萝卜素的饮食摄入可以降低肝病的发生率。然而，对于肝癌等恶性疾病，类胡萝卜素补充并没有显示出显著的效果。
