Although previous epidemiological studies have been conducted to investigate the relationship between nut consumption and the risk of nonalcoholic fatty liver disease (NAFLD), the evidence remains inconclusive and contentious. The aim of our study was to further conduct a meta-analysis of observational studies to explore the latest evidence of the influence of nut consumption on NAFLD. This meta-analysis included a comprehensive search of all articles published in the PubMed and Web of Science online databases as of April 2023. A total of 11 articles were included, comprising 2 prospective cohort studies, 3 cross-sectional studies, and 7 case–control studies, and a random effects model was used to evaluate the relationship between nuts and NAFLD. Results showed that the odds ratio (OR) of NAFLD was 0.90 (95% CI: 0.81–0.99, p < 0.001) when comparing the highest and lowest total nut intake, indicating a significant negative correlation. Furthermore, subgroup analysis revealed that the protective effect of nuts on NAFLD was more significant in females (OR = 0.88; 95% CI: 0.78–0.98, I2 = 76.2%). In summary, our findings provide support for a protective relationship between nut intake and risk of NAFLD. Further exploration of the association between other dietary components and NAFLD is an important avenue for future research.
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/m3 increase in PM2.5 concentration was significantly correlated with a 4.45% increase in alanine aminotransferase (ALT) level (95% CI: 0.51–8.38%, p = 0.03), a 3.99% increase in aspartate transferase (AST) level (95% CI: 0.88–7.10%, p = 0.01), and a 2.91% increase in gamma-glutamyl transferase (GGT) level (95% CI: 1.18–4.64%, p < 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.
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