The sex-specific effects of blood lead, mercury, and cadmium levels on hepatic steatosis and fibrosis: Korean nationwide cross-sectional study
The sex-specific effects of blood lead, mercury, and cadmium levels on hepatic steatosis and fibrosis: Korean nationwide cross-sectional study
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DOI：
10.1016/j.jtemb.2020.126601
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发表时间：
2020-12-01
影响因子：
3.5
通讯作者：
Lee, Hyoung Woo
中科院分区：
文献类型：
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作者：
Chung, Seung Min;Moon, Jun Sung;Lee, Hyoung Woo
目的：重金属对非酒精性脂肪性肝病（NAFLD）的潜在影响尚不清楚。我们调查了血铅（BPb），汞（BHg）和镉（BCd）水平与肝脂肪变性（HS）和纤维化（HF）的性别特异性关系。方法：我们纳入了2016-2017年韩国国家健康和营养检查调查的4420名参与者。排除高危酗酒者和慢性B或C型肝炎感染或肝硬化患者。我们计算了肝脂肪变性指数（HSI）和纤维化-4指数（FIB-4）值;我们将HS和HF的存在分别定义为HSI >= 36和FIB-4评分> 2.67。结果：在男性（n = 1860）中，HSI与BPb水平呈负相关，与BHg水平呈正相关（均P < 0.01）。FIB-4评分与BPb、BCd水平呈正相关（均P < 0.01）。在女性（n = 2560）中，HSI和FIB-4评分与BPb、BHg和BCd水平呈正相关（均p < 0.01）。调整后，BHg水平增加了两名男性的HS风险（OR = 1.065，p = 0.003）和女性（OR = 1.061，p = 0.048），且BCd水平增加女性HF的风险结论：血液重金属水平与HSI、FIB 4评分呈正相关，女性高于男性。BHg水平与男性和女性的HS相关，BCd水平与女性的HF相关。根据重金属状态和性别对NAFLD进展的进一步研究是必要的。
Aim: The potential effects of heavy metals on non-alcoholic fatty liver disease (NAFLD) remain unknown. We investigated the sex-specific relationships of blood lead (BPb), mercury (BHg), and cadmium (BCd) levels with hepatic steatosis (HS) and fibrosis (HF).Method: We included 4420 participants from the 2016-2017 Korea National Health and Nutrition Examination Survey. High-risk alcoholics and patients with chronic hepatitis B or C infections or liver cirrhosis were excluded. We calculated the hepatic steatosis index (HSI) and fibrosis-4 index (FIB-4) values; we defined the presence of HS and HF as an HSI >= 36 and FIB-4 score > 2.67, respectively. We adjusted for age, smoking and alcohol consumption statuses, hypertension, obesity, diabetes, hypertriglyceridemia, and BPb, BHg, and BCd levels.Result: In males (n = 1860), the HSI was correlated negatively with the BPb level and positively with the BHg level (both p < 0.01). The FIB-4 score was correlated positively with the BPb and BCd levels (both p < 0.01). In females (n = 2560), the HSI and FIB-4 score were correlated positively with the BPb, BHg, and BCd levels (all p < 0.01). After adjustments, the BHg level increased the risk of HS in both males (OR = 1.065, p = 0.003) and females (OR = 1.061, p = 0.048), and the BCd level increased the risk of HF in females (OR = 1.668, p = 0.012).Conclusion: Blood heavy metal levels were generally correlated positively with the HSI and FIB4 score, more so in females than males. The BHg level was associated with HS in males and females, and the BCd level was associated with HF in females. Further studies on NAFLD progression according to heavy metal status and sex are warranted.