Association of per- and polyfluoroalkyl substance exposure with fatty liver disease risk in US adults.
Association of per- and polyfluoroalkyl substance exposure with fatty liver disease risk in US adults.
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DOI：
10.1016/j.jhepr.2023.100694
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发表时间：
2023-05
期刊：
影响因子：
8.3
通讯作者：
Zhang, Xuehong
中科院分区：
文献类型：
--
作者：
Zhang, Xinyuan;Zhao, Longgang;Ducatman, Alan;Deng, Chuanjie;von Stackelberg, Katherine Ellen;Danford, Christopher J.;Zhang, Xuehong
关键词：
全氟烷基和多氟烷基物质（PFAS）是广泛存在的污染物，具有肝毒性。很少有研究在成年人群中检查PFAS与脂肪肝疾病（FLD）风险之间的关联。在这项针对2017-2018年国家健康和营养检查调查参与者的横断面研究中，测量了血清PFAS，并通过振动控制瞬态弹性成像确定了FLD病例。Logistic回归模型被用来检查循环PFAS水平和FLD风险之间的关联。分析按酒精摄入状态分为非酒精性FLD和酒精性FLD风险组，并控制其他风险因素，包括个人人口统计学，生活方式因素和相关健康因素。在1，135名合格参与者中，446人患有FLD。对于FLD风险，全氟己烷磺酸盐（PFHxS）的多变量校正比值比/对数转换SD增加（ORSD）为1.13（95% CI 1.01-1.26）。PFHxS与FLD的相关性在肥胖或高脂饮食的个体中更强（均P <0.05）。当将分析限制在212名酗酒者时，（女性≥2杯/天，男性≥3杯/天），全氟辛酸水平越高，酒精性FLD的风险越高（ORSD 1.79; 95% CI 1.07-2.99），PFHxS（ORSD 2.06; 95% CI 1.17-3.65）和全氟庚烷磺酸（ORSD 1.44; 95% CI 1.00-2.07），总PFAS的风险略高（ORSD 2.12; 95% CI 0.99-4.54）。在从不或少量饮酒者中，我们没有观察到PFAS与非酒精性FLD之间有任何显著相关性。发现PFAS与天冬氨酸转氨酶、γ-谷氨酰转氨酶、总胆红素和白蛋白显著正相关（β范围为0.008至0.101，均p <0.05）。在一般人群中，较高的血清PFAS与FLD风险和肝功能恶化中度相关，并且在具有独立风险因素的人群中，包括大量饮酒，肥胖或高脂饮食，PFAS增加了风险。这些结果表明，在全国代表性的美国人群中，通过生物监测数据和生活方式风险因素测量的PFAS暴露对肝脏脂肪变性具有协同效应。全氟烷基和多氟烷基物质（PFAS）可能会增加人类慢性肝病的风险。在2017-2018年国家健康和营养检查调查的1，135名美国成年人中，我们发现血清PFAS较高与脂肪肝风险较高和肝功能较差相关，特别是在具有肝病风险因素的人群中，包括大量饮酒，肥胖或高脂肪饮食。持续监测人群中的PFAS并检查它们如何增强肝脏风险至关重要。PFAS可能会增加人类慢性肝病的风险。我们发现，较高的血清PFAS与较高的脂肪肝疾病风险和肝功能较差相关。这在那些有肝病风险因素的人中尤其明显，包括大量饮酒，肥胖或高脂肪饮食。持续监测人群中的PFAS并检查它们如何增强肝脏风险至关重要。
Per- and polyfluoroalkyl substances (PFAS) are widespread pollutants with demonstrated hepatotoxicity. Few studies have examined the association between PFAS and fatty liver disease (FLD) risk in an adult population. In this cross-sectional study of participants from the 2017–2018 National Health and Nutrition Examination Survey, serum PFAS were measured, and FLD cases were ascertained by vibration-controlled transient elastography. Logistic regression models were used to examine the association between circulating PFAS levels and FLD risk. Analyses were stratified into non-alcoholic FLD and alcoholic FLD risk groups by alcohol intake status, as well as controlling for other risk factors, including personal demographics, lifestyle factors, and related health factors. Among 1,135 eligible participants, 446 had FLD. For FLD risk, the multivariable-adjusted odds ratio per log-transformed SD increase (ORSD) in perfluorohexane sulfonate (PFHxS) was 1.13 (95% CI 1.01–1.26). The association between PFHxS and FLD appeared stronger among individuals with obesity or high-fat diets (both pinteraction <0.05). When limiting the analysis to 212 heavy drinkers (≥2 drinks/day for women and ≥3 drinks/day for men), significantly higher risk of alcoholic FLD was found for higher levels of perfluorooctanoic acid (ORSD 1.79; 95% CI 1.07–2.99), PFHxS (ORSD 2.06; 95% CI 1.17–3.65), and perfluoroheptane sulfonic acid (ORSD 1.44; 95% CI 1.00–2.07), and marginally significant higher risk for total PFAS (ORSD 2.12; 95% CI 0.99–4.54). In never or light drinkers, we did not observe any significant association between PFAS and non-alcoholic FLD. Significant positive associations were found for PFAS with aspartate aminotransferase, gamma-glutamyl transaminase, total bilirubin, and albumin (β ranged from 0.008 to 0.101, all p <0.05). Higher serum PFAS was moderately associated with FLD risk and worse liver function in the general population, and among those with independent risk factors, including heavy alcohol intake, obesity, or high-fat diets, PFAS increased the risk. These results suggest synergistic effects on hepatic steatosis between PFAS exposures as measured through biomonitoring data and lifestyle risk factors in a nationally representative US population. The per- and polyfluoroalkyl substances (PFAS) may convey higher risk for chronic liver disease in humans. Among 1,135 US adults in the 2017–2018 National Health and Nutrition Examination Survey, we found that higher serum PFAS was associated with higher fatty liver disease risk and worse liver function, especially among those with liver disease risk factors, including heavy alcohol intake, obesity, or high-fat diets. Continuously monitoring PFAS in the population and examining how they potentiate risk to the liver are essential. PFAS may convey higher risk for chronic liver disease in humans. We found that higher serum PFAS was associated with higher fatty liver disease risk and worse liver function. This was especially evident in those with liver disease risk factors, including heavy alcohol intake, obesity, or high-fat diets. Continuously monitoring PFAS in the population and examining how they potentiate risk to the liver are essential.
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影响因子：
11.8
作者：
Chen Z;Yang T;Walker DI;Thomas DC;Qiu C;Chatzi L;Alderete TL;Kim JS;Conti DV;Breton CV;Liang D;Hauser ER;Jones DP;Gilliland FD
通讯作者：
Gilliland FD
影响因子：
10.4
作者：
通讯作者：
--
影响因子：
8.3
作者：
Jain, Ram B.;Ducatman, Alan
通讯作者：
Ducatman, Alan
影响因子：
25.7
作者：
Asrani, Sumeet K.;Devarbhavi, Harshad;Kamath, Patrick S.
通讯作者：
Kamath, Patrick S.
DOI：
10.1039/d0em00291g
发表时间：
2020-12-01
期刊：
Environmental science. Processes & impacts
影响因子：
--
作者：
Glüge J ;Scheringer M ;Cousins IT ;DeWitt JC ;Goldenman G ;Herzke D ;Lohmann R ;Ng CA ;Trier X ;Wang Z
通讯作者：
Wang Z