期刊
ENVIRONMENTAL HEALTH PERSPECTIVES
卷 118, 期 12, 页码 1735-1742出版社
US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE
DOI: 10.1289/ehp.1002720
关键词
environmental liver disease; hepatotoxicity; lead; mercury; NAFLD; NASH; nonalcoholic fatty liver disease; nonalcoholic steatohepatitis; PCBs; polychlorinated biphenyls; TASH
资金
- National Institute of Environmental Health Sciences [P30ES014443-01A1]
- National Center for Research Resources [5P20RR024489-02]
- National Institute on Alcohol Abuse and Alcoholism [1P01AA017103-01, K23AA18399-01A, RC2AA019385]
- Department of Veterans Affairs
- American Association for the Study of Liver Diseases
- National Institutes of Health
BACKGROUND: High-level occupational exposures to some industrial chemicals have been associated with liver diseases, including nonalcoholic fatty liver disease (NAFLD). However, the potential role of low-level environmental pollution on liver disease in the general population has not been evaluated. OBJECTIVE: We determined whether environmental pollutants are associated with an elevation in serum alanine aminotransferase (ALT) activity and suspected NAFLD in U.S. adults. METHODS: This cross-sectional cohort study evaluated adult participants without viral hepatitis, hemochromatosis, or alcoholic liver disease from the National Health and Nutrition Examination Survey (NHANES) for 2003-2004. ALT elevation was defined in men as >= 37 IU/L (age18-20 years) and >= 48 IU/L (age >= 21 years) and in women as >= 30 IU/L (age 18-20 years) and >= 31 IU/L (age >= 21 years). Adjusted odds ratios (ORs) for ALT elevation were determined across exposure quartiles for 17 pollutant subclasses comprising 111 individual pollutants present with at least a 60% detection rate. Adjustments were made for age, race/ethnicity, sex, body mass index, poverty income ratio, and insulin resistance. Individual pollutants from subclasses associated with ALT elevation were subsequently analyzed. RESULTS: The overall prevalence of ALT elevation was 10.6%. Heavy metals and polychlorinated biphenyls (PCBs) were associated with dose-dependent increased adjusted ORs for ALT elevation. Within these subclasses, increasing whole-blood levels of lead and mercury and increasing lipid-adjusted serum levels of 20 PCBs were individually associated with ALT elevation. CONCLUSIONS: PCB, lead, and mercury exposures were associated with unexplained ALT elevation, a proxy marker of NAFLD, in NHANES 2003-2004 adult participants.
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