Lin Yen-Chih, Lian Ie-Bin, Kor Chew-Teng, Chang Chia-Chu, Su Pei-Yuan, Chang Wan-Tzu, Liang Yu-Fen, Su Wei-Wen, Soon Maw-Soan
Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Institute of Statistics and Information Science, National Changhua University of Education, Taiwan.
BMJ Open. 2017 Jan 23;7(1):e014215. doi: 10.1136/bmjopen-2016-014215.
Metabolic factors are major risk factors for non-alcoholic fatty liver disease although other factors may also contribute to development of fatty liver disease. We explored the association between exposure to soil heavy metals and prevalence of fatty liver disease.
We retrospectively analysed data from patients diagnosed with fatty liver disease in 2014 at the Health Evaluation Centre of Chang-Hua Christian Hospital (n=1137). We used residency data provided in the records of the Health Evaluation Centre and data for soil metal concentrations from a nationwide survey conducted by the Environmental Protection Administration of Taiwan. We studied the correlations between the severity of fatty liver disease and concentrations of soil heavy metals (arsenic, mercury, cadmium, chromium, copper, nickel, lead and zinc).
The prevalence of moderate to severe fatty liver disease in our study was 26.5%. Using univariate and multivariate analysis, we demonstrated that the presence of soil heavy metals was a significant risk factor for fatty liver disease in men (OR 1.83, 95% CI 1.161 to 2.899, p=0.009). With stratification by body mass index (BMI) and gender, lean men with a BMI <24 kg/m were the most susceptible to soil heavy metals (OR 5.059, 95% CI 1.628 to 15.728, p<0.05).
Our study suggested a significant association between exposure to soil heavy metals and fatty liver disease in lean men.
代谢因素是非酒精性脂肪性肝病的主要危险因素，尽管其他因素也可能导致脂肪性肝病的发生。我们探讨了土壤重金属暴露与脂肪性肝病患病率之间的关联。
我们回顾性分析了2014年在彰化基督教医院健康评估中心被诊断为脂肪性肝病的患者数据（n = 1137）。我们使用了健康评估中心记录中提供的居住数据以及台湾环境保护局进行的全国性调查中的土壤金属浓度数据。我们研究了脂肪性肝病严重程度与土壤重金属（砷、汞、镉、铬、铜、镍、铅和锌）浓度之间的相关性。
在我们的研究中，中度至重度脂肪性肝病的患病率为26.5%。通过单因素和多因素分析，我们证明土壤重金属的存在是男性脂肪性肝病的一个重要危险因素（OR 1.83，95% CI 1.161至2.899，p = 0.009）。按体重指数（BMI）和性别分层后，BMI <24 kg/m的瘦男性最易受土壤重金属影响（OR 5.059，95% CI 1.628至15.728，p<0.05）。
我们的研究表明，瘦男性的土壤重金属暴露与脂肪性肝病之间存在显著关联。
