Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China.
Department of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.
Environ Sci Pollut Res Int. 2019 Oct;26(30):31384-31391. doi: 10.1007/s11356-019-06224-5. Epub 2019 Aug 31.
Little is known regarding the effects of environmental mercury (Hg) exposure on liver dysfunction in adolescents. We aimed to explore the association between Hg exposure and the risk of nonalcoholic fatty liver disease (NAFLD) in the adolescent population. The cross-sectional associations between blood Hg concentrations and serum alanine aminotransferase (ALT) levels, a surrogate for suspected NAFLD, were evaluated using data from adolescents (aged 12-17 years old) who participated in the National Health and Nutrition Examination Survey (NHANES), 1999-2014. A final sample of 6389 adolescents was analysed. Elevated ALT was defined as > 25 IU/L and > 22 IU/L for boys and girls ≤ 17 years old, respectively. Odds ratios (ORs) of Hg levels in association with serum ALT levels were estimated using a logistic regression after adjusting for gender, age, ethnicity, serum cotinine, body mass index, the poverty income ratio, and NHANES cycles. The median blood Hg level was 0.73 ± 0.91 μg/L amongst US adolescents. In the adjusted model, the ORs of elevated ALT levels of those in the 4th quartile were higher amongst non-Hispanic white adolescents (OR = 1.76, 95% CI 1.20, 2.59; P = 0.035) and those who were normal or underweight (OR = 1.41, 95% CI 1.08, 1.85; P = 0.020). No association was observed for the other variables. Our results indicate that the positive association between blood Hg exposure and the risk of NAFLD in US adolescents is the highest amongst non-Hispanic white and those who are normal or underweight, regardless of ethnicity. More research is necessary to confirm this association and to clarify the potential mechanisms.
关于环境汞 (Hg) 暴露对青少年肝功能障碍的影响知之甚少。我们旨在探讨青少年人群中 Hg 暴露与非酒精性脂肪性肝病 (NAFLD) 风险之间的关联。利用参加 1999-2014 年全国健康与营养调查 (NHANES) 的青少年 (年龄 12-17 岁) 的数据，评估了血液 Hg 浓度与血清丙氨酸氨基转移酶 (ALT) 水平（疑似 NAFLD 的替代指标）之间的横断面关联。采用 logistic 回归对性别、年龄、种族、血清可替宁、体重指数、贫困收入比和 NHANES 周期进行调整后，分析了 6389 名青少年的最终样本。对于≤17 岁的男女孩，ALT 升高定义为 >25 IU/L 和 >22 IU/L。在校正模型中，第 4 四分位数 Hg 水平与 ALT 水平升高的比值比 (OR) 在非西班牙裔白种青少年中更高 (OR = 1.76, 95%CI 1.20, 2.59; P = 0.035) 和那些体重正常或体重不足的青少年中更高 (OR = 1.41, 95%CI 1.08, 1.85; P = 0.020)。对于其他变量未观察到相关性。我们的结果表明，在美国青少年中，血液 Hg 暴露与 NAFLD 风险之间的正相关性在非西班牙裔白人和体重正常或体重不足的人群中最高，无论种族如何。需要进一步的研究来证实这种关联，并阐明潜在的机制。
