Guo Bing, Guo Yuming, Nima Qucuo, Feng Yuemei, Wang Ziyun, Lu Rong, Ma Yue, Zhou Junmin, Xu Huan, Chen Lin, Chen Gongbo, Li Shanshan, Tong Huan, Ding Xianbin, Zhao Xing
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
J Hepatol. 2022 Mar;76(3):518-525. doi: 10.1016/j.jhep.2021.10.016. Epub 2021 Dec 6.
BACKGROUND & AIMS: Accumulating animal studies have demonstrated the harmful contribution of ambient air pollution (AP) to metabolic dysfunction-associated fatty liver disease (MAFLD), but corresponding epidemiological evidence is limited. We examined the associations between long-term AP exposure and MAFLD prevalence in a Chinese population.
We conducted a cross-sectional study of 90,086 participants recruited in China from 2018 to 2019. MAFLD was assessed based on radiologically diagnosed hepatic steatosis and the presence of overweight/obese status, diabetes mellitus, or metabolic dysregulation. Residence-specific levels of air pollutants, including particulate matter with aerodynamic diameters of ≤1 μm (PM), ≤2.5 μm (PM), and ≤10 μm (PM), and nitrogen dioxide (NO), were estimated by validated spatiotemporal models. We used logistic regression models to examine the AP-MAFLD associations and further evaluated potential effect modifications by demographics, lifestyle, central obesity, and diabetes status.
Increased exposure levels to all 4 air pollutants were significantly associated with increased odds of MAFLD, with odds ratios (ORs) of 1.13 (95% CI 1.10-1.17), 1.29 (1.25-1.34), 1.11 (1.09-1.14), and 1.15 (1.12-1.17) for each 10 μg/m increase in PM, PM, PM, and NO, respectively. Further stratified analyses revealed that individuals who are male, alcohol drinkers, and current and previous smokers, those who consume a high-fat diet, and those with central obesity experience more significant adverse effects from AP exposure than other individuals.
This study provides evidence that long-term exposure to ambient PM, PM, PM, and NO may increase the odds of MAFLD in the real world. These effects may be exacerbated by unhealthy lifestyle habits and central obesity.
We conducted an epidemiological study on the potential effect of ambient air pollution on the risk of metabolic dysfunction-associated fatty liver disease (MAFLD) in approximately 90 thousand adults in China. We found that long-term exposure to ambient air pollution may increase the odds of MAFLD, especially in individuals who are male, smokers, and alcohol drinkers, those who consume a high-fat diet, and those with central obesity.
越来越多的动物研究表明，环境空气污染（AP）对代谢功能障碍相关脂肪性肝病（MAFLD）有有害影响，但相应的流行病学证据有限。我们研究了中国人群中长期暴露于AP与MAFLD患病率之间的关联。
我们对2018年至2019年在中国招募的90086名参与者进行了一项横断面研究。MAFLD根据放射学诊断的肝脂肪变性以及超重/肥胖状态、糖尿病或代谢失调的存在情况进行评估。通过经过验证的时空模型估算特定居住地的空气污染物水平，包括空气动力学直径≤1μm（PM）、≤2.5μm（PM）和≤10μm（PM）的颗粒物以及二氧化氮（NO）。我们使用逻辑回归模型来研究AP与MAFLD之间的关联，并进一步评估人口统计学、生活方式、中心性肥胖和糖尿病状态对潜在效应的修正作用。
所有4种空气污染物暴露水平的增加均与MAFLD患病几率的增加显著相关，PM、PM、PM和NO每增加10μg/m，比值比（OR）分别为1.13（95%CI 1.10 - 1.17）、1.29（1.25 - 1.34）、1.11（1.09 - 1.14）和1.15（1.12 - 1.17）。进一步的分层分析显示，男性、饮酒者、当前和既往吸烟者、高脂饮食者以及中心性肥胖者比其他个体更容易受到AP暴露的显著不良影响。
本研究提供了证据表明，在现实世界中，长期暴露于环境中的PM、PM、PM和NO可能会增加患MAFLD的几率。不健康的生活习惯和中心性肥胖可能会加剧这些影响。
我们对中国约9万名成年人进行了一项关于环境空气污染对代谢功能障碍相关脂肪性肝病（MAFLD）风险潜在影响的流行病学研究。我们发现，长期暴露于环境空气污染可能会增加患MAFLD的几率，尤其是男性、吸烟者、饮酒者、高脂饮食者以及中心性肥胖者。
