Alvarez Christian S, Rivera-Andrade Alvaro, Kroker-Lobos María F, Florio Andrea A, Smith Joshua W, Egner Patricia A, Freedman Neal D, Lazo Mariana, Guallar Eliseo, Dean Michael, Graubard Barry I, Ramírez-Zea Manuel, McGlynn Katherine A, Groopman John D
Division of Cancer Epidemiology and Genetics National Cancer Institute Rockville Maryland USA.
INCAP Research Center for the Prevention of Chronic Diseases Institute of Nutrition of Central America and Panama Guatemala City Guatemala.
Health Sci Rep. 2022 Jan 20;5(1):e495. doi: 10.1002/hsr2.495. eCollection 2022 Jan.
Metabolic conditions such as obesity, type 2 diabetes, metabolic syndrome, and nonalcoholic fatty liver disease (NAFLD) are highly prevalent in Guatemala and increase the risk for a number of disorders, including hepatocellular carcinoma (HCC). Aflatoxin B (AFB) levels are also notably elevated in the population and are known to be associated with HCC risk. Whether AFB also contributes to the high prevalence of the metabolic disorders has not been previously examined. Therefore, the purpose of this study was to assess the association between AFB and the metabolic conditions.
Four-hundred twenty-three individuals were included in the study, in which AFB-albumin adduct levels were measured in sera. Metabolic conditions included diabetes, obesity, central obesity, metabolic syndrome, and NAFLD. Crude and adjusted prevalence odds ratios (PORs) and 95% confidence intervals (95% CI) were estimated for the associations between the metabolic conditions and AFB-albumin adduct levels categorized into quartiles.
The study found a significant association between AFB-albumin adduct levels and diabetes (Q4 vs Q1 POR = 3.74, 95%CI: 1.71-8.19; .003). No associations were observed between AFB-albumin adduct levels and the other conditions.
As diabetes is the metabolic condition most consistently linked to HCC, the possible association between AFB exposure and diabetes may be of public health importance. Further studies are warranted to replicate the findings and examine potential mechanisms.
肥胖、2型糖尿病、代谢综合征和非酒精性脂肪性肝病(NAFLD)等代谢状况在危地马拉极为普遍,会增加包括肝细胞癌(HCC)在内的多种疾病的风险。黄曲霉毒素B(AFB)水平在该人群中也显著升高,且已知与HCC风险相关。此前尚未研究AFB是否也导致了代谢紊乱的高患病率。因此,本研究的目的是评估AFB与代谢状况之间的关联。
423人纳入本研究,检测血清中AFB -白蛋白加合物水平。代谢状况包括糖尿病、肥胖、中心性肥胖、代谢综合征和NAFLD。估计代谢状况与分为四分位数的AFB -白蛋白加合物水平之间关联的粗患病率比值比(POR)和调整后患病率比值比以及95%置信区间(95%CI)。
研究发现AFB -白蛋白加合物水平与糖尿病之间存在显著关联(四分位数4与四分位数1相比,POR = 3.74,95%CI:1.71 - 8.19;P = 0.003)。未观察到AFB -白蛋白加合物水平与其他状况之间存在关联。
由于糖尿病是与HCC最密切相关的代谢状况,AFB暴露与糖尿病之间可能的关联可能具有公共卫生重要性。有必要进行进一步研究以重复这些发现并研究潜在机制。