School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Nutrients. 2022 Feb 28;14(5):1027. doi: 10.3390/nu14051027.
Aflatoxins (AFTs), as a group 1 carcinogen, could lead to hepatocellular carcinoma (HCC). Dietary intake is the primary way of AFT exposure in humans. However, the contribution of foodborne AFT intake to the HCC burden remains unknown in recent years in China. Hence, the present study was conducted to estimate the burden of HCC attributed to foodborne AFT exposure by using disability-adjusted life years (DALYs). The risk assessment was used to estimate the incidence of HCC related to AFT exposure. Concentrations of AFTs in peanuts, peanut oil, corn, and corn products were retrieved from literature published between 2010 and 2020 in China. Corresponding daily food consumption data were obtained from two nationwide Chinese surveys. A direct approach was used to calculate DALY and DALY rates to quantify the HCC burden attributed to dietary AFT exposure. The total amount of AFT intake through peanut, peanut oil, corn, and corn products was 4.018 ng/kg bw/day resulting in 0.125 extra HCC cases per year/100,000 persons, corresponding to a DALY number and DALY rate of 21,625.08 and 1.53 per 100,000 population, respectively. Regionally, DALYs were high in Guangxi and Guangdong provinces, corresponding to 5948 and 5595 DALYs. A total of 1.5 DALYs/100,000 were lost due to the AFT exposure. DALYs per 100,000 population were higher in several coastal areas. Though the disease burden of HCC caused by dietary AFTs was low in the Chinese population, a high health risk was found in the residents of some areas with high AFT exposure. AFTs are still a health challenge for the Chinese people.
黄曲霉毒素（AFTs）作为 1 类致癌物，可导致肝细胞癌（HCC）。膳食摄入是人类接触 AFT 的主要途径。然而，近年来，中国人群中食源性 AFT 摄入量对 HCC 负担的贡献仍不清楚。因此，本研究旨在利用伤残调整生命年（DALY）来估计食源性 AFT 暴露导致的 HCC 负担。采用风险评估方法估计与 AFT 暴露相关的 HCC 发病率。从 2010 年至 2020 年在中国发表的文献中检索了花生、花生油、玉米和玉米制品中 AFTs 的浓度。从中国的两项全国性调查中获得了相应的每日食物消费数据。采用直接方法计算 DALY 和 DALY 率，以量化食源性 AFT 暴露导致的 HCC 负担。通过花生、花生油、玉米和玉米制品摄入的 AFT 总量为 4.018ng/kg bw/day，导致每年每 10 万人中有 0.125 例额外 HCC 病例，相应的 DALY 数和 DALY 率分别为 21625.08 和 1.53/10 万。在区域上，广西和广东省的 DALY 较高，分别为 5948 和 5595 DALY。由于 AFT 暴露，共损失 1.5 DALY/10 万。沿海地区的每 10 万人口 DALY 更高。尽管中国人群因膳食 AFT 导致 HCC 的疾病负担较低，但一些 AFT 暴露较高地区的居民健康风险较高。AFT 仍然是中国人面临的健康挑战。
