Department of Hepatology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Hepatology, Yueyang Integrated Chinese and Western Medicine Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Front Public Health. 2022 Oct 20;10:995649. doi: 10.3389/fpubh.2022.995649. eCollection 2022.
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. We evaluated NAFLD using the US FLI to determine whether there is an association between urinary organophosphorus (OPE) levels and the "prevalence" of NAFLD in US individuals.
The current study included 1,102 people aged 20 years and older with information from the 2011-2014 U.S. National Health and Nutrition Examination Survey. NAFLD was assessed using the U.S. FLI. Individual OPE metabolites and OPE combinations were linked to NAFLD using logistic regression and weighted quantile sum (WQS) regression. All analyzes were carried out separately on males and females. The possible impacts of age, serum total testosterone (TT), and menopausal state, as well as the importance of the interaction term with exposure, were investigated using stratified analysis.
Bis (2-chloroethyl) phosphate and bis (1,3-dichloro-2-propyl) phosphate were associated with NAFLD in all males after adjusting for covariates ( < 0.05). A combination of OPEs (OPE index) was positively linked with NAFLD in the WQS analysis of all males (odds ratio for OPE index: 1.52; 95% CI: 1.06, 2.19). Stratified analyzes for males revealed that considerable connections were largely confined to individuals over 60 years old or with low total testosterone. In women, the connection was limited and inconsistent, except for the OPE index, which was positively linked with NAFLD in post-menopausal women.
In this study, environmental exposure to OPE was linked to an elevated risk of NAFLD in males, particularly those over 60 years old or with low TT levels. Aside from the continuous positive connection of a combination of OPEs with NAFLD risk in post-menopausal women, these correlations were weaker in women. However, these findings should be taken with caution and verified in future investigations by collecting numerous urine samples in advance to strengthen OPE exposure estimates.
非酒精性脂肪性肝病（NAFLD）是全球最常见的慢性肝病。我们使用美国 FLI 评估 NAFLD，以确定美国个体尿液有机磷（OPE）水平与“NAFLD 患病率”之间是否存在关联。
本研究纳入了 2011-2014 年美国国家健康和营养调查中年龄在 20 岁及以上的 1102 人。使用美国 FLI 评估 NAFLD。使用逻辑回归和加权分位数总和（WQS）回归将个体 OPE 代谢物和 OPE 组合与 NAFLD 联系起来。所有分析均分别在男性和女性中进行。通过分层分析研究了年龄、血清总睾酮（TT）和绝经状态的可能影响以及暴露与暴露相互作用项的重要性。
在调整了协变量后，所有男性的双（2-氯乙基）磷酸酯和双（1,3-二氯-2-丙基）磷酸酯与 NAFLD 相关（<0.05）。在所有男性的 WQS 分析中，OPE 组合（OPE 指数）与 NAFLD 呈正相关（OPE 指数的比值比：1.52；95%可信区间：1.06,2.19）。男性的分层分析表明，这种关联主要局限于 60 岁以上或总睾酮水平较低的个体。在女性中，这种关联是有限的和不一致的，除了 OPE 指数与绝经后女性的 NAFLD 呈正相关外。
在这项研究中，OPE 的环境暴露与男性 NAFLD 风险的升高有关，尤其是 60 岁以上或 TT 水平较低的男性。除了绝经后女性 OPE 组合与 NAFLD 风险的持续正相关外，女性的这些相关性较弱。然而，这些发现应谨慎对待，并在未来的研究中通过提前收集大量尿液样本来加强 OPE 暴露估计值进行验证。
