School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
BMC Public Health. 2024 May 20;24(1):1350. doi: 10.1186/s12889-024-18641-4.
The impacts of long-term exposure to air pollution on the risk of subsequent non-alcoholic fatty liver disease (NAFLD) among participants with type 2 diabetes (T2D) is ambiguous. The modifying role of Life's Essential 8 (LE8) remains unknown.
This study included 23,129 participants with T2D at baseline from the UK Biobank. Annual means of nitrogen dioxide (NO), nitrogen oxides (NO), and particulate matter (PM, PM, PM) were estimated using the land-use regression model for each participant. The associations between exposure to air pollution and the risk of severe NAFLD were evaluated using Cox proportional hazard models. The effect modification of LE8 was assessed through stratified analyses.
During a median 13.6 years of follow-up, a total of 1,123 severe NAFLD cases occurred. After fully adjusting for potential covariates, higher levels of PM (hazard ratio [HR] = 1.12, 95%CI:1.02, 1.23 per interquartile range [IQR] increment), NO (HR = 1.15, 95%CI:1.04, 1.27), and NO (HR = 1.08, 95%CI:1.01, 1.17) were associated with an elevated risk of severe NAFLD. In addition, LE8 score was negatively associated with the risk of NAFLD (HR = 0.97, 95% CI: 0.97, 0.98 per point increment). Compared with those who had low air pollution and high LE8, participants with a high air pollution exposure and low LE8 had a significantly higher risk of severe NAFLD.
Our findings suggest that long-term exposure to air pollution was associated with an elevated risk of severe NAFLD among participants with T2D. A lower LE8 may increase the adverse impacts of air pollution on NAFLD.
长期暴露于空气污染对 2 型糖尿病（T2D）患者发生非酒精性脂肪性肝病（NAFLD）的风险影响尚不清楚。Life's essential 8（LE8）的调节作用尚不清楚。
本研究纳入了英国生物库中 23129 名基线时患有 T2D 的参与者。利用土地利用回归模型，为每位参与者估算每年二氧化氮（NO）、氮氧化物（NO）和颗粒物（PM、PM、PM）的年均浓度。采用 Cox 比例风险模型评估空气污染暴露与严重 NAFLD 风险的相关性。通过分层分析评估 LE8 的效应修饰作用。
在中位随访 13.6 年期间，共发生 1123 例严重 NAFLD 病例。在充分调整潜在混杂因素后，较高水平的 PM（HR=1.12，95%CI：1.02，1.23，每增加一个四分位距[IQR]）、NO（HR=1.15，95%CI：1.04，1.27）和 NO（HR=1.08，95%CI：1.01，1.17）与严重 NAFLD 风险增加相关。此外，LE8 评分与 NAFLD 风险呈负相关（HR=0.97，95%CI：0.97，0.98，每增加 1 分）。与空气污染低且 LE8 评分高的参与者相比，空气污染暴露高且 LE8 评分低的参与者发生严重 NAFLD 的风险显著增加。
我们的研究结果表明，长期暴露于空气污染与 T2D 患者发生严重 NAFLD 的风险增加相关。较低的 LE8 可能会增加空气污染对 NAFLD 的不良影响。
