Zhao Yamin, Peng Yindi, Wang Minzhen, Zhao Yanan, He Yingqian, Zhang Lulu, Liu Jing, Zheng Shan
Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
Environ Geochem Health. 2024 Jul 13;46(9):304. doi: 10.1007/s10653-024-02071-7.
Accumulating animal studies have demonstrated associations between ambient air pollution (AP) and metabolic dysfunction-associated fatty liver disease (MAFLD), but relevant epidemiological evidence is limited. We evaluated the association of long-term exposure to AP with the risk of incident MAFLD in Northwest China. The average AP concentration between baseline and follow-up was used to assess individual exposure levels. Cox proportional hazard models and restricted cubic spline functions (RCS) were used to estimate the association of PM and its constituents with the risk of MAFLD and the dose-response relationship. Quantile g-computation was used to assess the joint effects of mixed exposure to air pollutants on MAFLD and the weights of the various pollutants. We observed 1516 cases of new-onset MAFLD, with an incidence of 10.89%. Increased exposure to pollutants was significantly associated with increased odds of MAFLD, with hazard ratios (HRs) of 2.93 (95% CI: 1.22, 7.00), 2.86 (1.44, 5.66), 7.55 (3.39, 16.84), 4.83 (1.89, 12.38), 3.35 (1.35, 8.34), 1.89 (1.02, 1.62) for each interquartile range increase in PM, SO, NO, NH, OM, and BC, respectively. Stratified analyses suggested that females, frequent exercisers and never-drinkers were more susceptible to MAFLD associated with ambient PM and its constituents. Mixed exposure to SO, NO, NH, OM and BC was associated with an increased risk of MAFLD, and the weight of BC had the strongest effect on MAFLD. Exposure to ambient PM and its constituents increased the risk of MAFLD.
越来越多的动物研究表明，环境空气污染（AP）与代谢功能障碍相关脂肪性肝病（MAFLD）之间存在关联，但相关的流行病学证据有限。我们评估了中国西北地区长期暴露于AP与MAFLD发病风险之间的关联。使用基线和随访期间的平均AP浓度来评估个体暴露水平。采用Cox比例风险模型和受限立方样条函数（RCS）来估计PM及其成分与MAFLD风险的关联以及剂量反应关系。采用分位数g计算来评估空气污染物混合暴露对MAFLD的联合效应以及各种污染物的权重。我们观察到1516例新发MAFLD病例，发病率为10.89%。污染物暴露增加与MAFLD发生几率增加显著相关，PM、SO、NO、NH、OM和BC每增加一个四分位数间距，风险比（HR）分别为2.93（95%CI：1.22，7.00）、2.86（1.44，5.66）、7.55（3.39，16.84）、4.83（1.89，12.38）、3.35（1.35，8.34）、1.89（1.02，1.62）。分层分析表明，女性、经常锻炼者和从不饮酒者更容易受到环境PM及其成分导致的MAFLD影响。SO、NO、NH、OM和BC的混合暴露与MAFLD风险增加相关，且BC对MAFLD的影响最强。暴露于环境PM及其成分会增加MAFLD风险。
