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基于美国国家健康与营养检查调查(NHANES)的一项横断面研究,钴暴露与肝脂肪变性和晚期肝纤维化风险相关。

Cobalt exposure was associated with the risk of hepatic steatosis and advanced liver fibrosis based on a cross-sectional study from NHANES.

作者信息

Zhang Ling, Ma Shijie, Sun Rui, Xie Rui, Shen Peng

机构信息

Department of Geriatric Medicine, The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, Huaian 223000, China.

Department of Gastroenterology, The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, Huaian 223000, China.

出版信息

Ecotoxicol Environ Saf. 2025 Mar 15;293:118003. doi: 10.1016/j.ecoenv.2025.118003. Epub 2025 Mar 10.

Abstract

BACKGROUND

Although Emerging evidence suggests the association of environmental factors with hepatic steatosis and fibrosis, the relationship between Cobalt exposure and hepatic steatosis and fibrosis was not clear.

AIM

Our study was aimed to explore the association between blood Cobalt level and hepatic steatosis and advanced liver fibrosis diagnosed by vibration controlled transient elastography (VCTE) in US adults.

METHODS

This study analyzed data from 3193 individuals participating in the 2017-2018 National Health and Nutrition Examination Surveys. Participants were classified into four groups according to the quartiles of blood cobalt concentration. Liver stiffness and fat content were assessed through vibration-controlled transient elastography (VCTE), including measurements of the controlled attenuation parameter (CAP). The association between blood cobalt levels and the prevalence of hepatic steatosis and advanced liver fibrosis was explored using logistic regression models and stratified subgroup analyses.

RESULTS

The CAP values showed a significant decline across increasing cobalt quartiles. Participants in the highest quartile had a 41 % lower risk of hepatic steatosis compared to those in the lowest quartile (odds ratio: 0.59, 95 % confidence interval: 0.46-0.76, p < 0.001). However, no significant association existed between blood Cobalt and advanced liver fibrosis. Subgroup analysis revealed that the relationship was consistent across age, gender and body mass index subgroups.

CONCLUSIONS

This study showed that blood Cobalt level was negatively association with hepatic steatosis. This may be due to increased development from hepatic steatosis to advanced liver fibrosis upon Cobalt exposure.

摘要

背景

尽管新出现的证据表明环境因素与肝脂肪变性和肝纤维化有关,但钴暴露与肝脂肪变性和肝纤维化之间的关系尚不清楚。

目的

我们的研究旨在探讨美国成年人血液钴水平与通过振动控制瞬时弹性成像(VCTE)诊断的肝脂肪变性和晚期肝纤维化之间的关联。

方法

本研究分析了参加2017 - 2018年国家健康和营养检查调查的3193名个体的数据。参与者根据血液钴浓度四分位数分为四组。通过振动控制瞬时弹性成像(VCTE)评估肝脏硬度和脂肪含量,包括控制衰减参数(CAP)的测量。使用逻辑回归模型和分层亚组分析探讨血液钴水平与肝脂肪变性和晚期肝纤维化患病率之间的关联。

结果

随着钴四分位数的增加,CAP值显著下降。与最低四分位数组相比,最高四分位数组的参与者发生肝脂肪变性的风险降低41%(优势比:0.59,95%置信区间:0.46 - 0.76,p < 0.001)。然而,血液钴水平与晚期肝纤维化之间不存在显著关联。亚组分析显示,这种关系在年龄、性别和体重指数亚组中是一致的。

结论

本研究表明血液钴水平与肝脂肪变性呈负相关。这可能是由于钴暴露后肝脂肪变性向晚期肝纤维化的进展增加所致。

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