Wang Zhuowen, Yu Shaofei, Yang Bin, Wang Pengpeng, Yang Yongli, Bo Yacong, Wang Wei
Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.
Environ Pollut. 2025 Sep 15;381:126570. doi: 10.1016/j.envpol.2025.126570. Epub 2025 May 29.
The associations between air pollution exposure and nonalcoholic fatty liver disease (NAFLD) remain unclear. The present study included 313,102 individuals from the UK Biobank. Data on air pollution included PM, PM, PM, PM, nitrogen dioxide (NO), and nitrogen oxides (NO). A weighted air pollution score (WAPS) was created using PM and NO to evaluate the comprehensive exposure to the five air contaminants. Using Cox proportional hazard models and restricted cubic spline (RCS) models, the relationship between air pollution exposure and the developing NAFLD risk was examined. We also examined the mediating role of BMI. We found that the increased risk of NAFLD was positively correlated with PM, PM, PM, PM, NO, NO, and WAPS (all P-trend <0.05). In comparison to individuals who were in the lowest quartile for air contaminants exposure, the HRs of NAFLD for those exposed to the highest quartile were: PM: 1.33 (95 % CI: 1.22 to 1.45), PM: 1.12 (95 % CI: 1.03 to 1.22), PM: 1.15 (95 % CI: 1.05 to 1.25), PM: 1.27 (95 % CI: 1.17 to 1.39), NO: 1.38 (95 % CI:1.26 to 1.50), NO: 1.33 (95 % CI:1.22 to 1.45), and WAPS: 1.32 (95 % CI:1.21 to 1.44). No correlation was found between WAPS and NAFLD risk in those who were normal weight, but it was strong in overweight and obese people. BMI (mediated proportion: 8.18 % for PM; 2.89 % for PM; 18.8 % for PM; 12.32 % for PM; 4.09 % for NO; 7.72 % for NO; 8.44 % for WAPS) significantly mediated a portion of the link between air pollution exposure and NAFLD (all P < 0.05). Overall, air pollution exposure can increase the developing NAFLD risk, and BMI significantly modifies and mediates the connection. These findings served as mechanical evidence that air pollution contributes to NAFLD in epidemiological investigations.
空气污染暴露与非酒精性脂肪性肝病（NAFLD）之间的关联仍不明确。本研究纳入了英国生物银行的313102名个体。空气污染数据包括细颗粒物（PM）、可吸入颗粒物（PM）、粗颗粒物（PM）、超细颗粒物（PM）、二氧化氮（NO₂）和氮氧化物（NOₓ）。使用PM₂.₅和NO₂创建了一个加权空气污染评分（WAPS），以评估对这五种空气污染物的综合暴露情况。采用Cox比例风险模型和受限立方样条（RCS）模型，研究了空气污染暴露与NAFLD发病风险之间的关系。我们还研究了体重指数（BMI）的中介作用。我们发现，NAFLD风险增加与PM₂.₅、PM₁₀、PM₁、PM₂.₅、NO₂、NOₓ和WAPS呈正相关（所有P趋势<0.05）。与空气污染物暴露处于最低四分位数的个体相比，暴露于最高四分位数的个体患NAFLD的风险比（HR）分别为：PM₂.₅：1.33（95%置信区间：1.22至1.45），PM₁₀：1.12（95%置信区间：1.03至1.22），PM₁：1.15（95%置信区间：1.05至1.25），PM₂.₅：1.27（95%置信区间：1.17至1.39），NO₂：1.38（95%置信区间：1.26至1.50），NOₓ：1.33（95%置信区间：1.22至1.45），WAPS：1.32（95%置信区间：1.21至1.44）。在体重正常的人群中，未发现WAPS与NAFLD风险之间存在相关性，但在超重和肥胖人群中相关性较强。BMI（中介比例：PM₂.₅为8.18%；PM₁₀为2.89%；PM₁为18.8%；PM₂.₅为12.32%；NO₂为4.09%；NOₓ为7.72%；WAPS为8.44%）显著介导了空气污染暴露与NAFLD之间的部分联系（所有P<0.05）。总体而言，空气污染暴露会增加NAFLD的发病风险，且BMI显著调节并介导了这种关联。这些发现为空气污染在流行病学调查中导致NAFLD提供了机制证据。
