Occupational exposure and risk of complications in MASLD patients:updates from a case:control study

IF 4 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Digestive and Liver Disease Pub Date : 2024-09-01 DOI:10.1016/j.dld.2024.08.014
B. Stefanini , D. Mandrioli , A. Vornoli , A. Salomone , D. Sgargi , F. Manservisi , F. Piscaglia , F. Tovoli
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Abstract

Introduction

Pollutants are increasingly being evaluated as possible contributors to the progression of liver damage in metabolic dysfunction-associated steatotic liver disease (MASLD). Recently, we published a case-control study showing that patients with MASLD-related advanced chronic liver disease (ACLD) and/or hepatocellular carcinoma (HCC) were more likely to report workplace toxicant exposure compared to those with uncomplicated MASLD. Consequently, an extension of the accrual and a transition to a multicenter study were decided.

Aim

To provide updated evidence following the first extension of the cohort from our original study, which aimed to assess the prevalence of self-reported occupational exposure to toxicants in patients with MASLD.

Methods

After the extension, this hospital-based prospective pilot study include 224 patients with MASLD. Data on workplace toxicant exposure were collected systematically using a structured questionnaire. Subsequently, patients with ACLD and/or HCC (n = 65) were compared to controls (n = 159). Logistic regression analysis and propensity score models were used to investigate the associations between self-reported occupational exposure and ACLD and/or HCC.

Results

The updated data confirmed that patients with ACLD/HCC are more likely to report exposure to metals, halogenated refrigerants, paint/resins, and fuel emissions than the controls. Durations of 21-30 years and >30 years of occupational exposure to toxicants were also more frequently associated with ACLD/HCC, with odds ratios (ORs) of 2.42 (95% confidence interval [CI]: 1.11-4.94, p = 0.020) and 4.21 (95% CI: 2.36-7.53, p < 0.001), respectively. These associations were confirmed after corrections for demographics and other confounders.

Conclusions

The extension of our cohort confirms that patients with MASLD complications are more likely to report workplace toxicant exposure than controls. A transition to a multicenter effort is underway. If confirmed, our results may help in developing prevention policies to reduce the risk of life-threatening diseases among exposed populations.

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MASLD 患者的职业暴露与并发症风险:病例对照研究的最新进展
引言 污染物越来越多地被评估为可能导致代谢功能障碍相关性脂肪性肝病(MASLD)肝损伤进展的因素。最近,我们发表了一项病例对照研究,结果显示,与无并发症的 MASLD 患者相比,与 MASLD 相关的晚期慢性肝病 (ACLD) 和/或肝细胞癌 (HCC) 患者更有可能报告在工作场所接触过有毒物质。目的在我们最初研究的队列首次扩展后提供最新证据,该研究旨在评估MASLD患者自我报告的职业毒物暴露流行率。方法扩展后,这项基于医院的前瞻性试点研究纳入了224名MASLD患者。采用结构化问卷系统地收集了有关工作场所毒物暴露的数据。随后,将患有 ACLD 和/或 HCC 的患者(n = 65)与对照组(n = 159)进行比较。结果最新数据证实,与对照组相比,ACLD/HCC 患者更有可能报告暴露于金属、卤化制冷剂、油漆/树脂和燃料排放物。接触有毒物质的职业时间为21-30年和30年的患者也更常与ACLD/HCC相关,其几率比(ORs)分别为2.42(95%置信区间[CI]:1.11-4.94,p = 0.020)和4.21(95%置信区间:2.36-7.53,p <0.001)。结论我们队列的扩展证实,与对照组相比,MASLD并发症患者更有可能报告工作场所的毒物暴露。目前正在向多中心研究过渡。如果得到证实,我们的研究结果将有助于制定预防政策,降低暴露人群罹患危及生命的疾病的风险。
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来源期刊
Digestive and Liver Disease
Digestive and Liver Disease 医学-胃肠肝病学
CiteScore
6.10
自引率
2.20%
发文量
632
审稿时长
19 days
期刊介绍: Digestive and Liver Disease is an international journal of Gastroenterology and Hepatology. It is the official journal of Italian Association for the Study of the Liver (AISF); Italian Association for the Study of the Pancreas (AISP); Italian Association for Digestive Endoscopy (SIED); Italian Association for Hospital Gastroenterologists and Digestive Endoscopists (AIGO); Italian Society of Gastroenterology (SIGE); Italian Society of Pediatric Gastroenterology and Hepatology (SIGENP) and Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD). Digestive and Liver Disease publishes papers on basic and clinical research in the field of gastroenterology and hepatology. Contributions consist of: Original Papers Correspondence to the Editor Editorials, Reviews and Special Articles Progress Reports Image of the Month Congress Proceedings Symposia and Mini-symposia.
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