砷暴露和砷代谢与非酒精性脂肪肝风险的关系

IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES International journal of hygiene and environmental health Pub Date : 2024-02-23 DOI:10.1016/j.ijheh.2024.114342
Yuenan Liu, Weiya Li, Jiazhen Zhang, Yan Yan, Qihang Zhou, Qianying Liu, Youbin Guan, Zhuoya Zhao, Jun An, Xu Cheng, Meian He
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引用次数: 0

摘要

越来越多的证据表明,砷暴露会导致非酒精性脂肪肝(NAFLD)风险,但研究结果仍不一致。此外,砷一旦被吸收,就会被甲基化成单甲基砷和二甲基砷。然而,没有研究调查了砷代谢与非酒精性脂肪肝的关系。我们的目的是评估砷暴露和砷代谢与非酒精性脂肪肝发病率的关系。我们对来自东风-同济队列的 1790 名参与者进行了病例对照研究,并测量了尿液中的砷种类(亚砷酸盐、砷酸盐、单甲基胂酸盐 [MMA]、二甲基胂酸盐 [DMA] 和砷甜菜碱)。砷暴露量(∑As)定义为无机砷(iAs)、MMA 和 DMA 的总和。砷代谢以无机砷相关种类的比例(iAs%、MMA% 和 DMA%)和甲基化效率比(一次甲基化指数 [PMI]、二次甲基化指数 [SMI])进行评估。非酒精性脂肪肝通过肝脏超声波诊断。采用逻辑回归评估相关性。∑As的中位数为13.24微克/克肌酐。∑As与中度/重度非酒精性脂肪肝呈非线性正相关(OR:每log-SD=1.33,95% CI:[1.03,1.71];非线性P=0.021)。iAs%(OR:每 SD = 1.16,95% CI:[1.03,1.30])和 SMI(OR:每 log-SD = 1.16,95% CI:[1.03,1.31])与非酒精性脂肪肝呈正相关,而 MMA%(OR:每 SD = 0.80,95% CI:[0.70,0.91])和 PMI(OR:每 log-SD = 0.86,95% CI:[0.77,0.96])与非酒精性脂肪肝呈反相关。此外,当 MMA% 降低时,iAs% 每增加 5%,非酒精性脂肪肝的 ORs(95% CI)为 1.36(1.17,1.58);当 DMA% 降低时,非酒精性脂肪肝的 ORs(95% CI)为 1.07(1.01,1.13);当 iAs% 和 DMA% 降低时,MMA% 每增加 5%,非酒精性脂肪肝的 ORs(95% CI)分别为 0.74(0.63,0.86)和 0.79(0.69,0.91)。结果表明,无机砷暴露与非酒精性脂肪肝风险呈正相关,砷甲基化效率在非酒精性脂肪肝中起作用。这些发现为探索预防非酒精性脂肪肝的潜在干预措施提供了线索。还需要进行前瞻性研究来验证我们的发现。
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Associations of arsenic exposure and arsenic metabolism with the risk of non-alcoholic fatty liver disease

Growing evidences supported that arsenic exposure contributes to non-alcoholic fatty liver disease (NAFLD) risk, but findings were still inconsistent. Additionally, once absorbed, arsenic is methylated into monomethyl and dimethyl arsenicals. However, no studies investigated the association of arsenic metabolism with NAFLD. Our objectives were to evaluate the associations of arsenic exposure and arsenic metabolism with NAFLD prevalence. We conducted a case-control study with 1790 participants derived from Dongfeng-Tongji cohort and measured arsenic species (arsenite, arsenate, monomethylarsonate [MMA], dimethylarsinate [DMA], and arsenobetaine) in urine. Arsenic exposure (∑As) was defined as the sum of inorganic arsenic (iAs), MMA, and DMA. Arsenic metabolism was evaluated as the proportions of inorganic-related species (iAs%, MMA%, and DMA%) and methylation efficiency ratios (primary methylation index [PMI], secondary methylation index [SMI]). NAFLD was diagnosed by liver ultrasound. Logistic regression was used to evaluate the associations. The median of ∑As was 13.24 μg/g creatinine. The ∑As showed positive and nonlinear association with moderate/severe NAFLD (OR: per log-SD = 1.33, 95% CI: [1.03,1.71]; P for nonlinearity = 0.021). The iAs% (OR: per SD = 1.16, 95% CI: [1.03,1.30]) and SMI (OR: per log-SD = 1.16, 95% CI: [1.03,1.31]) showed positive while MMA% (OR: per SD = 0.80, 95% CI: [0.70,0.91]) and PMI (OR: per log-SD = 0.86, 95% CI: [0.77,0.96]) showed inverse associations with NAFLD. Moreover, the ORs (95% CI) of NAFLD for each 5% increase in iAs% was 1.36 (1.17,1.58) when MMA% decreased and 1.07 (1.01,1.13) when DMA% decreased; and for each 5% increase in MMA%, it was 0.74 (0.63,0.86) and 0.79 (0.69,0.91) when iAs% and DMA% decreased, respectively. The results suggest that inorganic arsenic exposure is positively associated with NAFLD risk and arsenic methylation efficiency plays a role in the NAFLD. The findings provide clues to explore potential interventions for the prevention of NAFLD. Prospective studies are needed to validate our findings.

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来源期刊
CiteScore
11.50
自引率
5.00%
发文量
151
审稿时长
22 days
期刊介绍: The International Journal of Hygiene and Environmental Health serves as a multidisciplinary forum for original reports on exposure assessment and the reactions to and consequences of human exposure to the biological, chemical, and physical environment. Research reports, short communications, reviews, scientific comments, technical notes, and editorials will be peer-reviewed before acceptance for publication. Priority will be given to articles on epidemiological aspects of environmental toxicology, health risk assessments, susceptible (sub) populations, sanitation and clean water, human biomonitoring, environmental medicine, and public health aspects of exposure-related outcomes.
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