First evidence in the association of phenolic endocrine-disrupting chemicals with secondary non-alcoholic fatty liver disease: A case-control study in South China

The presence of phenolic endocrine disrupting chemicals (EDCs) in patients with secondary non-alcoholic fatty liver disease (S-NAFLD) and their associations with S-NAFLD incidence have not been previously documented. In this study, serum concentrations of 32 phenolic EDCs, including parabens, benzophenone-type UV-filters, bisphenols, and bisphenol A diglycidyl ether derivatives, were detected in patients with S-NAFLD as well as healthy population from South China. These target EDCs were ubiquitous in serum samples from both cohorts. Interestingly, significantly higher (p < 0.05) serum levels of most analytes were detected in individuals with S-NAFLD compared to those in the healthy population. Through multiple modeling analyses, we observed that parabens and bisphenols mixtures were positively associated with S-NAFLD incidence. A list of high-risk EDCs for S-NAFLD-related diseases was identified, including propyl paraben (PrP), butyl paraben (BuP), bisphenol A (BPA), and bisphenol AP (BPAP). Furthermore, significant positive correlations were found between the serum levels of these high-risk analytes and liver clinic indices. To the best of our knowledge, this study firstly examined the serum levels of multiple phenolic EDCs in patients with S-NAFLD, aiming to provide novel insights into high-risk EDCs associated with S-NAFLD incidence and their associations with clinic liver indices.