PMID- 36402077
OWN - NLM
STAT- MEDLINE
DCOM- 20221206
LR  - 20221206
IS  - 1090-2414 (Electronic)
IS  - 0147-6513 (Linking)
VI  - 248
DP  - 2022 Dec 15
TI  - Sex-specific associations of the urinary fourteen-metal mixture with NAFLD and 
      liver fibrosis among US adults: A nationally representative study.
PG  - 114306
LID - S0147-6513(22)01146-0 [pii]
LID - 10.1016/j.ecoenv.2022.114306 [doi]
AB  - Although previous studies have examined the hepatotoxicity of single metal 
      exposure, the associations between metal mixture and non-alcoholic fatty liver 
      disease (NAFLD) or fibrosis remain unclear. This study investigated the 
      associations of urinary metal mixture with the risks of NAFLD and liver fibrosis 
      in US adults using data from the National Health and Nutrition Examination Survey 
      (NHANES) from 2017.01 to 2020.03. Vibration-controlled transient elastography was 
      used to detect the controlled attenuation parameter (CAP) and liver stiffness 
      measurement (LSM), which are indicators of NAFLD and liver fibrosis respectively. 
      Three novel mixture modeling approaches including the Bayesian kernel machine 
      regression (BKMR), weighted quantile sum (WQS) regression and quantile 
      g-computation (qgcomp) were used to estimate the associations of the urinary 
      fourteen-metal mixture with Ln CAP and Ln LSM. There were 2283 adults aged over 
      18 years (1209 women and 1074 men) were included. Among women, urinary metal 
      mixture was positively associated with Ln CAP in the BKMR and qgcomp models (both 
      P < 0.05). However, no significantly associations of urinary metal mixture with 
      Ln CAP were observed among men in all models (all P > 0.05). The metal mixture 
      was not associated with Ln LSM in the three models regardless of genders (all 
      P > 0.05). In conclusion, we observed sex-specific associations between urinary 
      metal mixture and the prevalence of NAFLD in US adults. These findings emphasize 
      the role of environmental heavy metal exposure in the development of NAFLD, and 
      confirm the need for more prospective cohort studies on sex-specific manner.
CI  - Copyright (c) 2022 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Wan, Heng
AU  - Wan H
AD  - Institute and Department of Endocrinology and Metabolism, Shunde Hospital, 
      Southern Medical University (The First People's Hospital of Shunde), Foshan, 
      Guangdong, China.
FAU - Jiang, Yuqi
AU  - Jiang Y
AD  - Institute and Department of Endocrinology and Metabolism, Shunde Hospital, 
      Southern Medical University (The First People's Hospital of Shunde), Foshan, 
      Guangdong, China.
FAU - Yang, Jingli
AU  - Yang J
AD  - College of Earth and Environmental Sciences, Lanzhou University, Lanzhou, Gansu, 
      China.
FAU - Ma, Qintao
AU  - Ma Q
AD  - Institute and Department of Endocrinology and Metabolism, Shunde Hospital, 
      Southern Medical University (The First People's Hospital of Shunde), Foshan, 
      Guangdong, China.
FAU - Liu, Lan
AU  - Liu L
AD  - Institute and Department of Endocrinology and Metabolism, Shunde Hospital, 
      Southern Medical University (The First People's Hospital of Shunde), Foshan, 
      Guangdong, China.
FAU - Peng, Leiyang
AU  - Peng L
AD  - School of Public Health, Southern Medical University, Guangzhou, Guangdong, 
      China.
FAU - Liu, Han
AU  - Liu H
AD  - School of Public Health, Southern Medical University, Guangzhou, Guangdong, 
      China.
FAU - Xiong, Ning
AU  - Xiong N
AD  - School of Public Health, Southern Medical University, Guangzhou, Guangdong, 
      China.
FAU - Guan, Zhuofan
AU  - Guan Z
AD  - School of Public Health, Southern Medical University, Guangzhou, Guangdong, 
      China.
FAU - Yang, Aimin
AU  - Yang A
AD  - Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 
      Hong Kong Special Administrative Region of China.
FAU - Cao, Huanyi
AU  - Cao H
AD  - Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong 
      Academy of Medical Sciences, Guangzhou, Guangdong, China. Electronic address: 
      caohuanyi@link.cuhk.edu.hk.
FAU - Shen, Jie
AU  - Shen J
AD  - Institute and Department of Endocrinology and Metabolism, Shunde Hospital, 
      Southern Medical University (The First People's Hospital of Shunde), Foshan, 
      Guangdong, China. Electronic address: sjiesy@smu.edu.cn.
LA  - eng
PT  - Journal Article
DEP - 20221116
PL  - Netherlands
TA  - Ecotoxicol Environ Saf
JT  - Ecotoxicology and environmental safety
JID - 7805381
RN  - 0 (Metals)
SB  - IM
MH  - Adult
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Non-alcoholic Fatty Liver Disease/chemically induced/epidemiology
MH  - Nutrition Surveys
MH  - Bayes Theorem
MH  - Prospective Studies
MH  - Liver Cirrhosis/chemically induced/epidemiology
MH  - Metals
OTO - NOTNLM
OT  - BKMR
OT  - Heavy metal mixture
OT  - NAFLD
OT  - Qgcomp
OT  - WQS regression
COIS- Conflicts of interest No competing financial interests to declare.
EDAT- 2022/11/20 06:00
MHDA- 2022/12/07 06:00
CRDT- 2022/11/19 18:27
PHST- 2022/08/29 00:00 [received]
PHST- 2022/10/25 00:00 [revised]
PHST- 2022/11/14 00:00 [accepted]
PHST- 2022/11/20 06:00 [pubmed]
PHST- 2022/12/07 06:00 [medline]
PHST- 2022/11/19 18:27 [entrez]
AID - S0147-6513(22)01146-0 [pii]
AID - 10.1016/j.ecoenv.2022.114306 [doi]
PST - ppublish
SO  - Ecotoxicol Environ Saf. 2022 Dec 15;248:114306. doi: 
      10.1016/j.ecoenv.2022.114306. Epub 2022 Nov 16.