Association between soil heavy metals and fatty liver disease in men in Taiwan: a cross sectional study

Abstract

ObjectivesMetabolic factors are major risk factors for non-alcoholic fatty liver disease although other factors may also contribute to development of fatty liver disease. We explored the association between exposure to soil heavy metals and prevalence of fatty liver disease.MethodsWe retrospectively analysed data from patients diagnosed with fatty liver disease in 2014 at the Health Evaluation Centre of Chang-Hua Christian Hospital (n=1137). We used residency data provided in the records of the Health Evaluation Centre and data for soil metal concentrations from a nationwide survey conducted by the Environmental Protection Administration of Taiwan. We studied the correlations between the severity of fatty liver disease and concentrations of soil heavy metals (arsenic, mercury, cadmium, chromium, copper, nickel, lead and zinc).ResultsThe prevalence of moderate to severe fatty liver disease in our study was 26.5%. Using univariate and multivariate analysis, we demonstrated that the presence of soil heavy metals was a significant risk factor for fatty liver disease in men (OR 1.83, 95% CI 1.161 to 2.899, p=0.009). With stratification by body mass index (BMI) and gender, lean men with a BMI <24 kg/m2 were the most susceptible to soil heavy metals (OR 5.059, 95% CI 1.628 to 15.728, p<0.05).ConclusionsOur study suggested a significant association between exposure to soil heavy metals and fatty liver disease in lean men.

Associação entre a exposição a desreguladores endócrinos e desenvolvimento de doença hepática gordurosa não alcóolica

“…Nos demais estudos, a quantificação da exposição se deu pela análise de urina (n=5) (16,17,(19)(20)(21) , sangue (n=3) (22)(23)(24) , ou ambos (n=2) (25,26) , ou análise do solo (n=1) (27) Os estudos abrangeram diversos desreguladores endócrinos, com destaque ao Bisfenol A (BPA) (16,17,26) e ao Trialometanos (THM) (20,24) . Arsênico (19) , cádmio (21) , ferro (22) , metais pesados (27) , produtos petroquímicos (18) , chumbo, mercúrio e bifenilos policlorados (PCB) (25) e éter butílico metil terciário (MTBE) (23) também foram avaliados. Artigos que avaliaram a exposição à sobrecarga de ferro (22) e ao MTBE (23) A DHGNA é reconhecida como a doença hepática mais comum em países ocidentais, alcançando proporções epidêmicas nas últimas duas décadas (28,29) .…”

“…Vale ressaltar que a exposição a determinadas substâncias químicas, conhecidas como DE, pode provocar a progressão da DHGNA para suas formas mais graves de esteatohepatite e cirrose (21,26,27) . Na população obesa, a chance de desenvolver DHGNA mediante a maior exposição a DE é 50% maior (25) .…”

“…Em indivíduos obesos (17,19,25) , do sexo masculino (16,19,21,27) e de origem hispânica (17,19,25) houve maior risco de desenvolvimento de DHGNA pela interação com DE. Entretanto, alguns dos estudos apontaram que mulheres (21,25) e indivíduos magros (27) também possuem este risco, entretanto em menor grau. Uma das possíveis razões dessa diferença é o efeito protetor exercido pelo estrogênio, através de ações anti-inflamatórias e imunomodulatórias (35) .…”

Arsenic exposure and risk of nonalcoholic fatty liver disease (NAFLD) among U.S. adolescents and adults: an association modified by race/ethnicity, NHANES 2005–2014

“…The genetic variant, PNPLA3, which is common among Hispanics, has been associated with alanine aminotransferase (ALT) levels, a marker of liver damage, and increased hepatic fat [ 5 – 7 ]. Recent evidence suggests that exposure to environmental pollutants including those that are inhalation and ingestion toxicants [ 8 – 10 ], including heavy metals such as arsenic [ 11 ], may play a role. Lin et al previously found a significant association between several soil-derived heavy metals, including arsenic, and NAFLD in lean Tiawanese men, but the independent effect of arsenic was not examined [ 11 ].…”

La exposición a cadmio exacerba la hiperlipidemia en hepatocitos con sobrecarga de colesterol

“…Metabolic disorders are major risk factors for NAFLD, although other factors may also contribute to development of fatty liver disease. Lin (Lin et al, 2017) suggests a significant association between exposure to soil heavy metals and fatty liver disease in lean men. Besides environmental Cd exposure has been associated with hepatic necroinflammation, NAFLD and NASH in men .…”