The sex-specific effects of blood lead, mercury, and cadmium levels on hepatic steatosis and fibrosis: Korean nationwide cross-sectional study

Chung, Seung Min; Moon, Jun Sung; Yoon, Ji Sung; Won, Kyu Chang; Lee, Hyoung Woo

doi:10.1016/j.jtemb.2020.126601

Cited by 43 publications

(23 citation statements)

References 39 publications

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“…According the KoNEHS, despite the trend of decreasing heavy metal concentrations in Korean adults, they are higher than those in the United States and Canada, and higher or lower depending on the heavy metals for adults in Germany ( Table 4 ) [ 29 , 31 , 36 , 37 , 38 , 39 ]. According to previous studies, factors such as age, sex, BMI, and lifestyle are related to liver function biomarkers as well as to heavy metal concentrations [ 8 , 40 , 41 ]. In Asian countries such as Korea, Japan, and China, it is reported that the high seafood consumption frequency contributes to heavy metals exposure [ 42 , 43 , 44 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

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Association between Pb, Cd, and Hg Exposure and Liver Injury among Korean Adults

Kim

Ock

Moon

et al. 2021

IJERPH

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Background: Exposure to lead (Pb), cadmium (Cd), and mercury (Hg) has been reported to be associated with liver-related diseases. However, studies examining the association between heavy metal exposure and liver injury in a large population are scant and characterized by inconsistent results. This study aimed to evaluate the association between levels of heavy metal exposure and liver injury in the general population. Methods: Data for 2953 participants aged 19 years or more obtained from the Korean National Environmental Health Survey (KoNEHS) Cycle 3 (2015–2017) were used. The associations between levels of blood or urine heavy metals (Pb, Cd, and Hg) and liver function biomarkers [aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT)] were evaluated using multiple linear regression analysis. Results: Regarding the blood Pb (BPb), AST was higher in those of the 4th quartile, ALT was higher in those of the 2nd and 4th quartiles, and GGT was higher in those of the 3rd and 4th quartiles than in the 1st quartile. For urinary Cd (UCd), AST was higher in those of the 4th quartile; ALT was higher in those of the 2nd, 3rd, and 4th quartiles; and GGT was higher in the 4th quartile than in the 1st quartile. For the blood Hg (BHg), AST was higher in those of the 2nd and 4th quartile, ALT was higher in those of the 2nd, 3rd, and 4th quartiles; and GGT was higher in those of the 3rd and 4th quartiles than in the 1st quartile. There was no significant difference between urinary Hg (UHg) and liver function markers. Conclusion: Heavy metal exposure showed an association with liver injury among the general adult population in Korea. Further studies are required to clarify the relationship between heavy metals and liver injury.

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Section: Discussionmentioning

confidence: 99%

“…Heavy metals have the properties of accumulating in selected tissues of the human body and the potential to be toxic even at low levels of exposure [ 6 ]. Heavy metal exposure was associated with nonalcoholic fatty liver (NAFLD), nonalcoholic steatohepatitis (NASH), and hepatic fibrosis [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Association between Pb, Cd, and Hg Exposure and Liver Injury among Korean Adults

Kim

Ock

Moon

et al. 2021

IJERPH

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“…A positive association between blood mercury levels and the risk of NAFLD (based on ALT levels) has been reported in both US adolescents and adults [ 14 , 15 ]. In addition, blood mercury levels in the men were shown to be significantly associated with NAFLD, but not in the women, after adjusting for comorbidities [ 16 ]. These studies used BMI as a covariate in the multivariate analyses, instead of stratification.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, because the inverse relationship between serum GGT and antioxidants was already reported, serum GGT might be an early marker of oxidative stress [ 40 ]. It has been reported that mercury is significantly associated with the elevation of ALT, AST, and GGT [ 16 , 40 , 41 ]. In this study, the prevalence of abnormal ALT, AST, and GGT levels increased according to blood mercury levels.…”

Section: Discussionmentioning

confidence: 99%

“…Liver enzyme levels, which are a proxy marker for liver dysfunction and non-alcoholic fatty liver disease (NAFLD), were found to be associated with mercury exposure in recent epidemiological studies [ 14 , 15 , 16 ]. NAFLD may progress to liver failure and hepatocellular carcinoma [ 17 ]; accordingly, epidemiological interest in the search for factors related to the occurrence of NAFLD is increasing.…”

Section: Introductionmentioning

confidence: 99%

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Association between Blood Mercury Levels and Non-Alcoholic Fatty Liver Disease in Non-Obese Populations: The Korean National Environmental Health Survey (KoNEHS) 2012–2014

Yang

Park

et al. 2021

IJERPH

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Mercury is widely distributed in the environment, and a plausible association between mercury exposure and hepatic damage has been reported. Non-alcoholic fatty liver disease (NAFLD), which comprises a spectrum of liver diseases, has recently been recognized in non-obese subjects. However, there have been no studies on the relationship between internal mercury levels and NAFLD in non-obese individuals. Therefore, we investigated the association between blood mercury levels and NAFLD in non-obese subjects. Cross-sectional data (n = 5919) were obtained from the Korean National Environmental Health Survey (2012–2014). NAFLD was defined using the hepatic steatosis index (HSI). Blood mercury levels were log-transformed and divided into quartiles based on a weighted sample distribution. The association between blood mercury levels and NAFLD was analyzed using a multivariate logistic analysis after body mass index stratification. The geometric mean of blood mercury in the overweight group was significantly higher than that of the non-obese group (p < 0.001). The weighted frequencies of patients with NAFLD based on the HSI were 3.0–7.2% for the non-obese subjects and 52.3–63.2% for the overweight subjects. In the multivariate analysis, blood mercury levels were positively associated with NAFLD for both the overweight and non-obese groups (all p for trend < 0.001). Increased blood mercury levels are closely associated with NAFLD. In particular, mercury could be a risk factor for NAFLD in the non-obese population.

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The Association Between Coffee Consumption and Nonalcoholic Fatty Liver Disease in the South Korean General Population

Tan

Jung

Kim

et al. 2021

Molecular Nutrition Food Res

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Scope To identify the cross‐sectional and prospective association between coffee consumption and nonalcoholic fatty liver disease (NAFLD) among South Korean adults. Methods and Results Participants are selected from the Health Examinees study. NAFLD is defined using three non‐invasive indexes: fatty liver index (FLI), hepatic steatosis index, and fibrosis‐4 calculator (FIB‐4). In the cross‐sectional analysis, higher habitual coffee consumption is associated with a lower risk for NAFLD, define using the FLI, (men, odds ratio [OR] 0.702; women, OR 0.810) compared with non‐consumers. Participants who consumed coffee with sugar and creamer also have a lower risk for NAFLD, defined using the FIB‐4, compared with non‐coffee‐consumers (men, OR 0.739; women, OR 0.807). A prospective analysis indicated that higher coffee consumption is associated with a lower incidence of NAFLD, defined using the FLI, in men (hazard ratio, 0.706). In both men and women, a lower FIB‐4 index score is associated with higher coffee consumption regardless of coffee type (all p‐value <0.05). Conclusions Coffee consumption of >3 cups per day has a protective effect against the development of NAFLD to a certain extent, and a negative association is found between coffee consumed with sugar and creamer and the FIB‐4 index score in South Korean adults.

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The sex-specific effects of blood lead, mercury, and cadmium levels on hepatic steatosis and fibrosis: Korean nationwide cross-sectional study

Cited by 43 publications

References 39 publications

Association between Pb, Cd, and Hg Exposure and Liver Injury among Korean Adults

Association between Pb, Cd, and Hg Exposure and Liver Injury among Korean Adults

Association between Blood Mercury Levels and Non-Alcoholic Fatty Liver Disease in Non-Obese Populations: The Korean National Environmental Health Survey (KoNEHS) 2012–2014

The Association Between Coffee Consumption and Nonalcoholic Fatty Liver Disease in the South Korean General Population

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