Associations of phthalates with NAFLD and liver fibrosis: A nationally representative cross-sectional study from NHANES 2017 to 2018
ObjectiveAlthough phthalates are common environmental pollutants, few studies have focused on the relationship of phthalates exposure with non-alcoholic fatty liver disease (NAFLD) or liver fibrosis, and especially, the alternative phthalates have been questioned in recent years about whether they a...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-11-01
|
| Series: | Frontiers in Nutrition |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2022.1059675/full |
| _version_ | 1811189156566532096 |
|---|---|
| author | Xingying Chen Feng Tian Jianfeng Wu Lan Liu Ye Li Genfeng Yu Hualin Duan Yuqi Jiang Siyang Liu Yajun He Yaosheng Luo Cheng Song Huaizhi Li Yongqian Liang Heng Wan Jie Shen |
| author_facet | Xingying Chen Feng Tian Jianfeng Wu Lan Liu Ye Li Genfeng Yu Hualin Duan Yuqi Jiang Siyang Liu Yajun He Yaosheng Luo Cheng Song Huaizhi Li Yongqian Liang Heng Wan Jie Shen |
| author_sort | Xingying Chen |
| collection | DOAJ |
| description | ObjectiveAlthough phthalates are common environmental pollutants, few studies have focused on the relationship of phthalates exposure with non-alcoholic fatty liver disease (NAFLD) or liver fibrosis, and especially, the alternative phthalates have been questioned in recent years about whether they are better choices. Thus, this study aimed to explore the associations of exposure to major phthalates or alternative phthalates with NAFLD and liver fibrosis.MethodsData of 1450 adults from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 were collected. The urinary metabolite concentrations of di-2-ethylhexyl phthalate (DEHP), diisononyl phthalate (DINP) and diisodecyl phthalate (DIDP) were detected. Controlled attenuation parameter (CAP) and median liver stiffness measurement (LSM) were acquired for quantitative diagnosis of NAFLD and liver fibrosis by vibration-controlled transient elastography. Multivariate logistic regression analysis and linear regression analysis were performed to examine the associations between phthalates and NAFLD and liver fibrosis.ResultsAfter adjustment of the potential factors, the prevalence of NAFLD was significantly elevated among those in the fourth quartile of mono-(2-ethyl-5-carboxypentyl) phthalate (OR, 95%CI = 2.719, 1.296, 5.700, P = 0.016), mono (2-ethyl-5-hydroxyhexyl) phthalate (OR, 95%CI = 2.073, 1.111, 3.867, P = 0.037). No significant association was found between the alternative phthalates and NAFLD. The similar result was gained by linear regression analysis that MECPP was still significantly associated with Ln CAP (Q4 vs. Q1: β, 95%CI = 0.067, 0.017, 0.118, P = 0.027). After adjustment for the same covariates, no significant association between phthalates and liver fibrosis was found in logistics regression analysis.ConclusionsAll in all, higher prevalence of NAFLD is correlated with DEHP but not DINP or DIDP in American adults. There is no significant relationship between phthalates and liver fibrosis defined as LSM ≥ 8 Kpa. Nevertheless, further research is needed to provide evidence of causality. |
| first_indexed | 2024-04-11T14:31:10Z |
| format | Article |
| id | doaj.art-acfc15e559304a1a9ccb2353cc710e75 |
| institution | Directory Open Access Journal |
| issn | 2296-861X |
| language | English |
| last_indexed | 2024-04-11T14:31:10Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj.art-acfc15e559304a1a9ccb2353cc710e752022-12-22T04:18:38ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2022-11-01910.3389/fnut.2022.10596751059675Associations of phthalates with NAFLD and liver fibrosis: A nationally representative cross-sectional study from NHANES 2017 to 2018Xingying Chen0Feng Tian1Jianfeng Wu2Lan Liu3Ye Li4Genfeng Yu5Hualin Duan6Yuqi Jiang7Siyang Liu8Yajun He9Yaosheng Luo10Cheng Song11Huaizhi Li12Yongqian Liang13Heng Wan14Jie Shen15Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, ChinaHealth Management Division, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, ChinaNantong Haimen People's Hospital, Haimen Hospital of Nantong University, Nantong, ChinaDepartment of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, ChinaDepartment of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, ChinaDepartment of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, ChinaDepartment of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, ChinaDepartment of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, ChinaDepartment of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, ChinaDepartment of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, ChinaDepartment of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, ChinaDepartment of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, ChinaShenzhen University General Hospital, Shenzhen University, Shenzhen, Guangdong, ChinaDepartment of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, ChinaDepartment of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, ChinaDepartment of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, ChinaObjectiveAlthough phthalates are common environmental pollutants, few studies have focused on the relationship of phthalates exposure with non-alcoholic fatty liver disease (NAFLD) or liver fibrosis, and especially, the alternative phthalates have been questioned in recent years about whether they are better choices. Thus, this study aimed to explore the associations of exposure to major phthalates or alternative phthalates with NAFLD and liver fibrosis.MethodsData of 1450 adults from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 were collected. The urinary metabolite concentrations of di-2-ethylhexyl phthalate (DEHP), diisononyl phthalate (DINP) and diisodecyl phthalate (DIDP) were detected. Controlled attenuation parameter (CAP) and median liver stiffness measurement (LSM) were acquired for quantitative diagnosis of NAFLD and liver fibrosis by vibration-controlled transient elastography. Multivariate logistic regression analysis and linear regression analysis were performed to examine the associations between phthalates and NAFLD and liver fibrosis.ResultsAfter adjustment of the potential factors, the prevalence of NAFLD was significantly elevated among those in the fourth quartile of mono-(2-ethyl-5-carboxypentyl) phthalate (OR, 95%CI = 2.719, 1.296, 5.700, P = 0.016), mono (2-ethyl-5-hydroxyhexyl) phthalate (OR, 95%CI = 2.073, 1.111, 3.867, P = 0.037). No significant association was found between the alternative phthalates and NAFLD. The similar result was gained by linear regression analysis that MECPP was still significantly associated with Ln CAP (Q4 vs. Q1: β, 95%CI = 0.067, 0.017, 0.118, P = 0.027). After adjustment for the same covariates, no significant association between phthalates and liver fibrosis was found in logistics regression analysis.ConclusionsAll in all, higher prevalence of NAFLD is correlated with DEHP but not DINP or DIDP in American adults. There is no significant relationship between phthalates and liver fibrosis defined as LSM ≥ 8 Kpa. Nevertheless, further research is needed to provide evidence of causality.https://www.frontiersin.org/articles/10.3389/fnut.2022.1059675/fullphthalatesNAFLDliver fibrosisvibration-controlled transient elastographyNHANES (National Health and Nutrition Examination Survey) |
| spellingShingle | Xingying Chen Feng Tian Jianfeng Wu Lan Liu Ye Li Genfeng Yu Hualin Duan Yuqi Jiang Siyang Liu Yajun He Yaosheng Luo Cheng Song Huaizhi Li Yongqian Liang Heng Wan Jie Shen Associations of phthalates with NAFLD and liver fibrosis: A nationally representative cross-sectional study from NHANES 2017 to 2018 Frontiers in Nutrition phthalates NAFLD liver fibrosis vibration-controlled transient elastography NHANES (National Health and Nutrition Examination Survey) |
| title | Associations of phthalates with NAFLD and liver fibrosis: A nationally representative cross-sectional study from NHANES 2017 to 2018 |
| title_full | Associations of phthalates with NAFLD and liver fibrosis: A nationally representative cross-sectional study from NHANES 2017 to 2018 |
| title_fullStr | Associations of phthalates with NAFLD and liver fibrosis: A nationally representative cross-sectional study from NHANES 2017 to 2018 |
| title_full_unstemmed | Associations of phthalates with NAFLD and liver fibrosis: A nationally representative cross-sectional study from NHANES 2017 to 2018 |
| title_short | Associations of phthalates with NAFLD and liver fibrosis: A nationally representative cross-sectional study from NHANES 2017 to 2018 |
| title_sort | associations of phthalates with nafld and liver fibrosis a nationally representative cross sectional study from nhanes 2017 to 2018 |
| topic | phthalates NAFLD liver fibrosis vibration-controlled transient elastography NHANES (National Health and Nutrition Examination Survey) |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2022.1059675/full |
| work_keys_str_mv | AT xingyingchen associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 AT fengtian associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 AT jianfengwu associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 AT lanliu associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 AT yeli associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 AT genfengyu associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 AT hualinduan associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 AT yuqijiang associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 AT siyangliu associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 AT yajunhe associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 AT yaoshengluo associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 AT chengsong associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 AT huaizhili associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 AT yongqianliang associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 AT hengwan associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 AT jieshen associationsofphthalateswithnafldandliverfibrosisanationallyrepresentativecrosssectionalstudyfromnhanes2017to2018 |