美国成人砷暴露与肝损伤的关联：NHANES 2003–2018,Environmental Science and Pollution Research

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美国成人砷暴露与肝损伤的关联：NHANES 2003–2018
Environmental Science and Pollution Research Pub Date : 2023-02-09 , DOI: 10.1007/s11356-023-25540-5
Wenjie Li ₁ , Xingzhou Jiang ₁ , Haisheng Qian ₁ , Xinyan Li ₁ , Jing Su ₁ , Guoxin Zhang ₁ , Xuan Li ₁

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砷是一种具有复杂毒性的天然元素。长期接触砷会对健康造成多种损害。近年来，有一些关于砷暴露与肝损伤的研究。但很少有人试图衡量成人砷暴露与肝损伤指标之间的定量关系。因此，本研究旨在阐明它们之间的关系。这项横断面研究使用了 2003-2018 年全国健康和营养检查调查 (NHANES) 的数据。使用总尿砷和二甲基砷酸 (DMA) 评估砷暴露。我们选择丙氨酸氨基转移酶 (ALT)、天冬氨酸氨基转移酶 (AST)、γ-谷氨酰转移酶 (GGT)、总蛋白 (TP)、ALT/AST、总胆红素 (TBIL) 和白蛋白 (ALB) 作为肝损伤的标志物。多元线性回归用于探讨尿砷浓度与这些肝功能损伤标志物之间的关系。此外，在亚组中进一步分析了六个协变量（年龄、性别、吸烟者、饮酒者、BMI、糖尿病）。共有 13,420 名成年人被纳入分析。多元线性回归分析显示尿DMA与ALT呈正相关（β 0.135，95%CI 0.090，0.180，p < 0.001），AST（β 0.053，95%CI 0.014，0.092，p < 0.01），ALT/AST（β 0.052，95%CI 0.030，0.074，p < 0.001）、TBIL（β 0.061、95%CI 0.034、0.089、p < 0.001）和 GGT（β 0.178、95%CI 0.110、0.246，p < 0.001）。对总尿砷观察到类似的结果，表明与 AST ( β 0.048, 95%CI 0.016, 0.081, p < 0.01)、ALT ( β 0.090, 95%CI 0.049, 0.132, p < 0.001) 和 TBIL呈正相关( β 0.062, 95%CI 0.037, 0.088,p < 0.001）。在亚组分析中，性别和吸烟者在亚组间表现出显着差异。我们的结果表明成人尿砷暴露与肝损伤之间呈正相关。性别和吸烟者可能与砷的致病性有关。

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Associations of arsenic exposure with liver injury in US adults: NHANES 2003–2018

Arsenic is a natural element with complex toxicity. Long-term exposure to arsenic can cause a variety of health damage. In recent years, there are some studies on arsenic exposure and liver injury. But few of them tried to measure the quantitative relationship between arsenic exposure and indicators of liver injury in adult. Therefore, this study aimed to elucidate the relationship between them. This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) in 2003–2018. Arsenic exposure was assessed using total urinary arsenic and dimethylarsenate acid (DMA). We selected alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), total protein (TP), ALT/AST, total bilirubin (TBIL), and albumin (ALB) as markers of liver injury. Multiple linear regression was used to explore the relationship between urinary arsenic concentrations and these markers of liver function injury. In addition, six covariables (age, sex, smoker, alcohol user, BMI, diabetes) were further analyzed in subgroups. A total of 13,420 adults were included in the analysis. The multivariate linear regression analyses showed that urinary DMA was positively correlated with ALT (β 0.135, 95%CI 0.090, 0.180, p < 0.001), AST (β 0.053, 95%CI 0.014, 0.092, p < 0.01), ALT/AST (β 0.052, 95%CI 0.030, 0.074, p < 0.001), TBIL (β 0.061, 95%CI 0.034, 0.089, p < 0.001), and GGT (β 0.178, 95%CI 0.110, 0.246, p < 0.001). Similar results were observed for total urinary arsenic, suggesting a positive association with AST (β 0.048, 95%CI 0.016, 0.081, p < 0.01), ALT (β 0.090, 95%CI 0.049, 0.132, p < 0.001), and TBIL (β 0.062, 95%CI 0.037, 0.088, p < 0.001). In subgroup analysis, sex and smoker showed significant differences between subgroups. Our results demonstrate a positive association between urinary arsenic exposure and liver injury in adults. Sex and smokers may be related to arsenic pathogenicity.

更新日期：2023-02-09

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