Metabolic associated fatty liver disease (MAFLD) is a common liver disease with a prevalence of up to 25%; it not only adversely affects human health but also aggravates the economic burden of society. An increasing number of studies have suggested that the occurrence of chronic noncommunicable diseases is affected by both environmental exposures and genetic factors. Research has also shown that environmental pollution may increase the risk of MAFLD and promote its occurrence and development. However, the relationship between these concepts, as well as the underlying exposure effects and mechanism, remains incompletely understood. Lipidomics, a branch of metabolomics that studies lipid disorders, can help researchers investigate abnormal lipid metabolites in various disease states. Lipidome-exposome wide association studies are a promising paradigm for investigating the health effects of cumulative environmental exposures on biological responses, and could provide new ideas for determining the associations between metabolic and lipid changes and disease risk caused by chemical-pollutant exposure. Hence, in this study, targeted exposomics and nontargeted lipidomics studies based on ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) and ultra-high performance liquid chromatography-high resolution mass spectrometry (UHPLC-HRMS) were used to characterize exogenous chemical pollutants and endogenous lipid metabolites in the sera of patients with MAFLD and healthy subjects. The results demonstrated that fipronil sulfone, malathion dicarboxylic acid, and monocyclohexyl phthalate may be positively associated with the disease risk of patients diagnosed as simple fatty liver disease (hereafter referred to as MAFLD(0)). Moreover, fipronil sulfone, acesulfame potassium, perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluoroundecanoic acid (PFUnDA), 4-hydroxybenzophenone, and 3,5-di-tert-butyl-4-hydroxybenzoic acid (DBPOB) may be positively associated with the disease risk of patients diagnosed as fatty liver complicated by single or multiple metabolic disorders. Association analysis was carried out to explore the lipid metabolites induced by chemical residues. Triglyceride (TG) and diglyceride (DG) were significantly increased in MAFLD and MAFLD(0). The numbers of carbons of significantly changed DGs and TGs were mainly in the ranges of 32-40 and 35-60, respectively, and both were mainly characterized by changes in polyunsaturated lipids. Most of the lipid-effect markers were positively correlated with chemical residues and associated with increased disease risk. Our research provides a scientific basis for studies on the association and mechanism between serum chemical-pollutant residues and disease outcomes.
代谢相关脂肪性肝病是当前常见的一种肝脏疾病,在世界范围内的患病率高达25%,严重危害人类健康并对社会造成巨大的经济负担。越来越多的研究表明慢性非传染性疾病的发生是环境暴露与遗传因素共同作用的结果,环境污染是其不可小觑的健康风险因素。为了探究环境暴露对代谢相关脂肪性肝病风险及暴露效应,本研究利用超高效液相色谱-串联质谱(UHPLC-MS/MS)的靶向暴露组学和超高效液相色谱-高分辨质谱(UHPLC-HRMS)的非靶向脂质组学技术分别分析了代谢相关脂肪性肝病患者血清中外源性化学物质的暴露特征和内源性脂质代谢物的扰动,结合暴露组-脂质组关联分析,在脂代谢水平上探究环境暴露引起的代谢相关脂肪性肝病的风险及暴露效应。研究发现,代谢相关脂肪性肝病患者体内外源性化学物质与代谢相关脂肪性肝病的风险增加有关,其中氟虫腈砜(fipronil sulphone)、马拉硫磷二羧酸(malathion dicarboxylic acid)和邻苯二甲酸单环己酯(monocyclohexyl phthalate)与单纯性脂肪肝风险呈正相关,氟虫腈砜(fipronil sulphone)、安赛蜜(acesulfame potassium)、全氟辛酸(PFOA)、全氟壬酸(PFNA)、全氟十一酸(PFUnDA)和4-羟基二苯甲酮(4-hydroxybenzophenone)以及3,5-二叔丁基-4-羟基苯甲酸(DBPOB)与合并代谢性疾病的脂肪肝风险呈正相关。单纯性脂肪肝患者和合并代谢性疾病的脂肪肝患者的脂代谢发生了显著的改变,神经酰胺(Cer)、甘油三酯(TG)和甘油二酯(DG)显著升高,这些DG和TG的酰基碳数分别为32~40和35~60,且两者均表现为多不饱和的脂质分子的变化为主。大多数的脂质效应标志物与外源性化学物质残留呈正相关,并与疾病风险增加有关。本研究可以为环境化学物质暴露与代谢相关脂肪性肝病的关联与机制研究提供科学依据。
Keywords: exposomics; lipidomics; metabolic associated fatty liver disease (MAFLD); omics-wide association study.