Association of long-term ambient fine particulate matter (PM2.5) and incident non-alcoholic fatty liver disease in Chinese adults

Peizhi Deng; Haibo Tang; Liyong Zhu; Jingwen Duan; Fei Li; Yalan Li; Jie Wang; Jingjing Wu; Changjiang Meng; Wei Wang; Yiping Yang; Zhiheng Chen; Jiangang Wang; Hong Yuan; Zhijun Huang; Jingjing Cai; Yao Lu

doi:10.1016/j.envpol.2023.121666

Association of long-term ambient fine particulate matter (PM_2.5) and incident non-alcoholic fatty liver disease in Chinese adults

Environ Pollut. 2023 Jul 15:329:121666. doi: 10.1016/j.envpol.2023.121666. Epub 2023 Apr 18.

Authors

Peizhi Deng¹, Haibo Tang², Liyong Zhu², Jingwen Duan³, Fei Li³, Yalan Li³, Jie Wang³, Jingjing Wu³, Changjiang Meng³, Wei Wang³, Yiping Yang³, Zhiheng Chen⁴, Jiangang Wang⁴, Hong Yuan⁵, Zhijun Huang⁶, Jingjing Cai⁷, Yao Lu⁸

Affiliations

¹ Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, 410013, China; Department of Endoscopy and Laser, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, 510062, China.
² Department of Metabolic and Bariatric Surgery, The Third Xiangya Hospital, Central South University, Changsha, 410013, China.
³ Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, 410013, China.
⁴ Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, 410013, China.
⁵ Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, 410013, China; Department of Cardiology, The Third Xiangya Hospital of Central South University Changsha, 410013, China.
⁶ Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, 410013, China; National-Local Joint Engineering Laboratory of Drug Clinical Evaluation Technology, Central South University, Changsha, 410013, China.
⁷ Department of Cardiology, The Third Xiangya Hospital of Central South University Changsha, 410013, China.
⁸ Clinical Research Center, The Third Xiangya Hospital, Central South University, Changsha, 410013, China; Department of Cardiology, The Third Xiangya Hospital of Central South University Changsha, 410013, China; School of Life Course Sciences, King's College London, London, WC2R 2LS, United Kingdom. Electronic address: Yao.lu@kcl.ac.uk.

PMID: 37080516
DOI: 10.1016/j.envpol.2023.121666

Abstract

Air pollution is increasingly recognized as an important environmental risk factor for non-alcoholic fatty liver disease (NAFLD). However, epidemiologic evidence on long-term exposure to high air pollution concentrations with incident NAFLD is still very limited. Here, we constructed a population-based dynamic cohort involving 17,106 subjects who were enrolled between 2005 and 2013 and subsequently followed until 2017, combined with a high-resolution ambient fine particulate matter ≤2.5 μm (PM_2.5) dataset, to investigate the association of long-term PM_2.5 exposure (cumulative annual average levels ranged from 36.67 to 111.16 μg/m³) with NAFLD incidence (N = 4,640). We estimated the adjusted hazard ratio (HR) for incident NAFLD among those exposed to the highest quartile of PM_2.5 was 2.04 [95% confidence interval (CI), 1.80-2.30] compared with individuals exposed to the lowest quartile of PM_2.5. The dose-response relationships for PM_2.5 are non-linear for NAFLD across the exposure distribution. Further stratified analyses revealed that lean (<23 kg/m²), younger (<40-year-old), and women individuals appeared more vulnerable to the harmful effects of PM_2.5 exposure. Our study suggests a greater long-term high ambient PM_2.5 exposure is associated with an increased risk of NAFLD in Chinese adults, particularly in specific groups, including lean, women, and younger people.

Keywords: Air pollution; Environmental impact; Lean; Non-alcoholic fatty liver disease.

MeSH terms

Adult
Air Pollutants* / analysis
Air Pollution* / adverse effects
Air Pollution* / analysis
East Asian People
Environmental Exposure / adverse effects
Environmental Exposure / analysis
Female
Humans
Non-alcoholic Fatty Liver Disease* / chemically induced
Non-alcoholic Fatty Liver Disease* / epidemiology
Particulate Matter / analysis

Substances

Particulate Matter
Air Pollutants