| Title: | Associations of MAFLD subtypes and air pollutants with multi-system morbidity and all-cause mortality: A prospective cohort study |
| Journal: | Ecotoxicology and Environmental Safety |
| Published: | 16 Feb 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/39955868/ |
| DOI: | https://doi.org/10.1016/j.ecoenv.2025.117893 |
Publication 14389
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Abstract
BACKGROUND: Metabolic dysfunction-associated fatty liver disease (MAFLD) and air pollution are both significant health concerns. However, their combined effects on multi-system morbidity and all-cause mortality remain poorly understood.</p>
METHODS: We analyzed data from 434,417 UK Biobank participants, categorizing them into four groups: non-MAFLD, MAFLD-diabetes, MAFLD-lean, and MAFLD-overweight/obesity. To evaluate the long-term effects of air pollution exposure, we used time-varying Cox proportional hazard models to assess four air pollutants: particulate matter with an aerodynamic diameter < 2.5 μm (PM2.5), PM10, nitrogen dioxide (NO2), and nitrogen oxides (NOx). We examined the associations between these air pollutants, MAFLD subtypes, and their joint impact on multi-system morbidity and all-cause mortality. Furthermore, we explored the additive and multiplicative interactions between air pollutants and MAFLD subtypes.</p>
RESULTS: At baseline, 15,325 participants were classified as MAFLD-diabetes, 3341 as MAFLD-lean, and 140,934 as MAFLD-overweight/obesity. Among these groups, MAFLD-diabetes was most strongly associated with adverse outcomes compared to other subtypes. Air pollution exposure had a synergistic effect on cirrhosis risk across all MAFLD subtypes, with the most pronounced effects observed for PM2.5 [relative excess risk due to interaction (RERI): 2.10 (0.94, 3.26)] and NO2 [RERI:1.85 (0.67, 3.04)] in MAFLD-lean group. Positive additive and multiplicative interactions between air pollutants and MAFLD subtypes were also observed for coronary artery disease (CAD), with the exception of nitrogen oxide in the MAFLD-lean group. Additionally, only the MAFLD-diabetes demonstrated significant positive additive interactions with all four air pollutants in relation to chronic kidney disease (CKD).</p>
CONCLUSIONS: This study highlights the distinct impacts of MAFLD subtypes on multi-system morbidity and all-cause mortality, underscoring the critical need for targeted prevention and treatment strategies, particularly for individuals with MAFLD-diabetes. Our findings reveal significant additive and synergistic effects of air pollution exposure on the risks of cirrhosis, CAD, and CKD among MAFLD patients.</p>
18 Keywords
- Adult
- Aged
- Air Pollutants
- Air Pollution
- Diabetes Mellitus
- Environmental Exposure
- Fatty Liver
- Female
- Humans
- Male
- Middle Aged
- Nitrogen Dioxide
- Nitrogen Oxides
- Obesity
- Particulate Matter
- Proportional Hazards Models
- Prospective Studies
- United Kingdom
8 Authors
- Jingyi Zhang
- Shanshan Ran
- Shengtao Wei
- Fei Tian
- Lan Chen
- Zijun Yang
- Ge Chen
- Hualiang Lin
1 Application
| Application ID | Title |
|---|---|
| 69550 | Identifying the potential effects of environmental and other healthcare related factors influencing health outcomes, mediated by genetic variances |
Enabling scientific discoveries that improve human health