Air pollution associate with advanced hepatic fibrosis among patients with chronic liver disease
Journal
The Kaohsiung journal of Medical Sciences
Journal Volume
40
Journal Issue
3
Pages
304-314
Date Issued
2024-03
Author(s)
Jang, Tyng-Yuan
Ho, Chi-Chang
Liang, Po-Cheng
Wu, Chih-Da
Wei, Yu-Ju
Tsai, Pei-Chien
Hsu, Po-Yao
Hsieh, Ming-Yen
Lin, Yi-Hung
Hsieh, Meng-Hsuan
Wang, Chih-Wen
Yang, Jeng-Fu
Yeh, Ming-Lun
Huang, Chung-Feng
Chuang, Wan-Long
Huang, Jee-Fu
Cheng, Ya-Yun
Dai, Chia-Yen
Yu, Ming-Lung
Abstract
We aimed to investigate the association between air pollution and advanced fibrosis among patients with metabolic associated fatty liver disease (MAFLD) and chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. A total of 1376 participants who were seropositive for HBV surface antigen (HBsAg) or antibodies to HCV (anti-HCV) or had abnormal liver function in a community screening program from 2019 to 2021 were enrolled for the assessment of liver fibrosis using transient elastography. Daily estimates of air pollutants (particulate matter ≤2.5 μm in diameter [PM2.5 ], nitrogen dioxide [NO2 ], ozone [O3 ] and benzene) were aggregated into mean estimates for the previous year based on the date of enrolment. Of the 1376 participants, 767 (52.8%) and 187 (13.6) had MAFLD and advanced fibrosis, respectively. A logistic regression analysis revealed that the factors associated with advanced liver fibrosis were HCV viremia (odds ratio [OR], 3.13; 95% confidence interval [CI], 2.05-4.77; p < 0.001), smoking (OR, 1.79; 95% CI, 1.16-2.74; p = 0.01), age (OR, 1.04; 95% CI, 1.02-1.05; p < 0.001) and PM2.5 (OR, 1.10; 95% CI, 1.05-1.16; p < 0.001). Linear regression analysis revealed that LSM was independently correlated with PM2.5 (β: 0.134; 95% CI: 0.025, 0.243; p = 0.02). There was a dose-dependent relationship between different fibrotic stages and the PM2.5 level (the PM2.5 level in patients with fibrotic stages 0, 1-2 and 3-4: 27.9, 28.4, and 29.3 μg/m3 , respectively; trend p < 0.001). Exposure to PM2.5 , as well as HBV and HCV infections, is associated with advanced liver fibrosis in patients with MAFLD. There was a dose-dependent correlation between PM2.5 levels and the severity of hepatic fibrosis.
Subjects
MAFLD; PM2.5; advanced liver fibrosis; air pollution; transient elastography
Publisher
John Wiley and Sons Ltd
Type
journal article