血清全氟化合物与代谢相关脂肪性肝病患病风险的关系  

Relationship of serum perfluoroalkyl substances with the risk of metabolic associated fatty liver disease.

作　　者：张露露 刘婧 贺颖倩 赵亚楠 郑山[1] 王敏珍[1] ZHANG Lu-lu;LIU Jing;HE Ying-qian;ZHAO Ya-nan;ZHENG Shan;WANG Min-zhen(Institute of Epidemiology and Statistics,School of Public Health,Lanzhou University,Lanzhou 73000,China)

机构地区：[1]兰州大学公共卫生学院,流行病与卫生统计学研究所,甘肃兰州730000

出　　处：《中国环境科学》2023年第2期964-972,共9页China Environmental Science

基　　金：国家自然科学基金资助项目(41705122)。

摘　　要：基于2017~2018年美国国家营养调查与健康调查数据集(NHANES),探究血清全氟化合物(PFAS)对代谢相关脂肪性肝病(MAFLD)的影响以及在不同人群中的效应差异.采用Logistic回归模型和限制性立方样条评估各污染物的效应和剂量反应关系.结果表明:单污染物模型发现血清全氟辛烷磺酸(PFOS)、全氟己烷磺酸(PFHxS)、全氟癸酸(PFDA)与MAFLD患病风险呈负向关联,OR值分别为0.64(95%CI:0.45~0.91)、0.65(95%CI:0.46~0.93)、0.45(95%CI:0.30~0.67);多污染物模型中,与最低四分位数浓度(Q1)相比,血清全氟壬酸(PFNA)浓度处于Q2、Q3、Q4水平时,患MAFLD风险分别增加62%(OR=1.62,95%CI:1.10~2.39)、62%(OR=1.62,95%CI:1.01~2.60)、172%(OR=2.72,95%CI:1.53~4.84),且呈正向线性剂量-反应关系(Poverall=0.002).血清PFDA处于Q2、Q3、Q4水平时,可导致MAFLD风险分别减少39%(OR=0.61,95%CI:0.44~0.85)、46%(OR=0.54,95%CI:0.34~0.84)、74%(OR=0.26,95%CI:0.15~0.45),呈负向线性剂量-反应关系(Poverall<0.001).亚组分析显示血清PFDA对51~65岁人群罹患MAFLD的影响更为显著,而血清PFNA对女性的影响较大.综上所述,血清PFNA及PFDA与MAFLD患病风险关联,血清PFNA暴露是MAFLD发生的重要危险因素,而血清PFDA是保护因素,女性、中老年人群是潜在的易感人群.To explore the effect of serum perfluoroalkyl substances(PFAS)on the metabolic-associated fatty liver disease(MAFLD)on the basis of the 2017~2018 US National Health and Nutrition Survey(NHANES)database.The logistic regression model and restricted cubic spline(RCS)were used to evaluate the association and dose-response relationship between PFAS and MAFLD.The main results showed that in a single pollutant model,perfluorooctane sulfonic acid(PFOS),perfluorohexane sulfonic acid(PFHxS)and perfluorodecanoic acid(PFDA)were negatively associated with the risk of MAFLD,with the ORs of 0.64(95%CI:0.45~0.91),0.65(95%CI:0.46~0.93)and 0.45(95%CI:0.30~0.67),respectively.In the multi-pollutant model,compared with the lowest quantile(Q1),the risk of MAFLD increased with the increase of perfluoronanoic acid(PFNA)by 62%(OR=1.62,95%CI:1.10~2.39),62%(OR=1.62,95%CI:1.01~2.60)and 172%(OR=2.72,95%CI:1.53~4.84)at Q2,Q3,and Q4,respectively.Conversely,there was negative linear dose-response relationship(Poverall<0.001)between PFDA and the risk of MAFLD.The risk of MAFLD were 0.61(95%CI:0.44~0.85),0.54(95%CI:0.34~0.84)and 0.26(95%CI:0.15~0.45)when the concentration of PFDA reached to Q2,Q3,and Q4 levels.Subgroup analysis showed that serum PFDA had a more significant effect on the risk of MAFLD in 51~65 years old population.Females exposed to serum PFNA were more likely to develop MAFLD.In conclusion,serum PFNA and PFDA were significantly related to the risk of MAFLD,and PFNA exposure played a risky role in the occurrence of MAFLD while PFDA had protective effect.Women,middle-aged and elderly people might be potential susceptible groups.

关 键 词：全氟化合物 代谢相关脂肪性肝病 剂量反应关系 

分 类 号：X503.1[环境科学与工程—环境工程] X18