Environmental Microcystin Exposure Increases Liver Injury Risk Induced by Hepatitis B Virus Combined with Aflatoxin: A Cross-Sectional Study in Southwest China

作者：Wenyi Liu, Lingqiao Wang, Xiaohong Yang, Hui Zeng, Renping Zhang, Chaowen Pu, Chuanfen Zheng, Yao Tan, Yang Luo, Xiaobin Feng, Yingqiao Tian, Guosheng Xiao, Jia Wang, Yujing Huang, Jiaohua Luo, Lei Feng, Feng Wang, Changyou Yuan, Yuan Yao, Zhiqun Qiu, Jian Chen, Liping Wu, Qingqing Nong, Hui Lin, Weiqun Shu · 发表于：Environmental Science & Technology · 年份：2017 · DOI：10.1021/acs.est.6b05404 · 被引用次数：50 · 研究领域：Aquatic Ecosystems and Phytoplankton Dynamics

Three liver hazards, two confirmed—hepatitis B virus (HBV) and aflatoxin (AFB), and one rarely studied in populations—microcystin (MC), simultaneously exist in tropical and humid areas; however, there are no epidemiological data on their risks in the same population. We conducted a community-based cross-sectional survey among 5493 adults in two rural towns and statistically analyzed the comparative and combinative effects of the three factors after detecting HBsAg and HBV DNA titers, determining estimated daily intakes (EDIs) of AFB1 and MC-LR and testing serum AST and ALT as liver injury markers for each participant. We observed a HBsAg(+) rate of 7.6%, a relatively high AFB1 exposure level (mean EDI AFB1 = 471.30 ng/d), and a relatively low MC-LR exposure level (mean EDI MC-LR = 228.25 ng/d). ORs for abnormal AST (2.42, 95%CI = 1.69–3.45) and ALT (2.87, 95%CI = 1.91–4.29) increased in HBV infections compared with HBV-unexposed participants but did not increase in participants with separate or combined exposure to AFB1 and MC-LR (EDIs ≥ mean). Meanwhile, after adjustment for confounding factors, means of AST and ALT and ORs of abnormal AST and ALT were successively elevated after exposure to HBV, HBV&AFB1 (or HBV&MC-LR), and HBV&AFB1&MC-LR, especially in the group with detectable HBV DNA (AST: OR = 11.38, 95%CI = 3.91–33.17; ALT: OR = 17.09, 95%CI = 5.36–54.53). Notably, ORs for abnormal AST and ALT in the HBV exposed group were not significantly different from those in HBV&...