Associations of phthalates with NAFLD and liver fibrosis: A nationally representative cross-sectional study from NHANES 2017 to 2018

作者：Xingying Chen, Feng Tian, Jianfeng Wu, Lan Liu, Ye Li, Genfeng Yu, Hualin Duan, Yuqi Jiang, Si‐Yang Maggie Liu, Yajun He, Yaosheng Luo, Cheng Song, Huai Li, Yongqian Liang, Heng Wan, Jie Shen · 发表于：Frontiers in Nutrition · 年份：2022 · DOI：10.3389/fnut.2022.1059675 · 被引用次数：31 · 研究领域：Effects and risks of endocrine disrupting chemicals、Diet and metabolism studies、Metabolomics and Mass Spectrometry Studies

Objective Although phthalates are common environmental pollutants, few studies have focused on the relationship of phthalates exposure with non-alcoholic fatty liver disease (NAFLD) or liver fibrosis, and especially, the alternative phthalates have been questioned in recent years about whether they are better choices. Thus, this study aimed to explore the associations of exposure to major phthalates or alternative phthalates with NAFLD and liver fibrosis. Methods Data of 1450 adults from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 were collected. The urinary metabolite concentrations of di-2-ethylhexyl phthalate (DEHP), diisononyl phthalate (DINP) and diisodecyl phthalate (DIDP) were detected. Controlled attenuation parameter (CAP) and median liver stiffness measurement (LSM) were acquired for quantitative diagnosis of NAFLD and liver fibrosis by vibration-controlled transient elastography. Multivariate logistic regression analysis and linear regression analysis were performed to examine the associations between phthalates and NAFLD and liver fibrosis. Results After adjustment of the potential factors, the prevalence of NAFLD was significantly elevated among those in the fourth quartile of mono-(2-ethyl-5-carboxypentyl) phthalate (OR, 95%CI = 2.719, 1.296, 5.700, P = 0.016), mono (2-ethyl-5-hydroxyhexyl) phthalate (OR, 95%CI = 2.073, 1.111, 3.867, P = 0.037). No significant association was found between the alternative phthalates and NAFLD. The sim...