Association Between Perfluoroalkyl Substance (PFAS) Exposure and Nonalcoholic Fatty Liver Disease in Korean Adults: Results From the KoNEHS 2018-2020: A Cross-Sectional Study

作者：Yun J, Min YS · 发表于：American journal of industrial medicine · 年份：2025 · DOI：10.1002/ajim.23732 · 研究领域：Non-alcoholic Fatty Liver Disease、Fluorocarbons、Environmental Exposure、Environmental Pollutants、Humans、Republic of Korea、Male、Cross-Sectional Studies、Female、Middle Aged、Adult、Caprylates

OBJECTIVES: Nonalcoholic fatty liver disease (NAFLD) is a major public health problem and the most common chronic liver disease today. In Korea, the prevalence and incidence of NAFLD are currently very high, causing a serious social burden. Perfluoroalkyl substances (PFAS) have been consistently implicated as a potential cause of NAFLD, but research in Koreans is limited. METHODS: Using data from the 4th Korean National Environmental Health Survey (KoNEHS, n = 2792), we investigated the association between PFAS blood levels and NAFLD. Multivariable logistic regression models were used to calculate odds ratios (ORs) for the effects of PFAS. A mediation analysis was also conducted to examine the mediating effect of obesity. Finally, weighted quantile sum (WQS) and G-computation methods were implemented to evaluate the joint effect of PFAS mixtures. Hepatic steatosis index was used as a diagnostic tool for NAFLD. [Correction added on 15 May 2025, after first online publication: The KoNEHS n value was changed from 2859 to 2792 in this version.] RESULTS: Through multivariable logistic regression, statistically significant associations with NAFLD were observed for perfluorooctanoic acid (PFOA) (OR 1.09-1.39), perfluorooctansulfonate (PFOS) (1.09-1.40), perfluorohexanesulfonic acid (PFHxS) (1.04-1.22), perfluorononanoic acid (PFNA) (1.12-1.42), and total PFAS (1.21-1.81). We also found that obesity was a significant mediator for PFOA, PFNA, and total PFAS. The ORs for NAFLD obtaine...