TY - JOUR
T1 - Association of blood manganese, selenium with steatosis, fibrosis in the National Health and Nutrition Examination Survey, 2017-18
AU - Spaur, Maya
AU - Nigra, Anne E.
AU - Sanchez, Tiffany R.
AU - Navas-Acien, Ana
AU - Lazo, Mariana
AU - Wu, Hui Chen
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/10
Y1 - 2022/10
N2 - Background & aims: Chronic liver disease is a growing health burden worldwide. Chronic metal exposures may be associated with non-alcoholic fatty liver disease (NAFLD). We aimed to evaluate the association of blood cadmium (Cd), mercury (Hg), lead (Pb), manganese (Mn), and selenium (Se) with two hallmark features of NAFLD: liver steatosis and fibrosis in the general U.S. population. Methods: We analyzed transient liver elastography data from participants of the National Health and Nutrition Examination Survey (NHANES) 2017–18, using ordinal logistic regression analyses to evaluate the cross-sectional association between blood metal concentrations and clinical stages of steatosis and fibrosis. We applied survey weights, strata, and primary sampling units and analyses were conducted using the R survey package. Results: 4,154 participants were included. Median (IQR) for blood Mn and blood Se were 9.28 (7.48–11.39) and 191.08 (176.55–207.16) μg/L, respectively. Per interquartile range increase of natural log transformed blood Mn, the adjusted odds ratio (OR) (95% CI) was 1.59 (1.13–2.23) for a higher grade of steatosis and 1.16 (0.67–2.00) for liver fibrosis. The corresponding OR for steatosis was 2.00 (1.24–3.24) and 2.14 (1.04–4.42) in Black and Mexican American participants, respectively. The corresponding OR for liver fibrosis was 2.96 (1.42–6.17) for females. Per interquartile range increase of natural log transformed blood Se, the adjusted OR was 2.25 (1.30–3.89) for steatosis but 0.31 (0.13–0.72) for liver fibrosis. The inverse association of blood Se with liver fibrosis was also observed in males and White participants. Blood Cd, Hg, and Pb were not associated with liver steatosis and fibrosis in fully-adjusted models overall. Conclusions: In NHANES 2017–18, higher blood Mn was positively associated with liver steatosis, and higher Se was positively associated with liver steatosis but negatively associated with liver fibrosis. Longitudinal studies are needed to examine the association of Mn and Se with fibrosis progression.
AB - Background & aims: Chronic liver disease is a growing health burden worldwide. Chronic metal exposures may be associated with non-alcoholic fatty liver disease (NAFLD). We aimed to evaluate the association of blood cadmium (Cd), mercury (Hg), lead (Pb), manganese (Mn), and selenium (Se) with two hallmark features of NAFLD: liver steatosis and fibrosis in the general U.S. population. Methods: We analyzed transient liver elastography data from participants of the National Health and Nutrition Examination Survey (NHANES) 2017–18, using ordinal logistic regression analyses to evaluate the cross-sectional association between blood metal concentrations and clinical stages of steatosis and fibrosis. We applied survey weights, strata, and primary sampling units and analyses were conducted using the R survey package. Results: 4,154 participants were included. Median (IQR) for blood Mn and blood Se were 9.28 (7.48–11.39) and 191.08 (176.55–207.16) μg/L, respectively. Per interquartile range increase of natural log transformed blood Mn, the adjusted odds ratio (OR) (95% CI) was 1.59 (1.13–2.23) for a higher grade of steatosis and 1.16 (0.67–2.00) for liver fibrosis. The corresponding OR for steatosis was 2.00 (1.24–3.24) and 2.14 (1.04–4.42) in Black and Mexican American participants, respectively. The corresponding OR for liver fibrosis was 2.96 (1.42–6.17) for females. Per interquartile range increase of natural log transformed blood Se, the adjusted OR was 2.25 (1.30–3.89) for steatosis but 0.31 (0.13–0.72) for liver fibrosis. The inverse association of blood Se with liver fibrosis was also observed in males and White participants. Blood Cd, Hg, and Pb were not associated with liver steatosis and fibrosis in fully-adjusted models overall. Conclusions: In NHANES 2017–18, higher blood Mn was positively associated with liver steatosis, and higher Se was positively associated with liver steatosis but negatively associated with liver fibrosis. Longitudinal studies are needed to examine the association of Mn and Se with fibrosis progression.
KW - Environmental epidemiology
KW - Fatty liver disease
KW - Liver fibrosis
KW - Metals
KW - NHANES
KW - Steatosis
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U2 - 10.1016/j.envres.2022.113647
DO - 10.1016/j.envres.2022.113647
M3 - Article
C2 - 35691383
AN - SCOPUS:85132241965
SN - 0013-9351
VL - 213
JO - Environmental research
JF - Environmental research
M1 - 113647
ER -