Environmental Endocrine-Disrupting Chemicals and Metabolic Dysfunction-Associated Steatotic Liver Disease

Area of Science:

• Environmental Health
• Hepatology
• Toxicology

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease globally.
• Endocrine-disrupting chemicals (EDCs) are environmental contaminants with known metabolic toxicity.
• The link between EDC exposure and MASLD prevalence requires further quantitative investigation.

Purpose of the Study:

• To conduct a systematic review and meta-analysis of epidemiological studies.
• To quantify the association between exposure to various EDCs and MASLD prevalence.
• To synthesize current evidence on the role of EDCs in MASLD.

Main Methods:

• Systematic literature search of PubMed, Embase, Web of Science, and Cochrane Library.
• Inclusion of studies reporting quantitative associations between measured EDC exposure and MASLD/NAFLD/MAFLD.
• Data extraction and quality assessment using Newcastle-Ottawa Scale (NOS); random-effects models for meta-analysis.

Main Results:

• Phthalates, bisphenols, persistent organic pollutants (POPs), and heavy metals (mercury, lead, cadmium) showed significant positive associations with MASLD prevalence.
• Pooled analysis indicated increased MASLD risk with phthalate mixtures (OR: 1.17), bisphenols (OR: 1.29), POPs (OR: 1.30), and heavy metals (OR: 1.26).
• Per- and polyfluoroalkyl substances (PFAS) showed heterogeneous results (OR: 0.95).

Conclusions:

• Environmental exposure to several major EDC classes is associated with a higher prevalence of MASLD.
• The magnitude and consistency of associations vary across chemical classes and individual compounds.
• Findings are hypothesis-generating, highlighting the need for prospective studies and mechanistic research.