在慢性肝病患者中,空气污染与晚期肝纤维化有关
Tyng-Yuan Jang1,2,3,4, Chi-Chang Ho5, Po-Cheng Liang2,3
1Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung, Taiwan.
The Kaohsiung journal of medical sciences
|November 10, 2023
概括
空气污染,特别是细颗粒物 (PM2.5),与代谢相关脂肪肝病 (MAFLD) 患者的晚期肝纤维化有关. 这种关联表明了剂量依赖的关系,这意味着更高的PM2.5水平与更严重的纤维化相关.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 环境健康 环境健康
- 公共卫生 公共卫生
背景情况:
- 代谢相关脂肪肝 (MAFLD) 是一个日益严重的全球健康问题.
- 慢性病毒性肝炎,包括乙型肝炎病毒 (HBV) 和乙型肝炎病毒 (HCV) 感染,是肝病的重要原因.
- 空气污染等环境因素对肝纤维化严重性的影响是一个新兴的研究领域.
研究的目的:
- 调查暴露于环境空气污染物和MAFLD患者中晚期肝纤维化存在的关联.
- 探索特定空气污染物之间的关系,包括直径≤2.5μm的颗粒物 (PM2.5),二氧化 (NO2),臭氧 (O3) 和,以及肝纤维化.
- 确定空气污染暴露是否是MAFLD和慢性HBV或HCV感染的个体中晚期肝纤维化的一个独立风险因素.
主要方法:
- 一组1376名患有MAFLD和/或慢性HBV/HCV感染的参与者被从社区查计划 (2019-2021) 中招募.
- 肝纤维化被评估使用过渡性弹性成像,测量肝硬度 (LSM).
- 每天的空气污染物数据 (PM2.5,NO2,O3,) 被汇总成入学前的平均年估计值,并进行了后勤和线性回归分析.
主要成果:
- 在1376名参与者中,52.8%患有MAFLD,13.6%患有晚期纤维化.
- 后勤回归确定HCV病毒性,吸烟,年龄和PM2.5暴露是与晚期肝纤维化相关的显著因素 (p <0.001对于PM2.5).
- 线性回归表明LSM与PM2.5独立相关 (p=0.02),在增加PM2.5水平和肝纤维化阶段之间观察到剂量依赖的关系 (趋势p < 0.001).
结论:
- 暴露于PM2.5与MAFLD患者的晚期肝纤维化显著相关,独立于病毒性肝炎感染.
- 在PM2.5水平和肝纤维化严重程度之间存在明显的剂量依赖关系.
- 这些发现强调空气污染是可修改的环境风险因素,有助于MAFLD患者的肝纤维化进展.
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