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. 2023 Dec 4:10:1301319.
doi: 10.3389/fnut.2023.1301319. eCollection 2023.

Associations of multiple toxic metal exposures with metabolic dysfunction-associated fatty liver disease: NHANES 2011-2018

Yuguang Li #  1 , Zefeng Liu #  2 , Yu Chang #  3 , Naifei Chen  1 , Rong Zhang  1 , Xiangliang Liu  1 , Wei Song  1 , Jin Lu  1
Affiliations

Associations of multiple toxic metal exposures with metabolic dysfunction-associated fatty liver disease: NHANES 2011-2018

Yuguang Li et al. Front Nutr. .

Abstract

Background: The occurrence of metabolic dysfunction-associated fatty liver disease (MASLD) is driven by multiple factors including obesity, hypertension, dyslipidemia, and insulin resistance. However, epidemiological research investigating the association between metal exposure and MASLD occurrence remains limited.

Methods: We conducted a large cross-sectional study with 6,520 participants who were involved in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2018. Using generalized linear regression, we examined the relationship between five heavy metals (mercury, manganese, lead, selenium, cadmium) and MASLD. Furthermore, restricted cubic spline models and weighted quantile sum (WQS) analysis were employed to characterize the exposure-response relationship between the five metals and MASLD.

Results: Higher blood selenium levels were associated with an increased likelihood of MASLD among US adults. Blood lead exposure was also positively correlated with MASLD risk. However, there was no significant association observed between blood cadmium, mercury, manganese levels, and MASLD risk. Among the five metals, blood cadmium exposure accounted for the highest proportion of MASLD risk.

Conclusion: Our study indicated the significant association between blood cadmium and lead exposure levels and the occurrence of MASLD in a representative sample of US adults.

Keywords: MASLD; NHANES; cadmium; lead; manganese; mercury; selenium.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The flow diagram of the study participants, from NHANE 2011–2018.
Figure 2
Figure 2
Association between blood trace mineral concentration (μmol/L) and MASLD risk, and adjusted for sex, age, race/ethnicity, education attainment, poverty income ratio and BMI.
Figure 3
Figure 3
The non-linear relationship between blood cadmium (μg/L) (A), lead (μg/dL) (B), manganese (μg/L) (C), selenium (μg/L) (D), mercury (μg/L) (E) and MASLD risk, sex, age, race/ethnicity, education attainment, poverty income ratio and BMI were adjusted.
Figure 4
Figure 4
Weighted quantile sum analysis suggested potential synergistic interactions between blood trace mineral concentration and MAFLD risk.
Figure 5
Figure 5
Pearson correlation coefficients between the exposures to the five metallic elements. * p < 0.05; ** p < 0.01.
See this image and copyright information in PMC

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