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. 2025 Jun 11:13:1540357.
doi: 10.3389/fpubh.2025.1540357. eCollection 2025.

Association between polycyclic aromatic hydrocarbons exposure and metabolic dysfunction-associated steatotic liver disease in US adults

Jiajun Wu  1 , Shaoqian Cui  1 , Xuekui Li  2 , Xiaofei Zhang  2 , Siqi Yang  3 , Junhao Sun  4 , Xiubo Jiang  1
Affiliations

Association between polycyclic aromatic hydrocarbons exposure and metabolic dysfunction-associated steatotic liver disease in US adults

Jiajun Wu et al. Front Public Health. .

Abstract

Objective: To investigate the individual or combined effects of polycyclic aromatic hydrocarbons (PAHs) on metabolic dysfunction-associated steatotic liver disease (MASLD) in U.S. adults.

Methods: We enrolled 3,130 participants aged 20 and over from the 2007-2016 National Health and Nutrition Examination Survey (NHANES) and analyzed six urinary PAH metabolites. The Poisson regression, Bayesian kernel machine regression (BKMR), and weighted quantile sum (WQS) regression models were used to assess the associations between PAHs and MASLD.

Results: After adjusting for covariates, Poisson regression model showed significant associations [RRs (95% CIs)] between higher exposure quartiles of 2-hydroxynaphthalene (2-NAP) [Q2: 1.35 (1.06, 1.73); Q3: 1.67 (1.35, 2.07); Q4: 1.62 (1.23, 2.15); p-trend < 0.001], 2-hydroxyfluorene (2-FLU) [Q3: 1.36 (1.08, 1.70); p-trend = 0.073], 1-hydroxyphenanthrene (1-PHE) [Q4: 1.35 (1.03, 1.76); p-trend = 0.009], and 1-hydroxypyrene (1-PYR) [Q3: 1.37 (1.12, 1.69); Q4: 1.33 (1.01, 1.76); p-trend = 0.025] and MASLD (p < 0.05), compared with Q1. BKMR model exhibited a positive trend between mixed PAHs and MASLD. The WQS index constructed for six PAHs was significantly related to MASLD [OR (95% CI): 1.25 (1.06, 1.49)].

Conclusion: This study suggests that exposure to PAHs, individually or in combination, may be associated with an increased risk of MASLD.

Keywords: BKMR; NHANES; WQS; metabolic dysfunction-associated steatotic liver disease; polycyclic aromatic hydrocarbons.

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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
Flowchart for selecting eligible participants (National Health and Nutrition Examination Survey, United States, 2007–2016).
Figure 2
Figure 2
Spearman correlation coefficients among six PAH metabolites (National Health and Nutrition Examination Survey, United States, 2007–2016). All results for PAH metabolites were ln-transformed. *p < 0.05; **p < 0.01; ***p < 0.001.
Figure 3
Figure 3
Combined effects of the PAHs mixture on MASLD risk estimated by BKMR (National Health and Nutrition Examination Survey, United States, 2007–2016). All results for PAH metabolites were ln-transformed. Covariates included creatinine age, sex, race, educational level, marital status, PIR, NHANES cycle, cotinine, and physical activity.
Figure 4
Figure 4
The WQS index weights of each of the six PAHs associated with MASLD (National Health and Nutrition Examination Survey, United States, 2007–2016). All results for PAH metabolites were ln-transformed. Covariates included creatinine age, sex, race, educational level, marital status, PIR, NHANES cycle, cotinine, and physical activity.
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