Abstract：
Accumulating animal studies have demonstrated associations between ambient air pollution (AP) and metabolic dysfunction-associated fatty liver disease (MAFLD), but relevant epidemiological evidence is limited. We evaluated the association of long-term exposure to AP with the risk of incident MAFLD in Northwest China. The average AP concentration between baseline and follow-up was used to assess individual exposure levels. Cox proportional hazard models and restricted cubic spline functions (RCS) were used to estimate the association of PM2.5 and its constituents with the risk of MAFLD and the dose-response relationship. Quantile g-computation was used to assess the joint effects of mixed exposure to air pollutants on MAFLD and the weights of the various pollutants. We observed 1516 cases of new-onset MAFLD, with an incidence of 10.89%. Increased exposure to pollutants was significantly associated with increased odds of MAFLD, with hazard ratios (HRs) of 2.93 (95% CI: 1.22, 7.00), 2.86 (1.44, 5.66), 7.55 (3.39, 16.84), 4.83 (1.89, 12.38), 3.35 (1.35, 8.34), 1.89 (1.02, 1.62) for each interquartile range increase in PM2.5, SO42-, NO3-, NH4+, OM, and BC, respectively. Stratified analyses suggested that females, frequent exercisers and never-drinkers were more susceptible to MAFLD associated with ambient PM2.5 and its constituents. Mixed exposure to SO42-, NO3-, NH4+, OM and BC was associated with an increased risk of MAFLD, and the weight of BC had the strongest effect on MAFLD. Exposure to ambient PM2.5 and its constituents increased the risk of MAFLD.
摘要：
越来越多的动物研究表明，环境空气污染（AP）与代谢功能障碍相关的脂肪肝（MAFLD）之间存在关联。但相关流行病学证据有限。我们评估了中国西北地区长期接触AP与MAFLD事件风险的相关性。基线和随访之间的平均AP浓度用于评估个体暴露水平。使用Cox比例风险模型和有限的三次样条函数（RCS）来估计PM2.5及其成分与MAFLD风险和剂量反应关系的关联。分位数g计算用于评估混合暴露于空气污染物对MAFLD的联合影响以及各种污染物的重量。我们观察到1516例新发MAFLD，发病率为10.89%。暴露于污染物的增加与MAFLD的几率增加显著相关，风险比（HR）为2.93（95%CI：1.22，7.00），2.86(1.44,5.66),7.55(3.39,16.84),4.83(1.89,12.38),3.35(1.35,8.34),PM2.5、SO42-、NO3-,NH4+,OM,BC,分别。分层分析表明，女性，经常锻炼者和从不饮酒的人更容易受到与环境PM2.5及其成分相关的MAFLD的影响。混合暴露于SO42-，NO3-,NH4+,OM和BC与MAFLD风险增加相关，BC的体重对MAFLD的影响最强。暴露于环境PM2.5及其成分会增加MAFLD的风险。
