Associations between mercury exposure and the risk of nonalcoholic fatty liver disease (NAFLD) in US adolescents
- 106 Downloads
Little is known regarding the effects of environmental mercury (Hg) exposure on liver dysfunction in adolescents. We aimed to explore the association between Hg exposure and the risk of nonalcoholic fatty liver disease (NAFLD) in the adolescent population. The cross-sectional associations between blood Hg concentrations and serum alanine aminotransferase (ALT) levels, a surrogate for suspected NAFLD, were evaluated using data from adolescents (aged 12–17 years old) who participated in the National Health and Nutrition Examination Survey (NHANES), 1999–2014. A final sample of 6389 adolescents was analysed. Elevated ALT was defined as > 25 IU/L and > 22 IU/L for boys and girls ≤ 17 years old, respectively. Odds ratios (ORs) of Hg levels in association with serum ALT levels were estimated using a logistic regression after adjusting for gender, age, ethnicity, serum cotinine, body mass index, the poverty income ratio, and NHANES cycles. The median blood Hg level was 0.73 ± 0.91 μg/L amongst US adolescents. In the adjusted model, the ORs of elevated ALT levels of those in the 4th quartile were higher amongst non-Hispanic white adolescents (OR = 1.76, 95% CI 1.20, 2.59; P = 0.035) and those who were normal or underweight (OR = 1.41, 95% CI 1.08, 1.85; P = 0.020). No association was observed for the other variables. Our results indicate that the positive association between blood Hg exposure and the risk of NAFLD in US adolescents is the highest amongst non-Hispanic white and those who are normal or underweight, regardless of ethnicity. More research is necessary to confirm this association and to clarify the potential mechanisms.
KeywordsNHANES Mercury Adolescent Nonalcoholic fatty liver disease (NAFLD) Alanine aminotransferase
Runsen Chen and Yang Xu wrote the main manuscript text, Yaqin Shu and Siyu Ma prepared Tables 1, 2, and 3, and Changgui Lu prepared Fig. 1. Cheng Xu and Xuming Mo were responsible for the accuracy of all content in the proof. All authors reviewed the manuscript.
This work was supported by funding from the National Key Research and Development Program of China (2017YFC1308105; 2016YFC1101001); Key Project supported by Medical Science and Technology Development Foundation, Nanjing Department of Health (201723006).
Compliance with ethical standards
Ethics approval and consent to participate
The consent form was signed by participants in the survey, and participants consented to storing specimens of their blood for future research. The CDC/NCHS Ethics Review Board (ERB) approved the NHANES study and gave approval for public dissemination.
Consent for publication
Non applicable. There is no individual level data in our publication.
- Andreoli V, Sprovieri F (2017) Genetic Aspects of Susceptibility to Mercury Toxicity: An Overview. Int J Environ Res Public Health 14Google Scholar
- Centers for Disease Control and Prevention (2006) National Center for Health Statistics. National Health and Nutrition Examination Survey. Available at: https://wwwn.cdc.gov/Nchs/Nhanes/2005-2006/PBCD_D.htm
- Fernandes Azevedo B, Barros Furieri L, Pecanha FM, Wiggers GA, Frizera Vassallo P, Ronacher Simoes M, Fiorim J, Rossi de Batista P, Fioresi M, Rossoni L, Stefanon I, Alonso MJ, Salaices M, Valentim Vassallo D (2012) Toxic effects of mercury on the cardiovascular and central nervous systems. J Biomed Biotechnol 2012:949048CrossRefGoogle Scholar
- Fourth National Report on Human Exposure to Environmental Chemicals UT (2015) Centers for Disease Control and Prevention, Department of Health and Human Services: Atlanta, GA, USA, 2015. Available online: (2015): https://www.cdc.gov/biomonitoring/pdf/fourthreport_updatedtables_feb2015.pdf. Accessed 16 Apr 2018
- Poursafa P, Ataee E, Motlagh ME, Ardalan G, Tajadini MH, Yazdi M, Kelishadi R (2014) Association of serum lead and mercury level with cardiometabolic risk factors and liver enzymes in a nationally representative sample of adolescents: the CASPIAN-III study. Environ Sci Pollut Res Int 21:13496–13502CrossRefGoogle Scholar
- Ruggieri F, Majorani C, Domanico F, Alimonti A (2017) Mercury in Children: Current State on Exposure through Human Biomonitoring Studies. Int J Environ Res Public Health 14Google Scholar
- Temple JL, Cordero P, Li J, Nguyen V, Oben JA (2016) A guide to non-alcoholic fatty liver disease in childhood and adolescence. Int J Mol Sci 17Google Scholar