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Associations of Urinary Nickel with NAFLD and Liver Fibrosis in the USA: A Nationwide Cross‑Sectional Study

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Abstract

Despite the robust correlation between metabolic disorders and heavy metals, there has been limited research on the associations between nickel levels and non-alcoholic fatty liver disease (NAFLD) as well as liver fibrosis. This study aimed to examine the associations among urinary nickel, NAFLD, and liver fibrosis. The data utilized in this study were obtained from the National Health and Nutrition Examination Survey 2017–2020. A comprehensive screening process was conducted, resulting in the inclusion of a total of 3169 American adults in the analysis. The measurement of urinary nickel was conducted through inductively coupled-plasma mass spectrometry. Vibration-controlled transient elastography was employed to assess the controlled attenuation parameter and liver stiffness measurement as indicators for NAFLD and liver fibrosis, respectively. Multivariable logistic regression models were employed to evaluate the associations among urinary nickel, NAFLD, and liver fibrosis. Restricted cubic splines were employed to explored the nonlinear associations. After adjusting for all covariates, the correlation between the highest quartile of urinary nickel and NAFLD was found to be significant (OR = 1.65; 95% CI, 1.19–2.27). Subgroup analysis revealed that the correlation was significant only in men. A significant association occurred between the second quartile of urinary nickel and liver fibrosis (OR 1.88; 95% CI, 1.22–2.90). Restricted cubic spline showed that the relationship was linear between urinary nickel and NAFLD and non-monotonic, inverse U-shaped between urinary nickel and liver fibrosis. This cross-sectional study indicated that the risk of NAFLD is associated with urinary nickel, and this correlation was only present among males.

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Data Availability

The National Health and Nutrition Examination Survey dataset is publicly available at the National Center for Health Statistics of the Center for Disease Control and Prevention (https://www.cdc.gov/nchs/nhanes/index.htm.)

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Acknowledgements

The authors thank NCHS for its research design and data sharing, as well as all investigators and participants.

Funding

This work was supported by the National Natural Science Foundation of China (No. 81973034) and Natural Science Foundation of Heilongjiang Province (YQ2020H032).

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Author notes

  1. Kening Zhang and Chunxiao Yang contributed equally.

Authors and Affiliations

  1. Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, No.157 Baojian Road, Nangang District, Heilongjiang Province, Harbin, 150081, China

    Kening Zhang, Chunxiao Yang, Xue Zhao, Yuanyuan Wang, Zhuo Gu, Ruiming Yang, Haiyan Ding, Shuangshuang Li, Jian Qin & Xia Chu

  2. Heilongjiang Academy of Medical Sciences, Harbin, China

    Xia Chu

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  1. Kening Zhang
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Contributions

Conceptualization, KZ and XZ; methodology, KZ; software, CY; validation, YW, ZG, and RY; formal analysis, KZ; investigation, HD and SL; resources, JQ; data curation, CY; writing—original draft preparation, KZ; writing—review and editing, XC; visualization, XZ and CY; supervision, XC; project administration, XC; funding acquisition, XC. All authors have read and approved the final manuscript.

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Correspondence to Xia Chu.

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Zhang, K., Yang, C., Zhao, X. et al. Associations of Urinary Nickel with NAFLD and Liver Fibrosis in the USA: A Nationwide Cross‑Sectional Study. Biol Trace Elem Res (2024). https://doi.org/10.1007/s12011-024-04151-2

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