Background: Information on the relation of air pollution with non-alcoholic fatty liver disease (NAFLD) is scarce. We thus conducted a large cross-sectional study in Asia to investigate the role of air pollution in NAFLD.

Methods: We recruited 329,048 adults (mean age: 41.0 years) without other liver disease (hepatitis and cirrhosis) or excessive alcohol consumption in Taiwan and Hong Kong from 2001 to 2018. The concentrations of nitrogen dioxide (NO) and ozone (O) were estimated using a space-time regression model, and the concentrations of fine particulate matter (PM) was evaluated using a satellite-based spatio-temporal model. NAFLD was determined using either the fatty liver index (FLI) or the hepatic steatosis index (HSI). The NAFLD-related advanced fibrosis was defined according to BARD score or the fibrosis-4 (FIB-4). A logistic regression model was adopted to explore the relationships of ambient air pollution with the odds of NAFLD and NAFLD-related advanced fibrosis.

Results: We found positive relationships between PM and the odds of NAFLD and advanced fibrosis, with every standard deviation (SD, 7.5 µg/m) increases in PM exposure being associated with a 10% (95% confidence interval [CI]: 9%-11%) increment in the prevalence of NAFLD and an 8% (95% CI: 7%-9%) increment in the prevalence of advanced fibrosis. Similarly, the prevalence of NAFLD and advanced fibrosis increased by 8% (95% CI: 7%-9%) and 7% (95% CI: 6%-8%) with per SD (18.9 µg/m) increasement in NO concentration, respectively. Additionally, for every SD (9.9 µg/m) increasement in O concentration, the prevalence of NAFLD and advanced fibrosis decreased by 12% (95% CI: 11%-13%) and 11% (95% CI: 9%-12%), respectively.

Conclusion: Higher ambient PM and NO are linked with higher odds of NAFLD and advanced fibrosis. Our findings indicate that reducing PM and NO concentrations may be an effective way for preventing NAFLD. Further studies on O are warranted.

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http://dx.doi.org/10.1016/j.ecoenv.2024.116245DOI Listing

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