Heavy Metals Are Liver Fibrosis Risk Factors in People Without Traditional Liver Disease Etiologies

Details

• Journal Article:
  Journal of Environmental Sciences
• Personal Author:
  Ma, Ning ; Bansal, Meena B. ; Chu, Jaime ; Woodward, Mark ; Branch, Andrea D.
• Description:
  Liver fibrosis is an important predictor of mortality. Liver disease case definitions changed in 2023. These definitions include an easily over-looked group with no traditional etiology (NTE) of liver disease and no steatosis. We analyzed heavy metals and cardiometabolic risk factors (CMRFs) as fibrosis risk factors in the NTE group and in people with another newly-defined condition, metabolic dysfunction-associated steatotic liver disease (MASLD). Two National Health and Nutrition Examination Survey (NHANES) datasets were analyzed. In NHANES III (1988-1994), fibrosis and steatosis were defined by Fibrosis-4 scores and ultrasound, respectively, in 12,208 adults. In NHANES 2017-2020, fibrosis and steatosis were defined by transient elastography and the controlled attenuation parameter (CAP) in 5525 adults. Fibrosis risk factors varied over time and by race/ethnicity. In the earlier dataset, NTE-fibrosis had a positive, non-significant, association with high blood levels of lead (Pb). MASLD-fibrosis was associated with Pb (OR = 2.5, 95 % CI, 1.4-4.4) and not with CMRFs in non-Hispanic Blacks but was associated with CMRFs in non-Hispanic Whites. Heavy metal exposures fell between the two time periods. In the later dataset, NTE-fibrosis was associated with Pb (OR = 4.2, 95 % CI, 2.6-6.8) and cadmium (OR = 1.8, 95 % CI, 1.1-3.0) in the total population, but not with most CMRFs. MASLD-fibrosis was strongly-significantly associated with CMRFs in every racial/ethnic group except non-Hispanic Blacks in whom CMRFs were only weakly associated with MASLD-fibrosis. Heavy metal pollution, which disproportionately impacts minoritized populations, decreased over time, but remained strongly associated with liver fibrosis in people lacking traditional etiological factors for liver disease. Description provided by NIOSH
• Subjects:
  • Lead
  • Liver
  • Metbolism
  • Metals, Heavy
  • Occupational Health
  • Safety
• Keywords:
  • Fibrosis; Liver disease; Metabolic disorders; Heavy metals; Risk factors; Lead; Cadmium;
  • Author Keywords: Metabolic dysfunction-associated steatotic liver disease (MASLD) Fibrosis; Transient elastography; Racial disparities; Heavy metal; Cardiometabolic risk factors; CMRFs
• Source:
  J Environ Sci 2025 Sep; 155:329-341
• ISSN:
  1001-0742
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  New York ; New York City Region OSHA
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  14 pdf pages
• Volume:
  155
• NIOSHTIC Number:
  nn:20071631
• Contact Point Address:
  Andrea D. Branch, Division of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, 10029, USA
• Email:
  andrea.branch@mssm.edu
• CAS Registry Number:
  • Cadmium (CAS RN 7440-43-9)
  • Lead (CAS RN 7439-92-1)
• Federal Fiscal Year:
  2025
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  True
• Start Date:
  20230701
• End Date:
  20260630
• Download URL:
  https://stacks.cdc.gov/view/cdc/259406/cdc_259406_DS1.pdf
• File Type:
  [PDF - 3.27 MB]
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7e4e159e9a8ed8f0f8566f897f245bb723efe6473e6c6205b972881230a9122579c2757f61ebba1b8ff9a43be509221456d00250bf047b0f871c40ff480d1022