有毒金属和氧化平衡评分对NAFLD成人死亡风险的相互作用和联合作用

IF 6.1 2区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Ecotoxicology and Environmental Safety Pub Date : 2025-03-11 DOI:10.1016/j.ecoenv.2025.117958

Hua-nan Chen , Guo-qiang Chen , Li-hua Li , Wei-ping Zhang , Yong-jun Wang , Kun Li , Ying Lian

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引用次数: 0

摘要

高氧化平衡评分（OBS）可以减轻炎症水平，从而减轻有毒金属引起的不良健康影响。我们评估了有毒金属和OBS对非酒精性脂肪性肝病（NAFLD）患者死亡率的独立、联合影响及其相互作用。方法纳入1999-2018年国家健康与营养检查调查（NHANES）中患有NAFLD的参与者。截至2019年12月31日的国家死亡指数记录确定了死亡率和潜在死亡原因。Cox回归模型用于估计全因死亡率和疾病特异性死亡率的风险比（hr）。此外，我们评估了OBS和有毒金属对死亡率的倍增和加性相互作用。结果5263例NAFLD患者中，1097例在平均10.27年的随访期间死亡。与OBS组1相比，组3的全因死亡风险较低（HR=0.79, 95 %CI: 0.64, 0.96）。与血铅浓度最低的个体相比，血铅浓度最高的个体死亡风险增加，全因死亡率、心血管疾病死亡率和癌症死亡率的hr（95 % ci）分别为1.23（1.01,1.51）、1.53（1.06,2.20）和1.94（1.25,3.01）。血液中的镉含量也有类似的结果。联合关联分析发现，低铅和高obs水平个体的全因、心血管疾病和癌症死亡风险最低，hr（95 % ci）分别为0.58（0.40,0.85）、0.45（0.21,0.93）和0.35（0.15,0.81）。发现OBS和血镉对全因死亡（HR=0.87, 95 %CI: 0.78, 0.97）和CVD死亡（HR=0.81, 95 %CI: 0.67, 0.99）存在乘法相互作用。结论高OBS和低有毒金属暴露与NAFLD患者较低的死亡风险相关。采用抗氧化生活方式可减轻NAFLD患者有毒金属的有害影响。综合策略对于降低死亡风险和潜在地减轻NAFLD的总体负担至关重要。

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Interactive and joint effects of toxic metals and oxidative balance score on the risk of mortality in adults with NAFLD

Background

High oxidative balance score (OBS) may mitigate inflammation levels and thereby alleviate the adverse health effects induced by toxic metals. We assessed the independent, joint effects as well as their interactions of toxic metals and OBS on mortality among individuals with non-alcoholic fatty liver diseases (NAFLD).

Methods

Participants with NAFLD from the National Health and Nutrition Examination Survey (NHANES) 1999–2018 were included. Mortality and underlying causes of death were certain by National Death Index records through 31 December 2019. Cox regression models were used to estimate hazard ratios (HRs) for all-cause and disease-specific mortality. Additionally, we assessed multiplicative and additive interactions of OBS and toxic metals on mortality.

Results

Among 5263 patients with NAFLD, 1097 deaths occurred during a mean follow-up of 10.27 years. Compared with those in the OBS tertile 1, participants in tertile 3 had lower risk of all-cause mortality (HR=0.79, 95 %CI: 0.64, 0.96). Compared with individuals in the lowest lead concentration in blood, those in the highest had an increased risk of mortality, with the HRs (95 %CIs) being 1.23 (1.01, 1.51), 1.53(1.06, 2.20) and 1.94(1.25, 3.01) for all-cause, CVD and cancer mortality, respectively. Similar results were also found for blood cadmium level. Joint associations analyses found that individuals with low lead and high-OBS levels had the lowest risk of all-cause, CVD and cancer mortality, with the HRs(95 %CIs) being 0.58(0.40, 0.85), 0.45(0.21, 0.93) and 0.35(0.15, 0.81), respectively. Multiplicative interactions between OBS and blood cadmium on all-cause death (HR=0.87, 95 %CI: 0.78, 0.97) and CVD death (HR=0.81, 95 %CI: 0.67, 0.99) were found.

Conclusions

High OBS and low exposure to toxic metals were associated with lower risk of mortality among participants with NAFLD. Adopting anti-oxidative lifestyle could alleviate the harmful effects of toxic metals in NAFLD patients. Comprehensive strategies are essential to decrease the risk of mortality and potentially mitigate the overall burden of NAFLD.

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来源期刊

Ecotoxicology and Environmental Safety 环境科学-毒理学

CiteScore

12.10

自引率

5.90%

发文量

1234

审稿时长

88 days

期刊介绍： Ecotoxicology and Environmental Safety is a multi-disciplinary journal that focuses on understanding the exposure and effects of environmental contamination on organisms including human health. The scope of the journal covers three main themes. The topics within these themes, indicated below, include (but are not limited to) the following: Ecotoxicology、Environmental Chemistry、Environmental Safety etc.