Prevalence of nonalcoholic fatty liver disease in workers of an automobile enterprise: the role of low-dose heavy metal exposure and related factors of the disease

TANG Ting; ZHU Changqing; QIU Congxi; LI Yanru; BAI Shuzhen; CHEN Hanqing; SONG Huidong

doi:10.11836/JEOM24189

Volume 41 Issue 10

Oct. 2024

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Journal of Environmental and Occupational Medicine > 2024 > 41(10): 1124-1129. > DOI: 10.11836/JEOM24189

TANG Ting, ZHU Changqing, QIU Congxi, LI Yanru, BAI Shuzhen, CHEN Hanqing, SONG Huidong. Prevalence of nonalcoholic fatty liver disease in workers of an automobile enterprise: the role of low-dose heavy metal exposure and related factors of the disease[J]. Journal of Environmental and Occupational Medicine, 2024, 41(10): 1124-1129. DOI: 10.11836/JEOM24189

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Prevalence of nonalcoholic fatty liver disease in workers of an automobile enterprise: the role of low-dose heavy metal exposure and related factors of the disease

1.
Occupational Health Surveillance Centre, Guangzhou Twelfth People's Hospital/ Guangzhou Occupational Disease Prevention and Treatment Hospital, Guangzhou, Guangdong 510620, China
2.
Department of Endocrinology, Guangzhou Twelfth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong 510620, China
3.
Department of Nutrition & Food Hygiene, School of Public Health, Capital Medical University, Beijing 100069, China

Funds: This study was funded.

More Information

Corresponding author:
CHEN Hanqing, E-mail: chenhq@ccmu.edu.cn

SONG Huidong, E-mail: 2354412112@qq.com
Received Date: April 27, 2024
Accepted Date: September 11, 2024

Graphical Abstract

Abstract

Abstract

Background
Some studies have found that exposure to heavy metals significantly increases the risk of nonalcoholic fatty liver disease (NAFLD), and welding operators in automobile manufacturing enterprises are exposed to heavy metals in the working environment.
Objective
To analyze the prevalence and related factors of NAFLD in workers of an automobile company in Guangzhou.
Methods
From January 1 of 2023 to December 31 of 2023, 5463 workers of an automobile company in Guangzhou who participated in the physical examination in the Occupational Health Surveillance Centre of Guangzhou Occupational Disease Prevention and Treatment Hospital were selected as research subjects. The general data, laboratory examinations, B-ultrasound examinations, and other data of the subjects were obtained through the physical examination system. The exposed occupational hazards were identified based on the workplace hazard surveillance report provided by the automotive company. Logistic regression was used to analyze potential influencing factors of NAFLD, and stratified analysis was used to adjust confounding factors according to the stepwise model to evaluate the relationship between exposure to manganese and its inorganic compounds and NAFLD.
Results
A total of 2129 cases (38.97%) were reported positive NAFLD. The results of logistic regression analysis showed that women had a lower risk of NAFLD (OR=0.40, 95%CI: 0.25, 0.64), while age > 25 years old (OR=1.49, 95%CI: 1.39, 1.60), body mass index (BMI) ≥24 kg·m⁻² (OR=7.54, 95%CI: 6.46, 8.79), and elevated alanine aminotransferase (ALT) (OR=4.87, 95%CI: 3.73, 6.36), γ-glutamyl transpeptidase (γ-GGT) (OR=1.54, 95%CI: 1.17, 2.02), triglyceride (TG) (OR=3.47, 95%CI: 2.92, 4.14), and fasting blood glucose (OR=1.70, 95%CI: 1.32, 2.20) associated with a higher risk of NAFLD. NAFLD was positive in 39.40% of heavy metal exposed workers (701/1779). NAFLD was positive in 45.19% of workers exposed to manganese and its inorganic compounds (169/374), and among workers over 34 years old, exposure to manganese and its inorganic compounds (OR=1.79, 95%CI: 1.07, 2.97) significantly increased the prevalence of NAFLD.
Conclusion
The association between heavy metal exposure and NAFLD in workers of an automobile enterprise in Guangzhou is not significant, but age and gender are related to the prevalence of NAFLD. BMI, ALT, γ-GGT, TG, and fasting blood glucose are positively correlated with the prevalence of NAFLD. Exposure to manganese and its inorganic compounds in welding workers of the automobile enterprise is associated with elevated risk of the disease, and the prevalence of NAFLD is significantly increased in workers over 34 years old.

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References (21)

References

[1]	Lin YC, Lian IB, Kor CT, et al. Association between soil heavy metals and fatty liver disease in men in Taiwan: a cross sectional study[J]. BMJ open. 2017;7(1): e014215.
[2]	中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会. 非酒精性脂肪性肝病防治指南(2018更新版)[J]. 中华肝脏病杂志, 2018, 26(3): 195-203. doi: 10.3760/cma.j.issn.1007-3418.2018.03.008 National Workshop on Fatty Liver and Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association, Fatty Liver Expert Committee, Chinese Medical Doctor Association. Guidelines of prevention and treatment for nonalcoholic fatty liver disease: a 2018 update[J]. Chin J Hepatol, 2018, 26(3): 195-203. doi: 10.3760/cma.j.issn.1007-3418.2018.03.008
[3]	Zhu JZ, Zhou QY, Wang YM, et al. Prevalence of fatty liver disease and the economy in China: A systematic review[J]. World J Gastroenterol, 2015, 21(18): 5695-706.
[4]	门金龙, 门敬尧, 张玉君, 等. 山东省20家汽车制造企业职业病危害现况调查[J]. 中华劳动卫生职业病杂志, 2021, 39(3): 198-202. MEN J L, MEN J Y, ZHANG Y J, et al. Investigation on occupational hazards in 20 automobile manufacturing enterprises in Shandong Province[J]. Chinese Journal of Industrial Hygiene and Occupational Diseases, 2021, 39(3): 198-202.
[5]	屈若迪. 煤矿工人混合金属暴露与非酒精性脂肪肝患病风险的相关性研究 [硕士]: 山西: 山西医科大学; 2023. QU R D. Study on the relationship between mixed metal exposure andthe risk of non-alcoholic fatty liver in coal miners[D]. Shanxi: Shanxi Medical University. 2023.
[6]	Sadighara P, Abedini AH, Irshad N, et al. Association Between Non-alcoholic Fatty Liver Disease and Heavy Metal Exposure: a Systematic Review[J]. Biological trace element research, 2023, 201(12): 5607-15.
[7]	Younossi ZM, Golabi P, Paik JM, et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review[J]. Hepatology (Baltimore, Md), 2023, 77(4): 1335-47.
[8]	吴车敏, 张从玉, 徐慧丽, 等. 我国非酒精性脂肪性肝病的流行病学研究和诊断现状分析[J]. 中国医药导报, 2023, 20(11): 158-161. WU CH M, ZHANG C Y, XU H L, et al. Epidemiological research and diagnosis of nonalcoholic fatty liver disease in China[J]. China Medical Herald, 2023, 20(11): 158-161.
[9]	徐利平, 钱棪梅, 徐宏伟, 等. 特勤人员健康促进生活方式与非酒精性脂肪肝患病情况相关性分析[J]. 中华保健医学杂志, 2021, 23(4): 359-361. doi: 10.3969/j.issn.1674-3245.2021.04.012 XU L P, QIAN Y M, XU H W, et al. Correlation analysis of health promoting lifestyle and fatty liver in secret service personnel[J]. Chinese Journal of Health Care and Medicine, 2021, 23(4): 359-361. doi: 10.3969/j.issn.1674-3245.2021.04.012
[10]	仝小玲, 张连文. 中青年人群非酒精性脂肪肝患病现状及影响因素分析[J]. 解放军预防医学杂志, 2021, 39(1): 70-72. TONG X L, ZHANG L W. Analysis of nonalcoholic fatty liver disease status and influencing factors in young and middle-aged population[J]. Journal of Preventive Medicine of Chinese People's Liberation Army, 2021, 39(1): 70-72.
[11]	吴学文, 闫焱, 吴丹, 等. 北京电力职工非酒精性脂肪肝的患病情况及危险因素分析[J]. 中国卫生标准管理, 2023, 14(15): 58-62. WU X W, YAN Y, WU D, et al. Analysis of Prevalence and Risk Factors of Non-Alcoholic Fatty Liver Disease Among Employees of Electric Power in Beijing[J]. China Health Standard Management, 2023, 14(15): 58-62.
[12]	Liu Z, Li H, Zheng Y, et al. Association of Lipoprotein-Associated Phospholipase A2 with the Prevalence of Nonalcoholic Fatty Liver Disease: A Result from the APAC Study[J]. Sci Rep, 2018, 8(1): 10127.
[13]	刘玲, 马文军. 某高校教职工非酒精性脂肪肝患病状况及影响因素分析[J]. 中国初级卫生保健, 2024, 37(1): 50-3. LIU L, MA W J. Analysis of Non-alcoholic Fatty Liver Disease and Influencing Factors among College Staff of A Certain University[J]. Chinese Primary Health Care, 2024, 37(1): 50-3.
[14]	张宇新, 张永红. 非酒精性脂肪肝合并2型糖尿病的临床特征分析[J]. 包头医学院学报, 2024, 40(1): 71-6. ZHANG Y X, ZHANG Y H. Clinical characteristics of nonalcoholic fatty liver complicated with type 2 diabetes mellitus[J]. Journal of Baotou Medical College, 2024, 40(1): 71-6.
[15]	Li L, Huang L, Huang S, et al. Non-linear association of serum molybdenum and linear association of serum zinc with nonalcoholic fatty liver disease: Multiple-exposure and Mendelian randomization approach[J]. The Science of the total environment, 2020, 720: 137655.
[16]	Zhang D, Wu S, Lan Y, et al. Blood manganese and nonalcoholic fatty liver disease: A cohort-based case-control study[J]. Chemosphere, 2022, 287(Pt 4): 132316.
[17]	Wei CC, Luo Z, Hogstrand C, et al. Zinc reduces hepatic lipid deposition and activates lipophagy via Zn(2+)/MTF-1/PPARα and Ca(2+)/CaMKKβ/AMPK pathways. FASEB journal : official publication of the Federation of American Societies for Experimental Biology. 2018: fj201800463.
[18]	刘万年. 新乡县农村居民非酒精性脂肪肝病与9种常见金属浓度水平的相关性研究 [硕士]: 河南: 新乡医学院; 2023. LIU W N. Correlation between non-alcoholic fatty liver disease and 9 common metals in rural residents of Xinxiang County[D]. He Nan: Xinxiang Medical University; 2023.
[19]	Wu L, Lan Y, Yu Z, et al. Blood manganese and non-alcoholic fatty liver disease in a high manganese exposure area in China[J]. Journal of health, population, and nutrition, 2023, 42(1): 118.
[20]	刘伟泽, 范红敏. 非酒精性脂肪肝影响因素研究进展. 现代养生. 2022;22(08): 571-4. LIU W Z, FANG H M. Research progress on influencing factors of non-alcoholic fatty liver disease[J]. 2022;22(08): 571-4.
[21]	王缕, 张志红, 冯健, 等. 泸州市某单位体检人群脂肪肝患病率及危险因素分析[J]. 现代预防医学, 2018, 45(6): 1109-13. WANG L, ZHANG ZH H, et al. Analysis of prevalence and risk factors for fatty liver in subjects undergoing routine physical examinations in Luzhou[J]. Modern Preventive Medicine, 2018, 45(6): 1109-13.