Abstract
Background Growing evidence suggest that ethylene oxide (EO) may have deleterious effects on health conditions, but the relationship between EO and adulthood nonalcoholic fatty liver disease (NAFLD) remains vague. Our objective is to evaluate whether EO exposure would influence the prevalence of NAFLD in a nationally cross-sectional study.
Materials and methods In this cross-sectional study, We analyzed 2,394 participants from the National Health and Nutrition Examination Survey (NHANES) 2013-2018. Blood concentrations of EO were measured using high-performance liquid chromatography coupled with tandem mass spectrometry. US fatty liver index (USFLI) and FLI were applied to define NAFLD. Logistic regression analysis was adopted to investigate the relationship of Hemoglobin adducts of EO (HbEO) exposure with the prevalence of NAFLD. Mediation analysis was performed to assess the effect of inflammatory biomarkers on the association between HbEO levels and USFLI, FLI, and NAFLD.
Results After adjustment for age, gender, race/ethnicity, education, income, smoking, drinking, hypertension, diabetes, and TC, logistic regression analysis showed that HbEO in the highest quartile was negatively associated with the prevalence of NAFLD than those in the lowest quartile (OR: 0.50, 95% CI: 0.33-0.92, P for trend = 0.008 for USFLI and OR: 0.42, 95% CI: 0.29-0.61, P for trend <0.001 for FLI). In addition, inflammation significantly mediated the relationships between HbEO and NAFLD.
Conclusions Our study demonstrated that higher EO levels were negatively associated with the prevalence of NAFLD. The underlying mechanisms were required to be identify in the future study.