Association between fine particle exposure and common test items in clinical laboratory: A time-series analysis in Changsha, China

The mediating and moderating effect of BMI in the relationship between air pollution and nonalcoholic fatty liver disease: A prospective cohort study

The associations between air pollution exposure and non-alcoholic fatty liver disease (NAFLD) remain unclear. The present study included 313,102 individuals from the UK Biobank. Data on air pollution included PM2.5, PMcoarse, PM10, PM2.5absorbance, nitrogen dioxide (NO2), and nitrogen oxides (NOx). A weighted air pollution score (WAPS) was created using PM10 and NOx to evaluate the comprehensive exposure to the five air contaminants. Using Cox proportional hazard models and restricted cubic spline (RCS) models, the relationship between air pollution exposure and the developing NAFLD risk was examined. We also examined the mediating role of BMI. We found that the increased risk of NAFLD was positively correlated with PM2.5, PMcoarse, PM10, PM2.5absorbance, NO2, NOx, and WAPS (all P-trend < 0.05). In comparison to individuals who were in the lowest quartile for air contaminants exposure, the HRs of NAFLD for those exposed to the highest quartile were: PM2.5: 1.33 (95% CI: 1.22 to 1.45), PMcoarse: 1.12 (95% CI: 1.03 to 1.22), PM10: 1.15 (95% CI: 1.05 to 1.25), PM2.5 absorbance: 1.27 (95% CI: 1.17 to 1.39), NO2: 1.38 (95% CI:1.26 to 1.50), NOx: 1.33 (95% CI:1.22 to 1.45), and WAPS: 1.32 (95% CI:1.21 to 1.44). No correlation was found between WAPS and NAFLD risk in those who were normal weight, but it was strong in overweight and obese people. BMI (mediated proportion: 8.18% for PM2.5; 2.89% for PM2.5absorbance; 18.8% for PMcoarse; 12.32% for PM10; 4.09% for NO2; 7.72% for NOX; 8.44% for WAPS) significantly mediated a portion of the link between air pollution exposure and NAFLD (all PIE < 0.05). Overall, air pollution exposure can increase the developing NAFLD risk, and BMI significantly modifies and mediates the connection. These findings served as mechanical evidence that air pollution contributes to NAFLD in epidemiological investigations.

Identification of a new fish trypanosome from the large yellow croaker (Larimichthys crocea) and description of its impact on host pathology, blood biochemical parameters and immune responses

The aim of this study was to clarify the taxonomic identification of a hemoflagellate and assess the effect of trypanosome infection on Larimichthys crocea. Giemsa staining showed the presence of three morphotypes of trypomastigotes. The trypanosomes had the following morphological characteristics: a slender body with a long flagellum at the front; body size 12.30-30.90 × 1.13-2.33 μm; elongated oval nucleus situated in the median region; kinetoplast small, oval, located at the posterior end. The parasite had significant morphological differences from Trypanosoma epinepheli Su, Feng, Jiang, Guo, Liu & Xu, 2014 and Trypanosoma carassii (Mitrofanov) Doflein, 1901. The 18S rDNA sequences of the trypanosome from L. crocea had the highest homology (98.4%) with T. carassii. Phylogenetic analysis indicated that the parasite clustered with freshwater fish trypanosomes. Based on the differences in morphological characteristics and molecular data, it is considered a new species, Trypanosoma larimichthysi n. sp. Trypanosome infection had no effect on the growth of L. crocea, but significantly increased the concentration of blood urea nitrogen (BUN), and induced pathological changes in the gills, liver, spleen and kidney. The pro-inflammatory immune genes, including TNF-α, IFN-γ, IL-1β, CXCL8 and iNOS, were significantly upregulated in the L. crocea infected with trypanosomes. These results suggest that the trypanosome has negative impacts on host health.

Association of PM2.5 exposure in early pregnancy and maternal liver function: A retrospective cohort study in Shenzhen, China

OBJECTIVE

Studies have shown that fine particulate matter (PM2.5) has adverse effects on the liver function, but epidemiological evidence is limited, especially regarding pregnant women. This study aims to investigate the association between PM2.5 exposure in early pregnancy and maternal liver function during pregnancy.

METHODS

This retrospective cohort study included 13,342 pregnant participants. PM2.5 and Ozone (O3) exposure level, mean temperature, and relative humidity for each participant were assessed according to their residential address. The levels of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin (TBIL) were measured during the second and third trimesters. Data on PM2.5 and O3 exposure level were sourced from Tracking Air Pollution in China (TAP), while the mean temperature and relative humidity were obtained from the ERA5 dataset. The Generalized Additive Model (GAM) was used to analyze the associations between PM2.5 exposure and maternal liver function during pregnancy, adjusting for potential confounding factors.

RESULTS

According to the results, each 10 μg/m3 increase in PM2.5 was associated with an increase of 3.57% (95% CI: 0.29%, 6.96%) in ALT and 4.25% (95% CI: 2.33%, 6.21%) in TBIL during the second trimester and 4.51% (95% CI: 2.59%, 6.47%) in TBIL during the third trimester, respectively. After adjusting for O3, these associations remained significant, and the effect of PM2.5 on ALT during the second trimester was further strengthened. No significant association observed between PM2.5 and AST.

CONCLUSIONS

PM2.5 exposure in early pregnancy is associated with increasement of maternal ALT and TBIL, suggesting that PM2.5 exposure may have an adverse effect on maternal liver function. Although this finding indicates an association between PM2.5 exposure and maternal liver function, more research is needed to confirm our findings and explore the underlying biological mechanisms.

Associations between inhalation of typical volatile and semi-volatile organic compounds in e-waste dismantling workers with liver function damage

Studies in cell culture and animal models suggest hepatotoxicity of some volatile organic compounds (VOCs) and semi-volatile organic compounds (SVOCs), however, their effects in human populations under real exposure conditions have never been clarified. In this cross-sectional study, 224 participants, 38 e-waste dismantling workers and 186 subjects residing near to the dismantling sites in southern China, were evaluated for personal inhalational exposure to 72 VOCs and 91 SVOCs according to site-specific atmospheric chemical concentrations and personal exposure time. Additionally, their serum samples were subjected to liver function tests (LFTs), including total protein (TP), albumin (ALB), globulin (GLB), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), and bilirubin. Linear regression analysis of the VOC/SVOC levels against the LFTs results indicated that VOC exposure was negatively associated with the TP, ALB, GLB levels (indicating liver-specific protein synthesis functions), while positively associated with AST, ALT, GGT activities (marking liver damage). Somehow, SVOC exposure appeared to be positively associated with not only AST and ALT but also TP and ALB. These findings were supported by the quantile g-computation analysis and confirmed in the Bayesian kernel machine regression model. This study indicates that simultaneous inhalation of VOCs and SVOCs may impair human liver functions.

Association between ambient air pollution exposure in pregnant women with antiphospholipid syndrome in Nanjing, China

Antenatal exposure to air pollutants is thought to be associated with a variety of maternal blood markers as well as adverse birth outcomes. However, the dysgenic influence of air pollutants on the antiphospholipid syndrome (APS) in mothers and their pregnancy outcomes remains unclear. In the current study, 371 mother-infant pairs (189 healthy: 182 APS) from Nanjing Maternal and Child Health Hospital as well as air pollutants concentration from their living environment were used to investigate correlations between air pollution with maternal blood indicators and fetal birth weight in the groups of APS and healthy mothers. Generalized linear model was used to evaluate the contributions of air pollutant exposure during pregnancy to the blood indicators variation. The relationships between birth weight with specific air pollutant and blood index were analyzed using ridge regression. Results showed that APS fetal birth weight was significantly impacted by air pollutant exposure during pregnancy, in particular, the birth weight decreased significantly along with increasing fine particulate matter 2.5 (PM2.5) and fine particulate matter 10 (PM10) exposure concentrations throughout pregnancy. In contrast, birth weight increased significantly with sulfur dioxide (SO2) exposure. In addition, APS-related blood indicators comprised of platelet distribution width (PDW), total bilirubin (TBIL), mean platelet volume (MPV), platelet-larger cell ratio (P_LCR), homocysteine (HCY), alkaline phosphatase (ALP), direct bilirubin (DBIL), basophilic granulocyte (BAS), platelet thrombocytocrit (PCT), preprandial glucose levels (OGTT0), monocytes (MON), and monocytes ratio (MON_ratio) were also strongly related with prenatal exposure to PM2.5 and PM10, in which PDW levels showed most strongly negative impaction on fetal birth weight. Together, we showed that prenatal exposure to air pollutant (PM2.5 and PM10) may exacerbate the poor birth outcomes of low birth weight by impacting APS maternal blood indicators especially for PDW.

Associations of polycyclic aromatic hydrocarbons, water-soluble ions and metals in PM2.5 with liver function: Evidence from schizophrenia cohort

BACKGROUND

Fine particulate matter (PM_2.5) was reported to impact liver function, but the roles of specific PM_2.5 chemical components remained to be explored. Besides, severe liver dysfunction in schizophrenia patients deserves attention.

OBJECTIVE

To investigate the associations of short-term PM_2.5 components with liver function in schizophrenia patients.

METHODS

A repeated-measures study based on schizophrenia cohort including 1023 visits (n = 446) was conducted during 2017-2020. Liver function was reflected by 10 indicators including liver enzymes, proteins and bilirubin et al. Monitoring data of PM_2.5 and its components, including 16 polycyclic aromatic hydrocarbons (PAHs), 4 water-soluble ions and 10 metals were collected. Linear mixed effect and Bayesian kernel machine regression (BKMR) models were used to evaluate the single and combined effects of PM_2.5 components (0-3 day) on liver function in schizophrenia patients.

RESULTS

Several PAHs were significantly associated with liver enzymes, while water-soluble ions and metal components had almost no association. Specifically, with per interquartile range (IQR) increased in Fluoranthene, levels of alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate transaminase (AST) and gamma-glutamyl transpeptidase (GGT) increased by 2.06 %, 5.07 %, 4.94 % and 5.56 %, respectively. An IQR increases in Benzo[a]pyrene was significantly associated with 6.62 %, 3.67 % and 7.83 % increase in ALT, AST and GGT. Almost all PAHs, sulfate, nitrate, ammonium, Sb, Al, As, Pb, Mn and Tl were positively associated with albumin (ALB). Phenanthrene was associated with increased levels of direct bilirubin (DBIL) and total bilirubin (TBIL). The combined effects of significant PM_2.5 components on ALP, GGT, ALB, globulin (GLOB), ratio of albumin to globulin (A/G), TBIL and total bile acid (TBA) were found by BKMR, respectively.

CONCLUSIONS

Findings highlight the short-term combined effects of PM_2.5 components, especially PAHs, on liver function in schizophrenia patients, which contribute to the management of PM_2.5 sources including combustion activities and traffic emissions as well as improving schizophrenia comorbidities.

Effect of Fine Particulate Matter Exposure on Liver Enzymes: A Systematic Review and Meta-Analysis

Although previous studies have presented that fine particulate matter (PM2.5) regulates liver enzyme levels in the development of liver diseases, the evidence regarding the relationship between PM2.5 exposure and liver enzyme is not robust. We further aimed to conduct a systematic review and meta-analysis of observational studies to summarize the recent evidence on the effects of PM2.5 on liver enzyme in humans. In the meta-analysis, we retrieved online databases including PubMed and Web of Science database from 1982 up to 2022. A random-effects model was applied to evaluate the correlation between PM2.5 and liver enzyme level. A total of 10 studies fulfilled the inclusion criteria, including five prospective cohort studies, two cross-sectional studies, two longitudinal studies, and one time-series analysis. Each 10 μg/m3 increase in PM2.5 concentration was significantly correlated with a 4.45% increase in alanine aminotransferase (ALT) level (95% CI: 0.51-8.38%, p = 0.03), a 3.99% increase in aspartate transferase (AST) level (95% CI: 0.88-7.10%, p = 0.01), and a 2.91% increase in gamma-glutamyl transferase (GGT) level (95% CI: 1.18-4.64%, p < 0.001), but this significant association was not observed in alkaline phosphatase (ALP). Subgroup analysis revealed that PM2.5 has a significant correlation with ALT (5.07%, 95% CI: 0.81-9.33%), AST (4.11%, 95% CI: 0.74-7.48%), and GGT (2.74%, 95% CI: 1.09-4.38%) in Asia. Our meta-analysis showed that increments in PM2.5 exposure were significantly associated with a higher level of ALT, AST, and GGT. In addition, investigations into liver enzyme subtypes and specific chemical components of PM2.5 are important directions for future research.

Mining biomarkers from routine laboratory tests in clinical records associated with air pollution health risk assessment

Clinical laboratory in hospital can produce amounts of health data every day. The purpose of this study was to mine biomarkers from clinical laboratory big data associated with the air pollution health risk assessment using clinical records. 13, 045, 629 clinical records of all 27 routine laboratory tests in Changsha Central Hospital, including ALB, TBIL, ALT, DBIL, AST, TP, UREA, UA, CREA, GLU, CK, CKMB, LDL-C, TG, TC, HDL-C, CRP, WBC, Na, K, Ca, Cl, APTT, PT, FIB, TT, RBC and those daily air pollutants concentration monitoring data of Changsha, including PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃ from 2014 to 2016, were retrieved. The moving average method was used to the biological reference interval was established. The tests results were converted into daily abnormal rate. After data cleaning, GAM statistical model construction and data analysis, a concentration-response relationship between air pollutants and daily abnormal rate of routine laboratory tests was observed. Our study found that PM_2.5 had a stable association with TP (lag07), ALB (lag07), ALT (lag07), AST (lag07), TBIL (lag07), DBIL (lag07), UREA (lag07), CREA (lag07), UA (lag07), CK (lag 06), GLU (lag07), WBC (lag07), Cl (lag07) and Ca (lag07), (P < 0.05); O₃ had a stable association with AST (lag01), CKMB (lag06), TG (lag07), TC (lag05), HDL-C (lag07), K (lag05) and RBC (lag07) (P < 0.05); CO had a stable association with UREA (lag07), Na (lag7) and PT (lag07) (P < 0.05); SO₂ had a stable association with TP (lag07) and LDL-C (lag0) (P < 0.05); NO₂ had a stable association with APTT (lag7) (P < 0.05). These results showed that different air pollutants affected different routine laboratory tests and presented different pedigrees. Therefore, biomarkers mined from routine laboratory tests may potentially be used to low-cost assess the health risks associated with air pollutants.

Association between built environments and quality of life among community residents: mediation analysis of air pollution

OBJECTIVES

The aim of this study was to analyze the relationship between built environments and quality of life (QoL), and the mediating role of air pollution in that relationship.

STUDY DESIGN

This was a cross-sectional population-based study.

METHODS

Data of 5196 adults residing in 148 communities in three cities in Liaoning Province, China, were analyzed. Objective measures of traffic design included street connectivity, road network density, bus station density, and parking lot density; residential greenness was controlled as a confounder. QoL was evaluated using the 12-Item Short Form Health Survey. The average concentrations of PM_2.5 and SO₂ one month before QoL collection for each community were calculated.

RESULTS

Road network density and parking lot density were negatively associated with the Physical Component Summary (PCS), but street connectivity was positively associated with PCS for the participants. Bus station density, street connectivity, and parking lot density were negatively associated with the Mental Component Summary (MCS), and PM_2.5 and SO₂ mediated this association. In addition, gender and road network density and parking lot density had an interactive effect on the MCS of the participants.

CONCLUSIONS

Dense traffic affects people's health not only directly but also indirectly through air pollution. The effects of built environments and air pollution should be considered when building healthy, supportive communities, and healthy cities.

The short- and long-term associations of particulate matter with inflammation and blood coagulation markers: A meta-analysis

Inflammation and the coagulation cascade are considered to be the potential mechanisms of ambient particulate matter (PM) exposure-induced adverse cardiovascular events. Tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), and fibrinogen are arguably the four most commonly assayed markers to reflect the relationships of PM with inflammation and blood coagulation. This review summarized and quantitatively analyzed the existing studies reporting short- and long-term associations of PM2.5(PM with an aerodynamic diameter ≤2.5 μm)/PM10 (PM with an aerodynamic diameter≤10 μm) with important inflammation and blood coagulation markers (TNF-α, IL-6, IL-8, fibrinogen). We reviewed relevant studies published up to July 2020, using three English databases (PubMed, Web of Science, Embase) and two Chinese databases (Wang-Fang, China National Knowledge Infrastructure). The OHAT tool, with some modification, was applied to evaluate risk of bias. Meta-analyses were conducted with random-effects models for calculating the pooled estimate of markers. To assess the potential effect modifiers and the source of heterogeneity, we conducted subgroup analyses and meta-regression analyses where appropriate. The assessment and correction of publication bias were based on Begg's and Egger's test and "trim-and-fill" analysis. We identified 44 eligible studies. For short-term PM exposure, the percent change of a 10 μg/m3 PM2.5 increase on TNF-α and fibrinogen was 3.51% (95% confidence interval (CI): 1.21%, 5.81%) and 0.54% (95% confidence interval (CI): 0.21%, 0.86%) respectively. We also found a significant short-term association between PM10 and fibrinogen (percent change = 0.17%, 95% CI: 0.04%, 0.29%). Overall analysis showed that long-term associations of fibrinogen with PM2.5 and PM10 were not significant. Subgroup analysis showed that long-term associations of fibrinogen with PM2.5 and PM10 were significant only found in studies conducted in Asia. Our findings support significant short-term associations of PM with TNF-α and fibrinogen. Future epidemiological studies should address the role long-term PM exposure plays in inflammation and blood coagulation markers level change.