유기염소 살충제와 비알코올 지방간 질환의 관련성

Abstract

Background: Endocrine-disrupting chemicals (EDCs) are emerging as the cause of the nonalcoholic fatty liver disease (NAFLD). Widely used in the 20th century, organochlorine pesticides (OCPs) are absorbed into the body through food intake, respiratory tract, and skin contact and remain long even after discontinuing use. Recent studies have revealed a link between OCPs and metabolic syndromes such as obesity, diabetes, and dyslipidemia. However, little is known about their relevance with NAFLD. This study aimed to determine the association between exposure to OCPs and NAFLD prevalence.

Methods: We used National Health and Nutrition Examination Survey (NHANES) 2003–2004 data. Four substances, p,p’-DDE, oxychlordane, trans-nonachlor, and mirex, were analyzed. The exclusion criteria were as follows: age < 20 years, hepatitis B and C infection. The primary outcome was fatty liver index ≥ 60, a non-invasive marker for diagnosing NAFLD. We divided the serum concentration of OCPs into four quartiles and compared the adjusted odds ratios (OR) of NAFLD occurrence in each quartile.

Results: A total of 1512 participants was enrolled, and 579 were NAFLD patients who met the diagnostic criteria. We set the odds ratio (OR) to 1 as a reference in the fourth quartile for all substances. After adjusted logistic regression, oxychlordane had a higher risk of NAFLD with increasing serum concentrations (OR 0.288 in the first quartile, 95% CI 0.155–0.536). p,p’-DDE and trans-nonachlor did not significantly correlate with NAFLD, and mirex showed a higher prevalence of NAFLD at lower quartiles (OR 3.443 in the first quartile, 95% CI 2.072–5.721).

Conclusion: This study suggested that exposure to OCPs was associated with NAFLD prevalence, some of which showed a linear dose-dependent relationship. Periodic monitoring for NAFLD seems necessary for individuals with high exposure to OCPs in the general population.