Mercury and Liver Disease

[Guest guest]

New paper out on mercury (and other toxicants) and liver disease. Full

article from EHP available here:

http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info%3Adoi%2F1\

0.1289%2Fehp.1002720

Polychlorinated Biphenyls, Lead, and Mercury Are Associated with Liver

Disease in American Adults: NHANES 2003–2004

Matt Cave1,2,3, Savitri Appana4, Mihir Patel1, Cameron Falkner1,

Craig J. McClain1,2,3, Guy Brock4

1 Department of Medicine, Division of Gastroenterology, Hepatology, and

Nutrition, 2 Department of Pharmacology and Toxicology, 3 Robley Rex

Veterans Affairs Medical Center, and, 4 Department of Bioinformatics and

Biostatistics, University of Louisville, Louisville, Kentucky, USA

Abstract

Background: High-level occupational exposures to some industrial

chemicals have been associated with liver diseases, including

nonalcoholic fatty liver disease (NAFLD). However, the potential role of

low-level environmental pollution on liver disease in the general

population has not been evaluated.

Objective: We determined whether environmental pollutants are associated

with an elevation in serum alanine aminotransferase (ALT) activity and

suspected NAFLD in U.S. adults.

Methods: This cross-sectional cohort study evaluated adult participants

without viral hepatitis, hemochromatosis, or alcoholic liver disease

from the National Health and Nutrition Examination Survey (NHANES) for

2003–2004. ALT elevation was defined in men as ≥ 37 IU/L (age18–20

years) and ≥ 48 IU/L (age ≥ 21 years) and in women as ≥ 30 IU/L (age

18–20 years) and ≥ 31 IU/L (age ≥ 21 years). Adjusted odds ratios (ORs)

for ALT elevation were determined across exposure quartiles for 17

pollutant subclasses comprising 111 individual pollutants present with

at least a 60% detection rate. Adjustments were made for age,

race/ethnicity, sex, body mass index, poverty income ratio, and insulin

resistance. Individual pollutants from subclasses associated with ALT

elevation were subsequently analyzed.

Results: The overall prevalence of ALT elevation was 10.6%. Heavy metals

and polychlorinated biphenyls (PCBs) were associated with dose-dependent

increased adjusted ORs for ALT elevation. Within these subclasses,

increasing whole-blood levels of lead and mercury and increasing

lipid-adjusted serum levels of 20 PCBs were individually associated with

ALT elevation.

Conclusions: PCB, lead, and mercury exposures were associated with

unexplained ALT elevation, a proxy marker of NAFLD, in NHANES 2003–2004

adult participants.