586 posters, 8 topics, 23 sessions, 1,077 authors, 622 institutions

ISQua's 40th International Conference 2024

24th - 27th September 2024 | Istanbul, Türkiye

ISQUA2024-ABS-3390

Association between PM2.5 exposure and incident Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): a Cohort Study

View Poster Contact Presenter

Poster Presenter

Wei-Chun CHENG

Authors

Wei-Chun Cheng, Pin-Nan Cheng, Chung-Yi Li

Affiliations

National Cheng Kung University Hospital, 1Department of Gastroenterology and Hepatology, Tainan Hospital, Ministry of Health and Welfare, 2Department of Internal Medicine, 3Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan, 2Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, 1Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 4Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan

Part of Topic

Navigating Climate Change and Sustainability in Healthcare System

Introduction

Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a significant global health challenge. Recent redefinitions of the disease [1] highlight its growing prevalence and the associated increase in morbidity and mortality [2]. Emerging evidence suggests a link between MASLD and environmental factors, such as air pollution [3].

Aim

To explore the association between particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5) exposure incident MASLD

Method

•This retrospective cohort study included participants who underwent health checkups at the MJ Clinic in Taiwan between 2012 and 2015, with at least one follow-up health checkup completed by 2017.

•The three-year average exposure to PM2.5 prior to the health checkups were estimated using the geocoded home addresses of each participant, using a Hybrid Kriging-Land Use Regression model combined with an XGBoost algorithm [4].

•MASLD diagnosis was based on sonographic evidence of hepatic steatosis, coupled with at least one of five cardiometabolic criteria:
1) BMI ≥ 23 kg/m2 (in Asians) or waist circumference (WC) >94cm in men or WC >80cm for women; 2) fasting serum glucose ≥ 100 mg/dL or HbA1c ≥ 5.7% or type 2 diabetes or under treatment for type 2 diabetes; 3) BP ≥ 130/85mmHg or under specific antihypertensive drug treatment; 4) plasma triglyceride ≥ 150 mg/dL or under lipid lowering treatment ; 5) plasma high-density lipoprotein ≤ 40 mg/dL in or ≤ 50 mg/dL in women or under lipid lowering treatment [1].

•Each participant was followed until MASLD diagnosis, death, or the study's end on November 30, 2022.

A time-dependent Cox regression model, incorporating Fine-Gray sub-distribution hazards to account for mortality as a competing risk, was employed to analyze

he hazard ratio (HR) for MASLD development during the follow-up period.

Results

lThe study encompassed 19,464 participants without baseline MASLD. Over a median follow-up of 28.3 months, 3,220 individuals (16.5%) developed MASLD, and 580 (3.0%) died. The baseline demographic of these participants were presented in Table 1.

lThe Hazard ratio (HR) for MASLD was 1.09 (95% CI: 1.02-1.16) for every 10 μg/m3 increase in the 3-year average PM2.5 as determined by Fine-Gray sub-distribution hazard (SDH) analysis. A sensitivity analysis with cause-specific hazard (CSH) yielded similar results of HR as 1.09 (95% CI: 1.02-1.16) (Figure 2 )

lFigure 3 illustrates the dose-response relationship between the 3-year average PM₂.₅ exposure and the hazard ratio (HR) for MASLD.

Table 1. Baseline Demographic and Clinical Characteristics of Participants Without MASLD at Baseline in This study

Figure 2. Hazard Ratios (HRs) and 95% Confidence Intervals (CIs) of Risk Factors for incident MASLD

Figure 3. Dose-Response Curve of 3-Year Average PM₂.₅ Exposure and the Predicted Hazard Ratio for Incident MASLD

Conclusions:
The three-year average PM2.5 exposure, alongside dietary and lifestyle risk factors, was associated with the incidence of MASLD in health checkup participants.