ArticleInternational journal of hygiene and environmental health2013
Multiple classes of environmental chemicals are associated with liver disease: NHANES 2003-2004.
Article in International journal of hygiene and environmental health, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
65 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Systematic Review of Environmental Health Outcomes in Selected American Indian and Alaska Native Populations.Journal of racial and ethnic health disparities · 2020Pooled it
- AI/ML-based computational models for toxicity prediction.Environmental science and pollution research international · 2026Review
- Evaluation of integrated, multimedia biomarkers of prenatal metals exposure in association with child neurodevelopment in Puerto Rico.Journal of exposure science & environmental epidemiology · 2026Article
- Article
- Development and two-city validation of a Temperature-Sensitive Air Quality Health Index incorporating synergistic effects of air pollution and thermal stress.Frontiers in public health · 2026Article
- 13-Month Follow Up of Acclimation of Cynomolgus Macaques (Macaca fascicularis) on Haematology, Serum Biochemistry, and Body Weight Changes.Journal of medical primatology · 2025Article
- The Association between Multiple Environmental Exposures and Symptoms of Generalized Anxiety Disorder in a Prospective, US-Based Cohort Study.Environmental health perspectives · 2025Article
- Urinary phthalate metabolites associated with increased prevalence of gallstone disease in U.S. adults: data from the NHANES study.BMC public health · 2025Article
- Associations of flavonoid intakes with metabolic dysfunction-associated steatotic liver disease in US adults.PloS one · 2025Article
- Quantile regression based method for characterizing risk-specific behavioral patterns in relation to longitudinal left-censored biomarker data collected from heterogeneous populations.Journal of applied statistics · 2025Article
- A study of correlation of the dietary index for gut microbiota with non-alcoholic fatty liver disease based on 2007-2018 National Health and Nutrition Examination Survey.Frontiers in nutrition · 2025Article
- The relationship between life's essential 8 score and depression symptom severity: evidence from a nationally representative sample of U.S. adults.BMC psychiatry · 2024Article
- Systematic Exploration of the Association Between Vitamin A Intakes and Sarcopenia Prevalence in American Adults.Food science & nutrition · 2024Article
- Environmental toxicants modulate disease severity in pediatric metabolic dysfunction-associated steatohepatitis.Journal of pediatric gastroenterology and nutrition · 2024Article
- Exploring the association between lifestyle and cardiovascular health metrics and HPV infection risk: insights from the National Health and Nutrition Examination Survey 2005-2016 data.BMC public health · 2024Article
- Upregulation of fatty acid synthesis genes in the livers of adolescent female rats caused by inhalation exposure to PCB52 (2,2',5,5'-Tetrachlorobiphenyl).Environmental toxicology and pharmacology · 2024Article
- Association of Life's Essential 8 with metabolic dysfunction-associated steatotic liver disease (MASLD), a cross-sectional study from the NHANES 2003-2018.Scientific reports · 2024Article
- Association of volatile organic compound levels with chronic obstructive pulmonary diseases in NHANES 2013-2016.Scientific reports · 2024Article
- Associations between neonicotinoids and liver function measures in US adults: National Health and Nutrition Examination Survey 2015-2016.Environmental epidemiology (Philadelphia, Pa.) · 2024Article
- Accommodating detection limits of multiple exposures in environmental mixture analyses: an overview of statistical approaches.Environmental health : a global access science source · 2024Article
5 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
Biomonitoring studies show that humans carry a body burden of multiple classes of contaminants which are not often studied together. Many of these chemicals may be hepatotoxic. We used the 2003-2004 National Health and Nutrition Examination Survey to evaluate the relationship between alanine aminotransferase (ALT) and 37 environmental contaminants, comprising heavy metals, non-dioxin-like polychlorinated biphenyls (PCBs), and dioxin-like compounds, using a novel method. Linear regression models were constructed for each chemical separately, then as a class, using quartiles to represent exposure and adjusting for age, sex, race, income, and BMI. We then used an optimization approach to compile a weighted sum of the quartile scores, both within and across chemical classes. Using the optimization approach to construct weighted quartile scores, the dioxin like PCB, the non-dioxin like PCB and metal class-level scores were significantly associated with elevated ALT. A significant interaction was detected between the class-level score for metals, and the score for non-dioxin-like PCBs. When including all chemicals in one model, 3 chemicals accounted for 78% of the weight (mercury, PCB 180, 3,3',4,4',5-PNCB) with the remaining 22% associated with 4 chemicals (a dioxin and 3 PCBs). Validation with a holdout dataset indicated that the weighted quartile sum estimator efficiently identifies reproducible significant associations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.