ArticleEnvironmental health : a global access science source2018
Arsenic exposure and risk of nonalcoholic fatty liver disease (NAFLD) among U.S. adolescents and adults: an association modified by race/ethnicity, NHANES 2005-2014.
Article in Environmental health : a global access science source, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
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Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 103 citations in OpenAlex.
- Association Between Non-alcoholic Fatty Liver Disease and Heavy Metal Exposure: a Systematic Review.Biological trace element research · 2023Pooled it
- Gestational Arsenic Exposure Induces Metabolic Dysfunction-Associated Fatty Liver Disease-like Phenotypes in Middle-Aged Offspring.Environment & health (Washington, D.C.) · 2026Article
- Co-exposure to environmental cadmium and arsenic leads to kidney damage even at lower concentrations.Journal of exposure science & environmental epidemiology · 2026Article
- Article
- Metals in the human liver: An underappreciated risk factor of hepatic insulin resistance and associated pathophysiology.Environmental pollution (Barking, Essex : 1987) · 2025Review
- Environmental Pollutants, Occupational Exposures, and Liver Disease.Seminars in liver disease · 2025Review
- Correlation Between Hepatic Waveform Changes on Doppler Ultrasound and Disease Severity in Cirrhotic Patients.Cureus · 2025Article
- Arsenic and young liver: a case report of hepatic steatosis due to arsenic toxicity.Clinical journal of gastroenterology · 2025Article
- The hepatocellular model of fatty liver disease: from current imaging diagnostics to innovative proteomics technologies.Frontiers in medicine · 2025Review
- Integrating Multi-Omics with environmental data for precision health: A novel analytic framework and case study on prenatal mercury induced childhood fatty liver disease.Environment international · 2024Article
- Sustained effects of developmental exposure to inorganic arsenic on hepatic gsto2 expression and mating success in zebrafish.Biology open · 2024Article
- Update of the risk assessment of inorganic arsenic in food.EFSA journal. European Food Safety Authority · 2024Article
- Long-term exposure to air pollution and prevalent nonalcoholic fatty liver disease.Environmental epidemiology (Philadelphia, Pa.) · 2023Article
- Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021.Current environmental health reports · 2023Article
- Effects of Early Life Oral Arsenic Exposure on Intestinal Tract Development and Lipid Homeostasis in Neonatal Mice: Implications for NAFLD Development.Environmental health perspectives · 2023Article
- Article
- Sex, Nutrition, and NAFLD: Relevance of Environmental Pollution.Nutrients · 2023Review
- Thoughts on Non-Alcoholic Fatty Liver Disease and Chronic Disease.Integrative medicine (Encinitas, Calif.) · 2023Article
- Analysis of gut bacteriome ofFrontiers in microbiology · 2023Article
- Associations of metal mixtures with metabolic-associated fatty liver disease and non-alcoholic fatty liver disease: NHANES 2003-2018.Frontiers in public health · 2023Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundWhile associated with obesity, the cause of the rapid rise in prevalence of nonalcoholic fatty liver disease (NAFLD) in children, which is highest among Hispanics, is not well understood. Animal experiments have demonstrated that arsenic exposure contributes to liver injury. Our objective was to examine the association between arsenic exposure and NAFLD in humans and to determine if race/ethnicity modifies the association.
methodsUrinary inorganic arsenic concentrations among those ≥12 years in the National Health and Nutrition Examination Survey, 2005-2014 were used to assess the cross-sectional association with serum alanine aminotransferase (ALT) levels, a marker of liver dysfunction. We excluded high alcohol consumers (>4-5 drinks/day; n = 939), positive hepatitis B or C (n = 2330), those missing body mass index (n = 100) and pregnant women (n = 629) for a final sample of 8518. Arsenic was measured using liquid chromatography coupled with mass spectrometry and ALT was measured using standard methods. Sampling weights were used to obtain national estimates. Due to lack of normality, estimates were log transformed and are presented as geometric means. Logistic regression models controlling for age, sex, income, and weight category estimate adjusted odd ratios (aOR) of elevated ALT by quartile of arsenic and tested for effect modification by race/ethnicity and weight. Elevated ALT was defined as >25 IU/L and >22 IU/L for boys and girls ≤17 years, respectively and >30 IU/L and >19 IU/L for men and women, respectively.
resultsAmong all, aOR of elevated ALT were higher among those in the highest vs. lowest arsenic quartile (referent), 1.4 (95% confidence interval [CI]: 1.1, 1.7) with a borderline significant interaction (p = 0.07) by race/ethnicity but not weight (p = 0.4). In analysis stratified by race/ethnicity, aOR of elevated ALT among those in the 4th quartile were higher among Mexican Americans, 2.0 (CI: 1.3, 3.1) and non-Hispanic whites only, aOR 1.4 (CI: 1.1, 1.8) despite the fact that obesity prevalence was highest among non-Hispanic blacks.
conclusionsOur findings demonstrate a positive association between urinary arsenic exposure and risk of NAFLD among U.S. adolescents and adults that is highest among Mexican Americans and among those obese, regardless of race/ethnicity.
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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.