ArticleFood and chemical toxicology : an international journal published for the British Industrial Biological Research Association2020
Blood BTEXS and heavy metal levels are associated with liver injury and systemic inflammation in Gulf states residents.
Article in Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 53 citations in OpenAlex.
- Advances in biomarkers of benzene exposure and toxicity: From mechanistic insights to occupational health applications (Review).Molecular medicine reports · 2026Review
- Understanding molecular mechanisms driving cadmium-induced mitochondrial dysfunction in human metabolic liver disease.Environmental toxicology and pharmacology · 2026Review
- Metals in the human liver: An underappreciated risk factor of hepatic insulin resistance and associated pathophysiology.Environmental pollution (Barking, Essex : 1987) · 2025Review
- Article
- Hematological biochemical and liver function changes associated with BTEX exposure in a six year retrospective cohort study.Scientific reports · 2025Article
- Effect of co-exposure to multiple metals (Pb, Cd, Cr, Hg, Fe, Mn and Ni) and metalloid (As) on liver function in Swiss albino mice.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2025Article
- Hypothesis-driven weight of evidence evaluation indicates ethylbenzene lacks endocrine disruption potential by EATS pathways.EXCLI journal · 2025Article
- Article
- Obesogenic polystyrene microplastic exposures disrupt the gut-liver-adipose axis.Toxicological sciences : an official journal of the Society of Toxicology · 2024Article
- Article
- Plasma Cytokeratin-18 Fragment Level Reflects the Metabolic Phenotype in Obesity.Biomolecules · 2023Article
- Associations between residential volatile organic compound exposures and liver injury markers: The role of biological sex and race.Environmental research · 2023Article
- The association of blood metals with latent tuberculosis infection among adults and adolescents.Frontiers in nutrition · 2023Article
- Environmental Toxicants and NAFLD: A Neglected yet Significant Relationship.Digestive diseases and sciences · 2022Review
- Occupational exposure to BTEX and styrene in West Asian countries: a brief review of current state and limits.Arhiv za higijenu rada i toksikologiju · 2022Review
- Molecular evidence of the amelioration of toluene induced encephalopathy by human breast milk mesenchymal stem cells.Scientific reports · 2022Article
- Higher Blood Cadmium Concentration Is Associated With Increased Likelihood of Abdominal Aortic Calcification.Frontiers in cardiovascular medicine · 2022Article
- Circulating MicroRNAs, Polychlorinated Biphenyls, and Environmental Liver Disease in the Anniston Community Health Survey.Environmental health perspectives · 2022Article
- Associations Between Residential Exposure to Volatile Organic Compounds and Liver Injury Markers.Toxicological sciences : an official journal of the Society of Toxicology · 2021Article
- Prenatal and childhood exposure to air pollution and traffic and the risk of liver injury in European children.Environmental epidemiology (Philadelphia, Pa.) · 2021Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
introductionExposures to volatile organic compounds and metals have previously been associated with liver diseases including steatohepatitis, although more data are needed. Benzene, toluene, ethylbenzene, xylenes, styrene (BTEXS) and metals were measured in blood samples collected between May 2012-July 2013 from volunteers participating in home visits for the Gulf Long-term Follow-up (GuLF) Study. This cross-sectional analysis evaluates associations of exposure biomarkers with serum liver injury and adipocytokine biomarkers in a sample of 214 men.
methodsAdult nonsmoking men without a history of liver disease or heavy alcohol consumption were included. The serologic disease biomarkers evaluated were the hepatocellular injury biomarker, cytokeratin 18 [whole (CK18 M65) and caspase-cleaved fragment (CK18 M30)]; and adipocytokines. Confounder-adjusted beta coefficients were determined using linear regression models for the overall sample (primary endpoints) and for obesity-classified sub-groups (secondary endpoints). A product interaction term between the exposure of interest and a dichotomized indicator of obesity was included to determine the disease modifying effects of obesity on the biomarker associations.
resultsThe study sample was 57% white and 51% obese. In the overall sample, lead was positively associated with CK18 M30 (β = 21.7 ± 6.0 (SE), p = 0.0004); IL-1β (β = 32.8 ± 5.2, p < 0.0001); IL-6 (β = 72.8 ± 18.3, p = 0.0001); and IL-8 (β = 140.8 ± 42.2, p = 0.001). Cadmium exposures were associated with increased IL-1β (β = 77.8 ± 26.3, p = 0.003) and IL-8 (β = 419.5 ± 201.2, p = 0.04). There were multiple significant interactions between obesity and exposure to lead, cadmium, benzene and toluene in relation to outcome biomarkers. Among obese participants (n = 108), benzene, lead, and cadmium were each positively associated with CK18 M30, IL-1β, IL-6, and IL-8. In obese subjects, lead was also inversely associated with leptin, and toluene was positively associated with IL-1β.
conclusionFor the overall sample, heavy metal exposures were associated with liver injury (lead only) and/or systemic inflammation (lead and cadmium). Obesity modified the associations between BTEXS and heavy metal exposures on several of the outcome variables. In the obesity subgroup, liver injury was positively associated with lead, cadmium and benzene exposures; systemic inflammation was increased with lead, cadmium, benzene, and toluene exposures; and leptin was inversely associated with lead exposures. The cross-sectional design of this study makes it difficult to determine causality, and all results should be interpreted cautiously. Nonetheless, the potential impact of exposures to lead, cadmium, benzene and toluene in steatohepatitis, an obesity-associated inflammatory liver disease, warrants further investigation.
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