ArticleFrontiers in public health2023
Associations of metal mixtures with metabolic-associated fatty liver disease and non-alcoholic fatty liver disease: NHANES 2003-2018.
Article in Frontiers in public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Environmental Endocrine-Disrupting Chemicals and Metabolic Dysfunction-Associated Steatotic Liver Disease.Liver international : official journal of the International Association for the Study of the Liver · 2026Pooled it
- The biomedical application of inorganic metal nanoparticles in aging and aging-associated diseases.Journal of advanced research · 2025Pooled it
- Hepatic inflammation after exposure to a mixture of low-dose arsenic and cadmium in a murine model of fatty liver disease.Toxicological sciences : an official journal of the Society of Toxicology · 2026Article
- Reliability Assessment of Metal Quantification in Formalin-fixed, Paraffin-embedded Human Liver Tissue for Studying Liver Diseases.Research square · 2026Article
- Antimony: a cryptic metabolism disruptor ubiquitous in food contact materials.Journal of the Endocrine Society · 2026Review
- Article
- Understanding molecular mechanisms driving cadmium-induced mitochondrial dysfunction in human metabolic liver disease.Environmental toxicology and pharmacology · 2026Review
- Association Between Thyroid Function Indicators and Metabolic-Associated Fatty Liver Disease: Effect Modification by Iodine Nutritional Status.International journal of endocrinology · 2026Article
- Association of heavy metal mixtures with liver function biomarkers: multi-model analysis identifies cadmium as the primary driver.Frontiers in public health · 2026Article
- Metal Mixture Inflammatory Index and diabetes risk in US adults: a cross-sectional analysis of NHANES 1999-2020 and development of a LASSO-based prediction model.BMJ open diabetes research & care · 2025Article
- Combined Effects of Environmental and Lifestyle Exposures on Liver Health: The Mediating Role of Allostatic Load.Toxics · 2025Article
- Metals in the human liver: An underappreciated risk factor of hepatic insulin resistance and associated pathophysiology.Environmental pollution (Barking, Essex : 1987) · 2025Review
- Associations of greenhouse gases, air pollutants and dynamics of scrub typhus incidence in China: a nationwide time-series study.BMC public health · 2025Article
- The Relationship Between Metal Exposure and HPV Infection: Evidence from Explainable Machine Learning Methods.Biological trace element research · 2025Article
- Multifaceted environmental factors linked to metabolic dysfunction-associated fatty liver disease: an environment-wide association study.BMC public health · 2025Article
- Overview of the hazardous impacts of metabolism-disrupting chemicals on the progression of fatty liver diseases.Molecular & cellular toxicology · 2025Article
- Inflammatory and metabolic markers mediate the association between urinary metals and non-alcoholic fatty liver disease in U.S. adults: a cross-sectional study.Frontiers in public health · 2025Article
- Mechanisms of Metal-Induced Hepatic Inflammation.Current environmental health reports · 2024Review
- A comprehensive framework for managing metabolic dysfunction-associated steatotic liver disease: analyzing novel risk factors and advances in nanotechnology-based treatments and diagnosis.RSC medicinal chemistry · 2024Review
- Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: The hepatotoxicity of exposure to a single heavy metal has been examined in previous studies. However, there is limited evidence on the association between heavy metals mixture and non-alcoholic fatty liver disease (NAFLD) and metabolic-associated fatty liver disease (MAFLD). This study aims to investigate the associations of 13 urinary metals, individually and jointly, with NAFLD, MAFLD, and MAFLD components. Methods: This study included 5,548 adults from the National Health and Nutrition Examination Survey (NHANES) 2003-2018. Binary logistic regression was used to explore the associations between individual metal exposures and MAFLD, NAFLD, and MAFLD components. Bayesian kernel machine regression (BKMR) and Quantile-based g-computation (QGC) were used to investigate the association of metal mixture exposure with these outcomes. Results: In single metal analysis, increased levels of arsenic [OR 1.09 (95%CI 1.03-1.16)], dimethylarsinic acid [1.17 (95%CI 1.07-1.27)], barium [1.22 (95%CI 1.14-1.30)], cobalt [1.22 (95%CI 1.11-1.34)], cesium [1.35 (95%CI 1.18-1.54)], molybdenum [1.45 (95%CI 1.30-1.62)], antimony [1.18 (95%CI 1.08-1.29)], thallium [1.49 (95%CI 1.33-1.67)], and tungsten [1.23 (95%CI 1.15-1.32)] were significantly associated with MAFLD risk after adjusting for potential covariates. The results for NAFLD were similar to those for MAFLD, except for arsenic, which was insignificantly associated with NAFLD. In mixture analysis, the overall metal mixture was positively associated with MAFLD, NAFLD, and MAFLD components, including obesity/overweight, diabetes, and metabolic dysfunction. In both BKMR and QGC models, thallium, molybdenum, tungsten, and barium mainly contributed to the positive association with MAFLD. Conclusion: Our study indicated that exposure to heavy metals, individually or cumulatively, was positively associated with NAFLD, MAFLD, and MAFLD components, including obesity/overweight, diabetes, and metabolic dysfunction. Additional research is needed to validate these findings in longitudinal settings.
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