Increased Risk of Subclinical Hepatic Injury in Children Exposed to Thiodiglycolic Acid

Abstract

Background. Previous study have revealed a higher exposure level of urinary thiodiglycolic acid (TDGA), a major metabolite of vinyl chloride monomer (VCM), in school-aged children near a petrochemical complex. However, few study assess the risk of hepatic injury of children exposed to VCM. We aim to assess the risk of hepatic injury in school-aged children using urinary TDGA. Methods. We included 316 children (aged 7-13 years old) who provided blood and urine samples from an established cohort in 2013. First morning urine and blood samples were obtained from each subject on Wednesday from October 2013 to September 2014. Urinary TDGA was analyzed by LC/MS-MS. Serum sample was analysis for hepatic injury index including aspartate aminotransferase (AST), AST to platelet ratio index (APRI) and fibrosis-4 score (FIB-4). Results. We found that children with the highest quartile (Q4, >161 μg/g creatinine) of urinary TDGA level had significant higher AST levels than that in the lowest quartiles (Q1, <36 μg/g creatinine) (p= 0.03). We found that our subject with Q4 of urinary TDGA level significantly had a 2.49 fold risk of subclinical AST abnormal than that with Q1 (OR = 2.49; 95% CI: 1.06 ~ 5.83, p = 0.036) after adjustment for age, sex, BMI, physical activity, etc. Conclusions. We concluded that higher TDGA exposure in school-aged children near a petrochemical complex was significantly associated with increased risk of subclinical AST abnormal after adjustment for significant covariance.