Urinary metabolites of volatile organic compounds and polycyclic aromatic hydrocarbons increases the risk of nonalcoholic fatty liver disease in Korean adolescents: A Korean National Environmental Health Survey (KoNEHS) 2015-2017 analysis

Abstract

Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases in adolescents and is an urgent public health issue. Several animal studies have suggested that volatile organic compounds (VOCs) and polycyclic aromatic hydrocarbons (PAHs) led to NAFLD. However, few epidemiological studies have confirmed the associations of VOCs and PAHs with NAFLD in the general adolescent population. Therefore, we analyzed 798 adolescents from the Korean National Environmental Health Survey (KoNEHS) 2015-2017 to examine the associations of urinary metabolites for VOCs and PAHs with serum alanine aminotransferase (ALT) activity and NAFLD prevalence. We employed linear, logistic regression, and Bayesian kernel machine regression (BKMR) to evaluate the association of urinary VOCs and PAHs metabolites with ALT activity and NAFLD. After adjusting for all covariates, urinary benzylmercapturic acid level and 2-hydroxyfluorene level increased serum ALT activity and NAFLD prevalence. Additionally, the BKMR analyses showed a significantly positive overall effect on ALT activity and NAFLD prevalence with urinary concentrations of VOCs and PAHs metabolites, and 2-hydroxyfluorene contributed the most. Our study suggests that exposure to low-level VOCs and PAHs may have a detrimental effect on NAFLD risk in adolescents. Given the increasing prevalence of NAFLD in adolescents, future cohort studies are warranted to understand these chemicals’ impact on NAFLD risk. Keywords: volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), adolescents, Non-alcoholic fatty liver disease, Korean National Environmental Health Survey (KoNEHS)