Next Article in Journal
Advancing Liver Cancer Prevention for American Indian Populations in Arizona: An Integrative Review
Next Article in Special Issue
Impact of P-Chloroaniline on Oxidative Stress and Biomacromolecules Damage in the Clam Ruditapes philippinarums: A Simulate Toxicity Test of Spill Incident
Previous Article in Journal
A Systematic Review of the Effect of Centella asiatica on Wound Healing
Previous Article in Special Issue
Prevalence of Aspergillus-Derived Mycotoxins (Ochratoxin, Aflatoxin, and Gliotoxin) and Their Distribution in the Urinalysis of ME/CFS Patients
 
 
Article

Risk of Nonalcoholic Fatty Liver Disease Is Associated with Urinary Phthalate Metabolites Levels in Adults with Subclinical Hypothyroidism: Korean National Environmental Health Survey (KoNEHS) 2012–2014

1
Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul 03722, Korea
2
Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul 06974, Korea
3
Department of Convergence Science, College of Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon 22711, Korea
*
Author to whom correspondence should be addressed.
Academic Editors: Oliver Grundmann, Zhaomin Dong, Ying Wang and Xiaomin Li
Int. J. Environ. Res. Public Health 2022, 19(6), 3267; https://doi.org/10.3390/ijerph19063267
Received: 4 February 2022 / Revised: 2 March 2022 / Accepted: 7 March 2022 / Published: 10 March 2022
(This article belongs to the Special Issue Environmental Exposure, Health Effects and Risk)
Nonalcoholic fatty liver disease (NAFLD) is a condition of excess accumulation of fats in the liver. Thyroid dysfunction is commonly observed in adult populations with NAFLD. In subjects with thyroid dysfunction, phthalates, which are chemical compounds widely used to increase the flexibility of various plastic products, may increase the risk of NAFLD prevalence. Therefore, our study aimed to evaluate the relationship between the levels of urinary phthalate metabolites and the risk of NAFLD stratified by the levels of thyroid-stimulating hormone (TSH). Data (n = 2308) were obtained from the Korean National Environmental Health Survey II (2012–2014). Using the hepatic steatosis index, participants were classified into non-NAFLD (<30) and NAFLD (>36) groups. Participants with euthyroidism were defined as 0.45–4.5 mIU/L for serum TSH and normal thyroxine (T4) levels (n = 2125). Subclinical hypothyroidism (SCH) was defined as a higher TSH level (4.5–10 mIU/L) with normal total T4 levels in the serum (n = 183). A multivariate analysis was performed to assess the association of the urinary phthalate concentration with the risk of NAFLD after stratification based on the thyroid hormone levels. The levels of phthalate metabolites in urine were not significantly associated with NAFLD in adults with euthyroidism. However, a significant increased risk of NAFLD in those with SCH was observed in the fourth quartile of mono (2-ethyl-5-hydroxyhexyl) phthalate (odds ratio (OR) 13.59, 95% confidence interval (CI) 12.13–86.44), mono (2-ethyl-5-oxohexyl) phthalate (OR 8.55, 95% CI 1.20–60.53), mono-(2-ethyl-5-carboxypentyl) phthalate (OR 9.06, 95% CI 1.78–45.96), and mono-benzyl phthalate (OR 6.05, 95% CI 1.62–22.54) compared to those of the lowest quartile after being adjusted with covariates. In conclusion, the levels of phthalate metabolites in urine are positively associated with NAFLD in adults with SCH. More experimental studies are needed to clarify the risk of NAFLD caused by phthalate exposure in cases with poor thyroid function. View Full-Text
Keywords: phthalates; nonalcoholic liver disease; subclinical hypothyroidism; Korean National Environmental Health Survey phthalates; nonalcoholic liver disease; subclinical hypothyroidism; Korean National Environmental Health Survey
Show Figures

Figure 1

MDPI and ACS Style

Yang, E.-J.; Choi, B.-S.; Yang, Y.-J. Risk of Nonalcoholic Fatty Liver Disease Is Associated with Urinary Phthalate Metabolites Levels in Adults with Subclinical Hypothyroidism: Korean National Environmental Health Survey (KoNEHS) 2012–2014. Int. J. Environ. Res. Public Health 2022, 19, 3267. https://doi.org/10.3390/ijerph19063267

AMA Style

Yang E-J, Choi B-S, Yang Y-J. Risk of Nonalcoholic Fatty Liver Disease Is Associated with Urinary Phthalate Metabolites Levels in Adults with Subclinical Hypothyroidism: Korean National Environmental Health Survey (KoNEHS) 2012–2014. International Journal of Environmental Research and Public Health. 2022; 19(6):3267. https://doi.org/10.3390/ijerph19063267

Chicago/Turabian Style

Yang, Eun-Jung, Byung-Sun Choi, and Yun-Jung Yang. 2022. "Risk of Nonalcoholic Fatty Liver Disease Is Associated with Urinary Phthalate Metabolites Levels in Adults with Subclinical Hypothyroidism: Korean National Environmental Health Survey (KoNEHS) 2012–2014" International Journal of Environmental Research and Public Health 19, no. 6: 3267. https://doi.org/10.3390/ijerph19063267

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop