Prenatal exposure to endocrine-disrupting chemicals tied to ‘NAFLD epidemic’ in children
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Prenatal exposure to endocrine-disrupting chemicals may be a cause of increased incidence of nonalcoholic fatty liver disease in children, according to a study published in JAMA Network Open.
Vishal Midya, PhD, MStat, a postdoctoral fellow in the department of environmental medicine and public health at Icahn School of Medicine at Mount Sinai, and colleagues reported that NAFLD is “increasingly diagnosed in childhood,” occurring in 6% to 10% of the general pediatric population and approximately 36% of children with obesity.
To determine whether prenatal exposure to endocrine-disrupting chemicals could increase a child’s risk for liver injury and hepatocellular apoptosis, Midya and colleagues analyzed data collected from 1,108 mother-child pairs from population-based prospective birth cohort studies from France, Greece, Lithuania, Norway, Spain and the U.K.
Urine or blood samples had been collected from the mothers during pregnancy or from cord blood collected at birth, and serum samples from their children were collected at 6 to 11 years of age. Researchers assessed risk for liver injury via alanine aminotransferase, aspartate transferase and gamma-glutamyltransferase serum levels and hepatocellular apoptosis with cytokeratin 18 (CK-18) levels.
“We applied a novel analytical framework using [two] state-of-the-art statistical methods for exposure-mixture analysis with varying underlying assumptions that permitted us to assess the robustness of the results, independent of the statistical approach,” Midya and colleagues wrote.
Researchers assessed the exposure of 45 endocrine-disrupting chemicals, which included 10 phthalates, nine metals, five polychlorinated biphenyls, five perfluoroalkyl substances, four parabens, four organophosphate pesticides, three organochlorine pesticides, three phenols and two polybrominated diphenyl ethers.
According to study results, children had increased odds for liver injury from exposure to organochlorine pesticides (OR = 1.44; 95% credible interval, 1.21-1.71), polybrominated diphenyl ethers (OR = 1.57; 95% CI, 1.34-1.84), perfluoroalkyl substances (OR = 1.73; 95% CI, 1.45-2.09) and metals (OR = 2.21; 95% CI, 1.65-3.02). Conversely, researchers observed children had decreased odds for liver injury from exposure to high-molecular-weight phthalates (OR = 0.74; 95% CI, 0.6-0.91) and phenols (OR = 0.66; 95% CI, 0.54-0.78).
Further, researchers reported that increased CK-18 levels were linked to an increase in polybrominated diphenyl ether ( = 6.46 IU/L; 95% CI, 3.09-9.92) and polychlorinated biphenyl ( = 5.84 IU/L; 95% CI, 1.69-10.08) exposure.
“[We] found that prenatal exposures to ubiquitous endocrine-disrupting chemicals, and especially to organochlorine pesticides, polybrominated diphenyl ethers, perfluoroalkyl substances and metals, were associated with increased liver injury and/or hepatocellular apoptosis in children,” Midya and colleagues wrote. “Our findings can inform more efficient early-life prevention and intervention strategies to address the current NAFLD epidemic.”
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