Explore the Relationship Between Short-Term Ambient Air Pollution Exposure and Daily Outpatient Visits for Metabolic Related Fatty Liver

Ming-Wei Wang,1,* Lixia Sun,2,* Wen Wen,1,* Jie Wang,3 Chun-yi Wang,1 Jie Ni,1 Jing-jie Jiang,1 Zhan-Hui Feng,4 Yong-Ran Cheng5 1Metabolic Disease Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, People’s Republic of China; 2Zhejiang University of Water Resources and Electric Power, Hangzhou, People’s Republic of China; 3Hangzhou Zhenqi Technology Co., Ltd, Hangzhou, People’s Republic of China; 4Neurological Department, Affiliated Hospital of Guizhou Medical University, Guiyang, People’s Republic of China; 5School of Public Health, Hangzhou Medical College, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhan-Hui Feng; Yong-Ran Cheng, Email h9450203@126.com; chengyr@zjams.com.cnBackground: Many studies have shown that the pollution of fine particles in the air is related to the incidence of chronic diseases. However, research on air pollution and metabolism-associated fatty liver disease (MAFLD) is limited.Objective: The purpose of this study was to explore the relationship between short-term ambient air pollution and daily outpatient visits for metabolic-related fatty liver.Methods: We used a quasi-Poisson regression generalized additive model to stratify analyses by season, age, and gender.Results: From January 1, 2017, to August 31, 2019, 10,562 confirmed MAFLD outpatient visits were recorded. A 10 μg/m3 increase of fine particular matter (PM10and PM2.5) and NO2 concentrations corresponding with percent change were 0.82 (95% confidence interval [CI], 0.49– 1.15), 0.57 (95% CI, 0.18– 0.98), and 0.86 (95% CI, 0.59– 1.13) elevation in MAFLD outpatient visits. In terms of season, the impact estimates of NO2 and PM2.5% change were 3.55 (95% CI, 1.23– 5.87) and 1.12 (95% CI, 0.78– 1.46) in the hot season and transition season, respectively. Compared with the warm season, the impact estimates of PM10were more significant in the cool season: 2.88 (95% CI, 0.66– 5.10). NO2 has the greatest effect in the transition season, whereas PM10 has the greatest highest effect in the cool and hot seasons. Compared with other pollutants, PM2.5 has the greatest impact in the age stratification, which percent change are 2.69 (95% CI, 0.77– 5.61) and 2.88 (95% CI, 0.37– 6.40) respectively. The impact values of PM2.5 in male and female percent change were 3.60 (95% CI, 0.63– 6.57) and 1.65 (95% CI, 1.05– 2.25), respectively.Conclusion: This study shows that the air pollutants are related to the number of outpatient visits for MAFLD. The effects of different air pollutants on MAFLD outpatient visits were different by season, ages, and gender.Keywords: air pollutants, metabolism-associated fatty liver disease, generalized additive model