Various ambient air pollutants, residential green spaces, fibrosis 4 scores, genetic susceptibility, and risk of severe liver disease

Disease areas:

• cancer and other tissue growths
• gut health

Last updated:

2 July 2025

Author(s):

Ziliang Ye, Mengyi Liu, Panpan He, Qimeng Wu, Sisi Yang, Yanjun Zhang, Chun Zhou, Yuanyuan Zhang, Xiaoqin Gan, Jian Sun, Xianhui Qin

Publish date:

13 July 2023

Journal:

Ecotoxicology and Environmental Safety

PubMed ID:

37453269

DOI:

10.1016/j.ecoenv.2023.115246

Abstract

BACKGROUND: The relationship of air pollutants and residential exposure to greenspace with severe liver disease remains inconclusive.

OBJECTIVE: Our objective was to assess the relationship of joint exposure to air pollutants, residential exposure to greenspaces with new-onset severe liver disease.

METHODS: We included 427,697 participants without prior liver diseases from UK Biobank. A weighted air pollution score was calculated based on PM_2.5, PM₁₀, PM_2.5-10, NO₂, and NO_X. The percentage of land coverage by residential greenspaces was estimated using land use data. The primary outcome was new-onset severe liver disease, defined as a composite outcome including hospitalization or death due to compensated or decompensated liver cirrhosis, liver failure, and hepatocellular carcinoma.

RESULTS: During a median follow-up of 12.0 years, 4572 participants developed severe liver disease. A higher air pollution score was significantly associated with an increased risk of new-onset severe liver disease (per SD increment; adjusted hazard ratio [HR],1.07; 95% confidence interval [CI],1.04-1.10). Moreover, residential greenspace coverage was inversely associated with new-onset severe liver disease (per SD increment; adjusted HR, 0.95; 95% CI,0.92-0.98). Genetic risks of liver cirrhosis did not significantly modify the associations (both P-interactions >0.05). However, we observed a stronger positive association between air pollution scores and new-onset severe liver disease in individuals with higher fibrosis-4 (FIB-4) scores, lower residential greenspaces, hypertension, and smokers (all P-interactions <0.05). Similarly, a more pronounced inverse association between residential exposure to greenspaces and new-onset severe liver disease was found in smokers and individuals with higher FIB-4 scores (both P-interactions<0.05).

CONCLUSIONS: Our findings suggest a positive association between air pollution scores and the risk of new-onset severe liver disease, while residential greenspaces show an inverse association. These results underscore the importance of maintaining high exposure to green space and reducing air pollution to prevent serious liver disease.