Evidence map›Paper›PMID 36968216›Full record

ArticleJHEP reports : innovation in hepatology2023

Association of per- and polyfluoroalkyl substance exposure with fatty liver disease risk in US adults.

Xinyuan Zhang, Longgang Zhao, Alan Ducatman, Chuanjie Deng, Katherine Ellen von Stackelberg, Christopher J Danford, Xuehong Zhang

Open access · goldAbstract read
In one paragraph

Article in JHEP reports : innovation in hepatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 1 pooled it
14.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

55 citing papers in PubMed, 1 synthesis or guideline pooled it, 101 citations in OpenAlex.

  1. Environmental Endocrine-Disrupting Chemicals and Metabolic Dysfunction-Associated Steatotic Liver Disease.Liver international : official journal of the International Association for the Study of the Liver · 2026
    Pooled it
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  11. The Impact of Forever Chemicals on Protein Structure and Function.International journal of molecular sciences · 2026
    Review
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  19. Synergistic toxicity in alcohol-associated liver disease and PFAS exposure.Toxicological sciences : an official journal of the Society of Toxicology · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 1 country.

Xinyuan ZhangChanning Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Longgang ZhaoDepartment of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
Alan DucatmanDepartment of Occupational and Environmental Health Sciences, West Virginia University School of Public Health, Morgantown, WV, USA.
Chuanjie DengDepartment of Epidemiology, University of California, Los Angeles, Los Angeles, CA, USA.
Katherine Ellen von StackelbergDepartment of Environmental Health, Harvard T H Chan School of Public Health, Boston, MA, USA.
Christopher J DanfordTransplant Services, Intermountain Medical Center, Murray, UT, USA.
Xuehong ZhangChanning Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Brigham and Women's Hospital · USHarvard University · USIntermountain Medical Center · USUniversity of California, Los Angeles · USUniversity of South Carolina · USWest Virginia University · US

Funding

Perfluoroalkyl Substances (PFASs) and Liver Cancer Risk in the United StatesU01CA259208 · NCI · YALE UNIVERSITY · PI ZHANG, XUEHONG · 2022 to 2025
$2.9M
NCI NIH HHS U01 CA259208
6 · The paper itself

Abstract

Background & Aims: Per- and polyfluoroalkyl substances (PFAS) are widespread pollutants with demonstrated hepatotoxicity. Few studies have examined the association between PFAS and fatty liver disease (FLD) risk in an adult population. Methods: In this cross-sectional study of participants from the 2017-2018 National Health and Nutrition Examination Survey, serum PFAS were measured, and FLD cases were ascertained by vibration-controlled transient elastography. Logistic regression models were used to examine the association between circulating PFAS levels and FLD risk. Analyses were stratified into non-alcoholic FLD and alcoholic FLD risk groups by alcohol intake status, as well as controlling for other risk factors, including personal demographics, lifestyle factors, and related health factors. Results: Among 1,135 eligible participants, 446 had FLD. For FLD risk, the multivariable-adjusted odds ratio per log-transformed SD increase (OR Conclusions: Higher serum PFAS was moderately associated with FLD risk and worse liver function in the general population, and among those with independent risk factors, including heavy alcohol intake, obesity, or high-fat diets, PFAS increased the risk. These results suggest synergistic effects on hepatic steatosis between PFAS exposures as measured through biomonitoring data and lifestyle risk factors in a nationally representative US population. Impact and Implications: The per- and polyfluoroalkyl substances (PFAS) may convey higher risk for chronic liver disease in humans. Among 1,135 US adults in the 2017-2018 National Health and Nutrition Examination Survey, we found that higher serum PFAS was associated with higher fatty liver disease risk and worse liver function, especially among those with liver disease risk factors, including heavy alcohol intake, obesity, or high-fat diets. Continuously monitoring PFAS in the population and examining how they potentiate risk to the liver are essential.

Indexed as

AFLDFatty liver diseaseLiver functionNAFLDNHANESPer- and polyfluoroalkyl substancesPFASPFHxSPFOAPFOS

Identifiers

PMID36968216
PMCPMC10033989
OpenAlexW4318939183

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.