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A total of 1376 participants who were seropositive for HBV surface antigen (HBsAg) or antibodies to HCV (anti\u2010HCV) or had abnormal liver function in a community screening program from 2019 to 2021 were enrolled for the assessment of liver fibrosis using transient elastography. Daily estimates of air pollutants (particulate matter \u22642.5\u2009\u03bcm in diameter [PM<jats:sub>2.5<\/jats:sub>], nitrogen dioxide [NO<jats:sub>2<\/jats:sub>], ozone [O<jats:sub>3<\/jats:sub>] and benzene) were aggregated into mean estimates for the previous year based on the date of enrolment. Of the 1376 participants, 767 (52.8%) and 187 (13.6) had MAFLD and advanced fibrosis, respectively. A logistic regression analysis revealed that the factors associated with advanced liver fibrosis were HCV viremia (odds ratio [OR], 3.13; 95% confidence interval [CI], 2.05\u20134.77; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), smoking (OR, 1.79; 95% CI, 1.16\u20132.74; <jats:italic>p<\/jats:italic>\u2009=\u20090.01), age (OR, 1.04; 95% CI, 1.02\u20131.05; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and PM<jats:sub>2.5<\/jats:sub> (OR, 1.10; 95% CI, 1.05\u20131.16; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Linear regression analysis revealed that LSM was independently correlated with PM<jats:sub>2.5<\/jats:sub> (\u03b2: 0.134; 95% CI: 0.025, 0.243; <jats:italic>p<\/jats:italic>\u2009=\u20090.02). There was a dose\u2010dependent relationship between different fibrotic stages and the PM<jats:sub>2.5<\/jats:sub> level (the PM<jats:sub>2.5<\/jats:sub> level in patients with fibrotic stages 0, 1\u20132 and 3\u20134: 27.9, 28.4, and 29.3\u2009\u03bcg\/m<jats:sup>3<\/jats:sup>, respectively; trend <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Exposure to PM<jats:sub>2.5<\/jats:sub>, as well as HBV and HCV infections, is associated with advanced liver fibrosis in patients with MAFLD. There was a dose\u2010dependent correlation between PM<jats:sub>2.5<\/jats:sub> levels and the severity of hepatic fibrosis.<\/jats:p>","DOI":"10.1002\/kjm2.12781","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T11:59:38Z","timestamp":1699617578000},"page":"304-314","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Air pollution associate with advanced hepatic fibrosis among patients with chronic liver disease"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2961-130X","authenticated-orcid":false,"given":"Tyng\u2010Yuan","family":"Jang","sequence":"first","affiliation":[{"name":"Ph.D. Program in Environmental and Occupational Medicine, College of Medicine Kaohsiung Medical University and National Health Research Institutes  Kaohsiung Taiwan"},{"name":"Hepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University 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