{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T08:19:02Z","timestamp":1791101942216,"version":"4.1.0"},"reference-count":49,"publisher":"American Chemical Society (ACS)","issue":"12","license":[{"start":{"date-parts":[[2017,12,29]],"date-time":"2017-12-29T00:00:00Z","timestamp":1514505600000},"content-version":"vor","delay-in-days":2674,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>High-level occupational exposures to some industrial chemicals have been associated with liver diseases, including nonalcoholic fatty liver disease (NAFLD). However, the potential role of low-level environmental pollution on liver disease in the general population has not been evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We determined whether environmental pollutants are associated with an elevation in serum alanine aminotransferase (ALT) activity and suspected NAFLD in U.S. adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional cohort study evaluated adult participants without viral hepatitis, hemochromatosis, or alcoholic liver disease from the National Health and Nutrition Examination Survey (NHANES) for 2003\u20132004. ALT elevation was defined in men as \u2265 37 IU\/L (age18\u201320 years) and \u2265 48 IU\/L (age \u2265 21 years) and in women as \u2265 30 IU\/L (age 18\u201320 years) and \u2265 31 IU\/L (age \u2265 21 years). Adjusted odds ratios (ORs) for ALT elevation were determined across exposure quartiles for 17 pollutant subclasses comprising 111 individual pollutants present with at least a 60% detection rate. Adjustments were made for age, race\/ethnicity, sex, body mass index, poverty income ratio, and insulin resistance. Individual pollutants from subclasses associated with ALT elevation were subsequently analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall prevalence of ALT elevation was 10.6%. Heavy metals and polychlorinated biphenyls (PCBs) were associated with dose-dependent increased adjusted ORs for ALT elevation. Within these subclasses, increasing whole-blood levels of lead and mercury and increasing lipid-adjusted serum levels of 20 PCBs were individually associated with ALT elevation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PCB, lead, and mercury exposures were associated with unexplained ALT elevation, a proxy marker of NAFLD, in NHANES 2003\u20132004 adult participants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1289\/ehp.1002720","type":"journal-article","created":{"date-parts":[[2010,9,3]],"date-time":"2010-09-03T13:35:27Z","timestamp":1283520927000},"page":"1735-1742","source":"Crossref","is-referenced-by-count":267,"title":["Polychlorinated Biphenyls, Lead, and Mercury Are Associated with Liver Disease in American Adults: NHANES 2003\u20132004"],"prefix":"10.1021","volume":"118","author":[{"given":"Matt","family":"Cave","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition"},{"name":"Department of Pharmacology and Toxicology"},{"name":"Robley Rex Veterans Affairs Medical Center and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savitri","family":"Appana","sequence":"additional","affiliation":[{"name":"Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihir","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith Cameron","family":"Falkner","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig J.","family":"McClain","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition"},{"name":"Department of Pharmacology and Toxicology"},{"name":"Robley Rex Veterans Affairs Medical Center and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Brock","sequence":"additional","affiliation":[{"name":"Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"316","published-online":{"date-parts":[[2010,9,3]]},"reference":[{"issue":"(3)","key":"2026080513040551200_micit1","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s00244-002-2023-4","article-title":"Oxidative effects of lead in young and adult Fisher 344 rats","volume":"44","author":"Aykin-Burns","year":"2003","journal-title":"Arch Environ Contam Toxicol"},{"issue":"(1)","key":"2026080513040551200_micit2","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.2517-6161.1995.tb02031.x","article-title":"Controlling the false discovery rate: a practical and powerful approach to multiple testing","volume":"57","author":"Benjamini","year":"1995","journal-title":"J R Stat Soc Series B Stat Methodol"},{"issue":"(6)","key":"2026080513040551200_micit3","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1078\/1438-4639-00175","article-title":"Industrial solvents and liver toxicity: risk assessment, risk factors, and mechanisms","volume":"205","author":"Brautbar","year":"2002","journal-title":"Int J Hyg Environ Health"},{"issue":"(1\u20133)","key":"2026080513040551200_micit4","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/S0048-9697(01)01075-0","article-title":"Towards a global historical emission inventory for selected PCB congeners\u2014a mass balance approach. 1. 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