{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:15:23Z","timestamp":1792181723731,"version":"4.4.0"},"reference-count":54,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,6,19]],"date-time":"2022-06-19T00:00:00Z","timestamp":1655596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["R25 HL105400"],"award-info":[{"award-number":["R25 HL105400"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Toxoplasma gondii (T. gondii) is a ubiquitous obligatory intracellular parasite which infects over 40 million Americans and causes toxoplasmosis. Inside the human body, T. gondii can damage tissues and invade vital organs. Methods: This study evaluated the association of T. gondii infection and liver disease using data from the National Health and Nutrition Examination Survey (NHANES) 2009\u20132010, with a sample size of 3371 participants (age 20\u201380 years). Toxoplasma infection was determined by the level of T. gondii IgG antibody in serum samples. Liver disease was assessed by liver injury biomarkers and the Fatty Liver Index (US-FLI). The evaluation of the association between T. gondii infection and liver disease included the calculation of the Mantel\u2013Haenszel risk ratio (RRMH), Rho-Scott chi-square bivariate analyses, design-based t-tests, and linear and logistic regression models which were adjusted for demographic and anthropometric covariates. Results: Mean levels of aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were significantly more elevated in the T. gondii IgG-positive (IgG+) participants as compared to T. gondii-negative (IgG\u2212) participants, p = 0.0435 and 0.0310, respectively. In linear regression analysis, exposure to T. gondii IgG+ had statistically significant positive associations with AST (p = 0.0211), alanine aminotransferase (ALT) (p = 0.0221), and gamma-glutamyl transferase (GGT) (p = 0.0258) after adjusting for BMI, age, gender, and race. T. gondii exposure was associated with an elevated relative risk of chronic liver disease (CLD) (RRMH = 1.26, 95% CI: 1.05\u20131.51). This association was more pronounced in certain occupations, such as construction, agriculture, forestry, and fishing, where Toxoplasma infection is more common (p = 0.0477). Moreover, Toxoplasma infection increased the odds of nonalcoholic fatty liver disease (NAFLD) (OR = 6.99, 95% CI = 1.85\u201326.32, p = 0.0237). Conclusion: T. gondii IgG+ antibody was significantly associated with liver injury biomarkers (ALT, AST, GGT, and ALP) and an increased risk of CLD and NAFLD. Moreover, the association of Toxoplasma with CLD was more evident in specific occupations where the prevalence of Toxoplasma was high. The findings of this study provide insight into utilizing liver biomarkers and US-FLI to assess the health complications of Toxoplasma when imaging tests are not accessible.<\/jats:p>","DOI":"10.3390\/ijerph19127515","type":"journal-article","created":{"date-parts":[[2022,6,19]],"date-time":"2022-06-19T10:14:52Z","timestamp":1655633692000},"page":"7515","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The Association of Toxoplasma gondii IgG and Liver Injury in US Adults"],"prefix":"10.3390","volume":"19","author":[{"given":"Amani","family":"Babekir","sequence":"first","affiliation":[{"name":"Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA"},{"name":"Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8113-702X","authenticated-orcid":false,"given":"Sayed","family":"Mostafa","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Statistics, North Carolina A&T State University, Greensboro, 27411 NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radiah C.","family":"Minor","sequence":"additional","affiliation":[{"name":"Department of Animal Sciences, North Carolina A&T State University, Greensboro, NC 27411, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0886-5204","authenticated-orcid":false,"given":"Leonard L.","family":"Williams","sequence":"additional","affiliation":[{"name":"Center for Excellence in Post-Harvest Technologies, North Carolina A&T State University, Kannapolis, NC 28081, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9577-445X","authenticated-orcid":false,"given":"Scott H.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Biology, North Carolina A&T State University, Greensboro, NC 27411, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3195-706X","authenticated-orcid":false,"given":"Emmanuel","family":"Obeng-Gyasi","sequence":"additional","affiliation":[{"name":"Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA"},{"name":"Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,19]]},"reference":[{"key":"ref_1","unstructured":"Centers for Disease Control and Prevention (2022, June 18). 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