Association between organochlorine pesticides and metabolic dysfunction-associated steatotic liver disease: Findings from the Dongfeng-Tongji cohort

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease globally. However, its environmental chemical contributors remain unclear. To estimate the association between organochlorine pesticides (OCPs) and incident MASLD among Chinese population. We conducted a longitudinal study involving 1199 participants based on Dongfeng-Tongji cohort. Serum concentrations of 19 OCPs at baseline were assessed and MASLD was defined using the updated guidelines. We fitted multivariate logistic regression models to estimate the association between OCPs and MASLD. Restricted cubic spline was utilized to illustrate their potential non-linear dose-response relationships. We additionally investigated the interactive and joint effects of β-HCH and ΣDDTs, and performed stratified analyses to explore potential effect modifications. Compared to the lowest quartile, participants in the highest quartile of serum β-HCH and ΣDDTs had 2.48- and 1.95-fold higher odds of MASLD, respectively [Model 3: OR (95% CI) = 2.48 (1.37, 4.56) for β-HCH and 1.95 (1.20, 3.21) for ΣDDTs]. While β-HCH showed a linear association with incident MASLD, a non-linear relationship was noted for ΣDDTs (P for non-linear = 0.044). Stratified analysis suggested that the association could not be significantly modified by demographic or lifestyle factors. Meanwhile, individuals with both high β-HCH and ΣDDTs had the highest odds of MASLD compared to those with both low levels [OR (95% CI) = 2.90 (1.66, 5.18)]. This longitudinal study revealed that higher levels of β-HCH and ΣDDTs were associated with increased odds of MASLD, with a positive joint effect. More attention is needed on the harmful effects of OCP co-exposure and acceleration of OCP removal.