• J Chin Med Assoc · Feb 2025

    Air pollution causes abnormal alanine aminotransferase levels in patients with chronic hepatitis B.

    • Tyng-Yuan Jang, Yu-Ting Zeng, Po-Cheng Liang, Chih-Da Wu, Yu-Ju Wei, Pei-Chien Tsai, Po-Yao Hsu, Yi-Shan Tsai, Ming-Yen Hsieh, Yi-Hung Lin, Meng-Hsuan Hsieh, Chih-Wen Wang, Jeng-Fu Yang, Ming-Lun Yeh, Chung-Feng Huang, Wan-Long Chuang, Jee-Fu Huang, Batbold Batsaikhan, Chia-Yen Dai, Pau-Chung Chen, and Ming-Lung Yu.
    • Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung, Taiwan, ROC.
    • J Chin Med Assoc. 2025 Feb 13.

    BackgroundTo investigate the association between air pollution and abnormal alanine aminotransferase levels in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs.MethodsThis cross-sectional study enrolled 1,275 patients with chronic hepatitis B treated with nucleotide/nucleoside analogs from 2019 to 2022 in Kaohsiung and analyzed the incidence and risk factors for abnormal alanine aminotransferase levels. Daily air pollutant concentrations were estimated for the year prior to enrolment.ResultsAbnormal alanine aminotransferase levels were observed in 1,127 patients (88.4%) before treatment with nucleotide/nucleoside analogs (NAs). Logistic regression analysis revealed that the strongest factor associated with abnormal alanine aminotransferase levels was the level of hepatitis B virus DNA (odds ratio/confidence interval: 1.40/1.25-1.57; p<0.001), followed by concentration of particulate matter ≤2.5 µm in diameter (1.05/1.02-1.08; p<0.001) and liver cirrhosis (0.27/0.17-0.42; p<0.001). Among patients without cirrhosis, logistic regression analysis revealed that the strongest factors associated with abnormal alanine aminotransferase levels were the level of hepatitis B virus DNA (odds ratio/confidence interval: 1.52/1.28-1.82; p<0.001) and concentration of particulate matter ≤2.5 µm in diameter (1.06/1.101-1.11; p=0.01). Among patients with cirrhosis, logistic regression analysis revealed that the strongest factor associated with abnormal alanine aminotransferase levels was hepatitis B virus DNA level (odds ratio/confidence interval: 1.28/1.12-1.48; p=0.001).ConclusionHigher concentrations of particulate matter ≤2.5 µm in diameter caused elevated baseline alanine aminotransferase levels in patients with chronic hepatitis B receiving nucleotide/nucleoside analog therapy. The impact of particulate matter ≤2.5 µm in diameter on abnormal alanine aminotransferase levels was particularly pronounced in patients without cirrhosis.Copyright © 2025, the Chinese Medical Association.

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