Association of plasma antimony concentration with markers of liver function in Chinese adults

Environmental contextAntimony pollution has become a global issue given its wide distribution in the environment and its potential threat to human health. This large population-based study demonstrated that exposure to high levels of antimony may impair liver function in adults. The study highlights the potential hazard to liver function of antimony exposure, and provides convincing evidence of the need to monitor and control antimony exposure in the prevention of liver dysfunction. AbstractThe association of antimony exposure with serum liver enzymes and bilirubin levels remains unknown. We aimed to prospectively evaluate the associations of the plasma antimony concentration with serum liver enzymes [alkaline phosphatase (ALP), alanine aminotransferase (ALT) and aspartate aminotransferase (AST)] and bilirubin [total (TBil), direct (DBil) and indirect bilirubin (IBil)] levels among the Chinese middle-aged and elderly population. A total of 4733 participants who were free of cardiovascular disease (CVD), cancer and chronic hepatitis at the baseline survey (2008–2010) of the Dongfeng-Tongji cohort were included in the current study. We measured the baseline plasma antimony concentration by inductively coupled plasma mass spectrometry (ICP-MS), and the serum liver enzymes and bilirubin levels at the resurvey visit (2013) by using an automatic analyser. In the fully adjusted generalised linear models, we observed that an increased plasma antimony concentration was significantly associated with higher bilirubin levels. Moreover, we found that plasma antimony was positively associated with the elevation of DBil (≥7.0μmolL−1), where the adjusted odds ratios (ORs) comparing the extreme tertiles was 1.35 (95% CI: 1.06, 1.70, P trend=0.01). Spline regression analyses indicated that the plasma antimony concentration was linearly associated with the elevation of TBil and DBil (overall P=0.004 and P=0.002 respectively). Our study suggested that exposure to high levels of antimony may impair liver function in adults. Further investigations are warranted to confirm these findings in other populations.