The association between serum pinenes and non-alcoholic fatty liver disease based on the NHANES 2013–2014

Background: Terpenes are known to affect metabolic status, though their relationship with non-alcoholic fatty liver disease (NAFLD) remains unclear. Methods: Data from the 2013–2014 National Health and Nutrition Examination Survey (NHANES) were utilized in this cross-sectional study. Serum levels of α-pinene, β-pinene, and limonene were sourced from publicly available data provided by NHANES, determined through gas chromatography-tandem mass spectrometry assays. Participants with a fatty liver index (FLI) score more than 60 were classified as NAFLD. Analytical methods included regression models, mixed-effects models, restricted cubic splines, interaction tests, and mediation analysis. Results: Among 953 U.S. participants, 444 were diagnosed with NAFLD. The median concentrations of terpenes were 0.09 ng/mL for both α-pinene and β-pinene, and 1.47 ng/mL for limonene. Both single and combined exposure to terpenes were positively associated with NAFLD, with nonlinear associations observed for β-pinene and limonene. Additionally, terpenes were linked to increased levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), with nonlinear relationships noted between β-pinene and ALT and between limonene and both ALT and AST. Notably, ALT and AST levels in participants with NAFLD exhibited increased susceptibility to terpene exposure. As a mediator, NAFLD accounted for approximately 6.9 % and 6.7 % of the indirect effects between α-pinene and limonene with ALT, whereas the direct effects of pinenes on ALT and AST were found to be significant, emphasizing the impact of terpenes on these liver enzymes. Conclusion: Serum terpene levels were positively correlated with NAFLD, with β-pinene and limonene displaying nonlinear relationships. Additionally, terpene exposure may pose a risk for elevated ALT and AST levels in individuals with NAFLD.

Abstract licence: CC BY-NC-ND

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