Cadmium exposure and weight-adjusted waist index: Interactions with selenium in modulating hepatic fibrosis.

Exposure to cadmium (Cd) and elevated weight-adjusted-waist index (WWI) are known risk factors for metabolic dysfunction-associated steatotic liver disease (MASLD). However, their roles in hepatic fibrosis (HF), the critical stage advancing to irreversible liver damage, remain unclear. The interactive effects of selenium (Se), an antioxidant, with Cd and WWI on oxidative stress regulation remain to be fully elucidated. This study investigated the associations of Cd and WWI with HF, liver function indicators (LFIs), and all-cause mortality, as well as the potential protective effects of Se, using data from the adult population of NHANES. Results showed that Cd and WWI levels were positively correlated with HF, LFIs, and increased mortality. Conversely, Se exhibited a weak negative correlation with HF and LFIs and was associated with reduced mortality. Interaction analyses revealed that Se's protective effect on HF was attenuated at high Cd and WWI levels. These findings emphasize the detrimental impacts of Cd exposure and central obesity on liver health, as well as the moderate efficacy of Se. The study underscores the importance of addressing multiple risk factors, including environmental Cd and central obesity, in HF or MASLD prevention and management, while calling for further research into mechanisms and targeted interventions.