Non-alcoholic fatty liver disease (
NAFLD) is one of the most frequent
liver diseases among adolescents. Several animal studies have suggested that
volatile organic compounds (VOCs) and
polycyclic aromatic hydrocarbons (PAHs) increase
NAFLD risk. However, few epidemiological studies have confirmed the association between VOCs, PAHs and
NAFLD in the general adolescent population. Therefore, we analyzed 798 adolescents from the Korean National Environmental Health Survey (KoNEHS), 2015-2017, to examine the associations of urinary metabolites of VOCs and PAHs with serum
alanine aminotransferase (ALT) activity and
NAFLD prevalence. We performed linear regression, logistic regression, and Bayesian kernel machine regression (BKMR) to evaluate the association of urinary VOCs and PAHs metabolites with ALT levels and
NAFLD prevalence. After adjusting for all covariates, urinary
benzylmercapturic acid and
2-hydroxyfluorene levels were found to increase ALT activity and
NAFLD prevalence. Additionally, the BKMR analyses showed a significantly positive overall effect on ALT activity and
NAFLD prevalence with urinary concentrations of VOCs and PAHs metabolites, with
2-hydroxyfluorene as the biggest contributor. Our study suggests that exposure to low-level VOCs and PAHs may have a detrimental effect on
NAFLD risk in adolescents. Given the increasing prevalence of
NAFLD in adolescents, future cohort studies are confirmed to comprehend the effect of these chemicals on
NAFLD risk.