Associations of serum aflatoxin B1–lysine adduct level with socio-demographic factors and aflatoxins intake from nuts and related nut products in Malaysia

Aflatoxins are one of the major risk factors in the multi-factorial etiology of human hepatocellular carcinoma. Therefore, the information on aflatoxins exposure is very important in the intervention planning in order to reduce the dietary intake of aflatoxins, especially among the children. This study investigated the relationship between aflatoxin B1 (AFB1) lysine adduct levers in serum and socio-demographic factors and dietary intake of aflatoxins from nuts and nut products in Penang, Malaysia. A cross-sectional field study was conducted in five districts of Penang. A survey on socio-demographic characteristics was administered to 364 healthy adults from the three main ethnic groups (Malay, Chinese and Indian). A total of 170 blood samples were successfully collected and tested for the level of AFB1–lysine adduct. 97% of the samples contained AFB1–lysine adduct above the detection limit of 0.4 pg/mg albumin and ranged from 0.20 to 23.16 pg/mg albumin (mean ± standard deviation = 7.67 ± 4.54 pg/mg albumin; median = 7.12 pg/mg albumin). There was no significant association between AFB1–lysine adduct levels with gender, district, education level, household number and occupation when these socio-demographic characteristics were examined according to high or low levels of AFB1–lysine. However, participants in the age group of 31–50 years were 3.08 times more likely to have high AFB1 levels compared to those aged between 18 and 30 years (P = 0.026). Significant difference (P = 0.000) was found among different ethnic groups. Chinese and Indian participants were 3.05 and 2.35 times more likely to have high AFB1 levels than Malay. The result of AFB1–lysine adduct suggested that Penang adult population is likely to be exposed to AFB1 but at a level of less than that needed to cause direct acute illness or death.