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France Štiglic A, Falnoga I, Briški AS, Žavbi M, Osredkar J, Skitek M, Marc J. Reference intervals of 24 trace elements in blood, plasma and erythrocytes for the Slovenian adult population. Clin Chem Lab Med 2024; 62:946-957. [PMID: 38008765 DOI: 10.1515/cclm-2023-0731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/14/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVES The aim of the present study was to establish the population- and laboratory-specific reference intervals (RIs) for the Slovenian adult population for 24 trace elements (TEs) in blood, plasma and erythrocytes and to evaluate the impact of gender, age, seafood consumption, smoking habits and amalgam fillings on TEs levels. METHODS TEs (Mn, Co, Cu, Zn, Se and Mo, Li, Be, V, Cr, Ni, Ga, As, Rb, Sr, Ag, Cd, Sn, Cs, Au, Hg, Tl, Pb and U) were determined in 192 a priori selected blood donors (107 women and 85 men, aged 18-65 years), using inductively coupled plasma mass spectrometry (ICP-MS) with the Octopole Reaction System. Participants filled out a questionnaire, and RIs were established according to the Clinical and Laboratory Standards Institute (CLSI) guidelines for TEs. RESULTS Uniform RIs for non-essential and gender-specific for essential TEs in blood, plasma and erythrocytes were established. In our population, higher blood and plasma Cu, and erythrocyte Mn levels in women were found. In men, blood Zn, plasma Zn, Mn and Se, and erythrocyte Cu levels were higher. Zn levels were higher in 30-39 years age group. Pb and Sr increased with age. Smoking positively affected Cd, Pb, Cs and Rb; seafood consumption increased As, Hg and Zn; and amalgam increased Hg, Ag and Cu levels. CONCLUSIONS Essential TEs were inside recommended levels, and the non-essential ones were far below critical levels. Established RIs will provide an important foundation for clinical diagnostics, safety erythrocyte transfusions assessment, toxicology and epidemiological studies.
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Affiliation(s)
- Alenka France Štiglic
- Clinical Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Ingrid Falnoga
- Department of Environmental Sciences, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Alenka Sešek Briški
- Clinical Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Marko Žavbi
- Clinical Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Joško Osredkar
- Clinical Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Milan Skitek
- Clinical Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Janja Marc
- Clinical Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
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Wang X, Bakulski KM, Mukherjee B, Hu H, Park SK. Predicting cumulative lead (Pb) exposure using the Super Learner algorithm. CHEMOSPHERE 2023; 311:137125. [PMID: 36347347 PMCID: PMC10160242 DOI: 10.1016/j.chemosphere.2022.137125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 09/08/2022] [Accepted: 10/31/2022] [Indexed: 05/06/2023]
Abstract
Chronic lead (Pb) exposure causes long term health effects. While recent exposure can be assessed by measuring blood lead (half-life 30 days), chronic exposures can be assessed by measuring lead in bone (half-life of many years to decades). Bone lead measurements, in turn, have been measured non-invasively in large population-based studies using x-ray fluorescence techniques, but the method remains limited due to technical availability, expense, and the need for licensing radioactive materials used by the instruments. Thus, we developed prediction models for bone lead concentrations using a flexible machine learning approach--Super Learner, which combines the predictions from a set of machine learning algorithms for better prediction performance. The study population included 695 men in the Normative Aging Study, aged 48 years and older, whose bone (patella and tibia) lead concentrations were directly measured using K-shell-X-ray fluorescence. Ten predictors (blood lead, age, education, job type, weight, height, body mass index, waist circumference, cumulative cigarette smoking (pack-year), and smoking status) were selected for patella lead and 11 (the same 10 predictors plus serum phosphorus) for tibia lead using the Boruta algorithm. We implemented Super Learner to predict bone lead concentrations by calculating a weighted combination of predictions from 8 algorithms. In the nested cross-validation, the correlation coefficients between measured and predicted bone lead concentrations were 0.58 for patella lead and 0.52 for tibia lead, which has improved the correlations obtained in previously-published linear regression-based prediction models. We evaluated the applicability of these prediction models to the National Health and Nutrition Examination Survey for the associations between predicted bone lead concentrations and blood pressure, and positive associations were observed. These bone lead prediction models provide reasonable accuracy and can be used to evaluate health effects of cumulative lead exposure in studies where bone lead is not measured.
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Affiliation(s)
- Xin Wang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Kelly M Bakulski
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Bhramar Mukherjee
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Howard Hu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
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Aaronson DM, Awad AJ, Hedayat HS. Lead toxicity due to retained intracranial bullet fragments: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2022; 4:CASE21453. [PMID: 36164673 PMCID: PMC9514260 DOI: 10.3171/case21453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 07/08/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Lead toxicity (plumbism) secondary to retained lead bullet fragments is a rare complication in patients with gunshot wounds. To the authors' knowledge, there has been no definitive case reported of lead toxicity due to retained intracranial bullet fragments. OBSERVATIONS The authors reported the case of a 23-year-old man who presented after being found down. Computed tomography scanning of the head revealed bullet fragments within the calvaria adjacent to the left transverse sinus. During follow-up, he developed symptoms of plumbism with paresthesias in his bilateral hands and thighs, abdominal cramping, labile mood, and intermittent psychosis. Plumbism was confirmed with sequentially elevated blood lead levels (BLLs). The patient opted for surgical removal of the bullet fragments, which led to reduction in BLLs and resolution of his symptoms. LESSONS Although rare, lead toxicity from retained intracranial bullet fragments should be considered in patients who have suffered a gunshot wound to the head and have symptoms of lead toxicity with elevated BLLs. For safe and accessible intracranial bullet fragments in patients with plumbism, surgical intervention may be indicated.
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Lozano M, Murcia M, Soler-Blasco R, Casas M, Zubero B, Riutort-Mayol G, Gil F, Olmedo P, Grimalt JO, Amorós R, Lertxundi A, Vrijheid M, Ballester F, Llop S. Exposure to metals and metalloids among pregnant women from Spain: Levels and associated factors. CHEMOSPHERE 2022; 286:131809. [PMID: 34388877 DOI: 10.1016/j.chemosphere.2021.131809] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Humans are regularly exposed to metals and metalloids present in air, water, food, soil and domestic materials. Most of them can cross the placental barrier and cause adverse impacts on the developing foetus. OBJECTIVES To describe the prenatal concentrations of metals and metalloids and to study the associated sociodemographic, environmental and dietary factors in pregnant Spanish women. METHODS Subjects were 1346 pregnant women of the INMA Project, for whom the following metals arsenic (As), cadmium (Cd), cobalt (Co), copper (Cu), molybdenum (Mo), nickel (Ni), lead (Pb), antimony (Sb), selenium (Se), thallium (Tl) and zinc (Zn) were determined in urine, at both the first and the third trimesters of gestation. Sociodemographic, dietary and environmental information was collected through questionnaires during pregnancy. Multiple linear mixed models were built in order to study the association between each metal and metalloid concentrations and the sociodemographic, environmental and dietary factors. RESULTS The most detected compounds were As, Co, Mo, Sb, Se and Zn at both trimesters. Zn was the element found in the highest concentrations at both trimesters and Tl was detected in the lowest concentrations. We observed significant associations between As, Cd, Cu, Sb, Tl and Zn concentrations and working situation, social class and age. Seafood, meat, fruits, nuts, vegetables and alcohol intake affected the levels of all the metals but Cd and Cu. Proximity to industrial areas, fields and air pollution were related to all metals except Cd, Sb and Se. CONCLUSIONS This is the first large prospective longitudinal study on the exposure to metals and metalloids during pregnancy and associated factors to include several cohorts in Spain. The present study shows that some modifiable lifestyles, food intakes and environmental factors could be associated with prenatal exposure to metal(loid)s, which may be considered in further studies to assess their relationship with neonatal health outcomes.
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Affiliation(s)
- Manuel Lozano
- Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine Department, Universitat de València, Valencia, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain.
| | - Mario Murcia
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Servicio de Análisis de Sistemas de Información Sanitaria, Conselleria de Sanitat, Generalitat Valenciana, Valencia, Spain
| | - Raquel Soler-Blasco
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Maribel Casas
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Begotxu Zubero
- Preventive Medicine and Public Health Department, University of Basque Country, UPV/EHU, Leioa, Bizkaia, Spain; Health Research Institute, Biodonostia, San Sebastian, Gipuzkoa, Spain
| | - Gabriel Riutort-Mayol
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Spain
| | - Fernando Gil
- Department of Legal Medicine and Toxicology, School of Medicine, University of Granada, Spain
| | - Pablo Olmedo
- Department of Legal Medicine and Toxicology, School of Medicine, University of Granada, Spain
| | - Joan O Grimalt
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), Barcelona, Catalonia, Spain
| | - Rubén Amorós
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Aitana Lertxundi
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Preventive Medicine and Public Health Department, University of Basque Country, UPV/EHU, Leioa, Bizkaia, Spain; Health Research Institute, Biodonostia, San Sebastian, Gipuzkoa, Spain
| | - Martine Vrijheid
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Ferran Ballester
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Nursing, Universitat de València, Valencia, Spain
| | - Sabrina Llop
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Wang X, Ding N, Harlow SD, Randolph JF, Mukherjee B, Gold EB, Park SK. Urinary metals and metal mixtures and timing of natural menopause in midlife women: The Study of Women's Health Across the Nation. ENVIRONMENT INTERNATIONAL 2021; 157:106781. [PMID: 34311223 PMCID: PMC8490279 DOI: 10.1016/j.envint.2021.106781] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/21/2021] [Accepted: 07/15/2021] [Indexed: 05/02/2023]
Abstract
BACKGROUND Exposure to metals and metal mixtures may influence ovarian aging. However, epidemiologic evidence of their potential impact is lacking. OBJECTIVE We prospectively examined the associations of 15 urinary metal concentrations and their mixtures with natural menopause in the Study of Women's Health Across the Nation Multi-Pollutant Study. METHODS The study population consisted of 1082 premenopausal women from multiple racial/ethnic groups, aged 45-56 years at baseline (1999-2000), with the median follow-up of 4.1 years. Urinary concentrations of 15 metals, including arsenic, barium, cadmium, cobalt, cesium, copper, mercury, manganese, molybdenum, nickel, lead, antimony, tin, thallium, and zinc, were measured at baseline. Natural menopause was defined as the final bleeding episode prior to at least 12 months of amenorrhea, not due to surgery or hormone therapy. Cox proportional hazards models were used to examine associations between individual metal concentrations and timing of natural menopause. The associations between metal mixtures and natural menopause were evaluated using elastic net penalized Cox regression, and an environmental risk score (ERS) was computed to represent individual risks of natural menopause related to metal mixtures. RESULTS The median age at natural menopause was 53.2 years. Using the Cox proportional hazards models, the adjusted hazard ratio (HR) (and its 95% confidence interval (CI)) for natural menopause was 1.32 (1.03, 1.67) for arsenic and 1.36 (1.05, 1.76) for lead, comparing the highest with the lowest quartiles of metal concentrations. The predicted ages at natural menopause in the highest and lowest quartiles were 52.7 and 53.5 years for arsenic; and 52.9 and 53.8 years for lead. A significant association between ERS and menopause was also observed. Women in the highest vs. the lowest quartiles of ERS had an HR of 1.71 (1.36, 2.15), equivalent to a 1.6 year earlier median time to natural menopause. CONCLUSION This study suggests that arsenic, lead, and metal mixtures are associated with earlier natural menopause, a risk factor for adverse health outcomes in later life.
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Affiliation(s)
- Xin Wang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Ning Ding
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Siobán D Harlow
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - John F Randolph
- Department of Obstetrics and Gynecology, School of Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Bhramar Mukherjee
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Ellen B Gold
- Department of Public Health Sciences, University of California, Davis, School of Medicine, Davis, CA, United States
| | - Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States.
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Shahida S, Rehman S, Ilyas N, Khan MI, Hameed U, Hafeez M, Iqbal S, Elboughdiri N, Ghernaout D, Salih AA, Matouq M. Determination of Blood Calcium and Lead Concentrations in Osteoporotic and Osteopenic Patients in Pakistan. ACS OMEGA 2021; 6:28373-28378. [PMID: 34723034 PMCID: PMC8552473 DOI: 10.1021/acsomega.1c04565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 09/28/2021] [Indexed: 05/31/2023]
Abstract
Osteoporosis is the leading cause of deformity and bones fracture all over the world and has some relationship with the blood concentrations of calcium and lead. Therefore, in the current study, the blood samples of 58 control and 56 clinically diagnosed osteoporotic and osteopenic patients were taken from different hospitals in Pakistan and analyzed for calcium and lead concentrations using atomic absorption spectrometry. In female control samples, the mean calcium value was found to be 98.53 ± 4.81 μg/mL, and in male control samples, the mean blood calcium level was found to be 121.33 ± 7.27 μg/mL. In female control samples, the mean lead value was found to be 0.133 ± 0.005 μg/mL, and in male control samples, the mean lead level was found to be 0.183 ± 0.008 μg/mL. All the male and female control samples showed a mean value of calcium of 115.63 ± 5.2 μg/mL and a mean value of lead of 0.153 ± 0.007 μg/mL. In osteoporotic female patients, the decline in the mean calcium value was found to be 34.93 ± 1.9 μg/mL, and in male patients, the decrease in the mean calcium level was found to be 47.73 ± 2.5 μg/mL. The increase in the mean value of lead in osteoporotic females was 4.13 ± 0.22 μg/mL, whereas in male patients, the increase in the mean lead value was 0.95 ± 0.07 μg/mL. All the male and female patients showed a decrease in the mean value of calcium of 41.43 ± 2.2 μg/mL and an increase in the mean value of Pb of 3.63 ± 0.16 μg/mL.
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Affiliation(s)
- Shabnam Shahida
- Department
of Chemistry, University of Poonch, Rawalakot, Azad Kashmir 7475, Pakistan
| | - Sohaila Rehman
- Chemistry
Division, Pakistan Institute of Nuclear
Science and Technology, P.O. Nilore, Islamabad 44000, Pakistan
| | - Nabila Ilyas
- Department
of Chemistry, University of Poonch, Rawalakot, Azad Kashmir 7475, Pakistan
| | - Muhammad Imran Khan
- Research
Institute of Sciences and Engineering, University
of Sharjah, Sharjah 27272, United Arab Emirates
| | - Usman Hameed
- Department
of Chemistry, Women University of Azad Jammu
& Kashmir, Bagh 12500, Pakistan
| | - Muhammad Hafeez
- Department
of Chemistry, University of Azad Jammu and
Kashmir, Muzaffarabad 12500, Pakistan
| | - Sajid Iqbal
- Chemistry
Division, Pakistan Institute of Nuclear
Science and Technology, P.O. Nilore, Islamabad 44000, Pakistan
| | - Noureddine Elboughdiri
- Chemical
Engineering Department, College of Engineering, University of Ha’il, P.O. Box 2440, Ha’il 81441, Saudi Arabia
- Chemical
Engineering Process Department, National School of Engineers Gabes, University of Gabes, Gabes 6029, Tunisia
| | - Djamel Ghernaout
- Chemical
Engineering Department, College of Engineering, University of Ha’il, P.O. Box 2440, Ha’il 81441, Saudi Arabia
- Chemical
Engineering Department, Faculty of Engineering, University of Blida, P.O. Box 270, Blida 09000, Algeria
| | - Alsamani Ahmed Salih
- Chemical
Engineering Department, College of Engineering, University of Ha’il, P.O. Box 2440, Ha’il 81441, Saudi Arabia
| | - Mohammed Matouq
- Chemical
Engineering Department, Al-Balqa Applied
University, Amman, P.O. Box 4486, 11131, Jordan
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Yao W, Gallagher DL, Gohlke JM, Dietrich AM. Children and adults are exposed to dual risks from ingestion of water and inhalation of ultrasonic humidifier particles from Pb-containing water. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 791:148248. [PMID: 34139495 DOI: 10.1016/j.scitotenv.2021.148248] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 06/12/2023]
Abstract
Room-sized ultrasonic humidifiers are exposure pathways to aerosolized metals, with dose positively associated with increased concentrations of metals in fill water. This study innovatively quantifies water ingestion along with inhalation doses from humidifiers for 10-1000 μg/L dissolved lead (Pb) in tap water. The subsequent indoor air Pb concentrations, average daily doses, and inhalation deposited respiratory fractions were predicted under four room scenarios for 3-mo, 12-mo, 28-mo, and 6-yr children and adults. Elevated blood Pb levels (BLLs) in children were modeled using USEPA's Integrated Exposure Uptake Biokinetic (IEUBK) model. Indoor air Pb exceeds the USEPA ambient air standard of 0.15 μg/m3 when humidifier fill water contains 33 μg/L Pb in the small room of 33.5 m3 and 0.2 h-1 air exchange rate (AER). For this room, ~40-46% inhaled Pb-containing humidifier particles deposit in children's respiratory tracts; inhaling humidifier particles from ≥500 μg/L Pb water results in >1 μg/dL BLL in 2-7 yr children. For adults, ~23% of particles deposit in the respiratory tract; 8-h inhalation exposure with ≥17 μg/L Pb water exceeds the California EPA reproductive toxicity guideline of 0.5 μg/day. Larger rooms and higher AER decrease Pb inhalation exposure under the same water Pb concentration.
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Affiliation(s)
- Wenchuo Yao
- Department of Civil & Environmental Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Daniel L Gallagher
- Department of Civil & Environmental Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Julia M Gohlke
- Department of Population Health Sciences, Virginia Tech, Blacksburg, VA, USA
| | - Andrea M Dietrich
- Department of Civil & Environmental Engineering, Virginia Tech, Blacksburg, VA, USA.
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Peters JL, Perry MJ, McNeely E, Wright RO, Heiger-Bernays W, Weuve J. The association of cadmium and lead exposures with red cell distribution width. PLoS One 2021; 16:e0245173. [PMID: 33429420 PMCID: PMC7801027 DOI: 10.1371/journal.pone.0245173] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 12/22/2020] [Indexed: 11/19/2022] Open
Abstract
Elevated red blood cell distribution width (RDW), traditionally an indicator of anemia, has now been recognized as a risk marker for cardiovascular disease incidence and mortality. Experimental and acute exposure studies suggest that cadmium and lead individually affect red blood cell production; however, associations between environmental exposures and RDW have not been explored. We evaluated relationships of environmental cadmium and lead exposures to RDW. We used data from 24,607 participants aged ≥20 years in the National Health and Nutrition Examination Survey (2003-2016) with information on blood concentrations of cadmium and lead, RDW and socio-demographic factors. In models adjusted for age, sex, race/ethnicity, education, poverty income ratio, BMI, alcohol consumption, smoking status and serum cotinine, RDW was increasingly elevated across progressively higher quartiles of blood cadmium concentration. A doubling of cadmium concentration was associated with 0.16 higher RDW (95% CI: 0.14, 0.18) and a doubling of lead concentration with 0.04 higher RDW (95% CI: 0.01, 0.06). Also, higher cadmium and lead concentrations were associated with increased odds of high RDW (RDW>14.8%). The associations were more pronounced in women and those with low-to-normal mean corpuscular volume (MCV) and held even after controlling for iron, folate or vitamin B12 deficiencies. In analysis including both metals, cadmium remained associated with RDW, whereas the corresponding association for lead was substantially attenuated. In this general population sample, blood cadmium and lead exposures were positively associated with RDW. The associations may indicate hemolytic or erythropoietic mechanisms by which exposure increases mortality risk.
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Affiliation(s)
- Junenette L. Peters
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
| | - Melissa J. Perry
- Department of Environmental and Occupational Health, George Washington University, Washington, District of Columbia, United States of America
| | - Eileen McNeely
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Robert O. Wright
- Icahn School of Medicine, Mount Sinai Hospital, New York, New York, United States of America
| | - Wendy Heiger-Bernays
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, United States of America
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Wang X, Mukherjee B, Karvonen-Gutierrez CA, Herman WH, Batterman S, Harlow SD, Park SK. Urinary metal mixtures and longitudinal changes in glucose homeostasis: The Study of Women's Health Across the Nation (SWAN). ENVIRONMENT INTERNATIONAL 2020; 145:106109. [PMID: 32927284 PMCID: PMC7577932 DOI: 10.1016/j.envint.2020.106109] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/19/2020] [Accepted: 08/30/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Epidemiologic studies on associations between metals and insulin resistance and β-cell dysfunction have been cross-sectional and focused on individual metals. OBJECTIVE We assessed the association of exposure to metal mixtures, based on assessment of 15 urinary metals, with both baseline levels and longitudinal changes in homeostatic model assessments for insulin resistance (HOMA-IR) and β-cell function (HOMA-β). METHODS We examined 1262 women, aged 45-56 years at baseline (1999-2000), who were followed through 2015-2016, from the Study of Women's Health Across the Nation. Urinary concentrations of 15 metals (arsenic, barium, cadmium, cobalt, cesium, copper, mercury, manganese, molybdenum, nickel, lead, antimony, tin, thallium, and zinc) were determined at baseline. HOMA-IR and HOMA-β were repeatedly measured over 16 years of follow-up. A two-stage modeling was used to account for correlations in dependent and independent variables: In stage-1, linear mixed effects models were used to estimate the participant-specific baseline HOMA levels from random intercepts and participant-specific rates of changes from random slopes. In stage-2, adaptive elastic-net (AENET) models were fit to identify components of metal mixtures associated with participant-specific baseline levels and rates of changes in HOMA-IR and HOMA-β, respectively. An environmental risk score (ERS) was used to integrate metal mixture effects from AENET results. RESULTS In multivariable adjusted AENET models, urinary zinc was associated with higher HOMA-IR at baseline, whereas molybdenum was associated with lower HOMA-IR at baseline. The estimated changes in baseline HOMA-IR for one standard deviation increase in log-transformed urinary metal concentrations were 5.76% (3.05%, 8.55%) for zinc and -3.25% (-5.45%, -1.00%) for molybdenum, respectively. Urinary zinc was also associated with lower HOMA- β at baseline. Arsenic was associated with a slightly faster rate of decline in HOMA-β in the AENET model evaluating associations between metals and rate of changes. Significant associations of ERS with both HOMA-IR and HOMA-β at baseline were observed. ERS for the rate of changes was not calculated and examined in relation to rates of changes in HOMA-IR and HOMA-β because only a single metal was selected by AENET. CONCLUSION Exposure to metal mixtures may be exerting effects on insulin resistance and β-cell dysfunction, which might be mechanisms by which metal exposures lead to elevated diabetes risks.
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Affiliation(s)
- Xin Wang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Bhramar Mukherjee
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | | | - William H Herman
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Stuart Batterman
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Siobán D Harlow
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States.
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Rygiel CA, Dolinoy DC, Perng W, Jones TR, Solano M, Hu H, Téllez-Rojo MM, Peterson KE, Goodrich JM. Trimester-Specific Associations of Prenatal Lead Exposure With Infant Cord Blood DNA Methylation at Birth. Epigenet Insights 2020; 13:2516865720938669. [PMID: 32734142 PMCID: PMC7372614 DOI: 10.1177/2516865720938669] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/03/2020] [Indexed: 12/23/2022] Open
Abstract
Gestational exposure to lead (Pb) adversely impacts offspring health through
multiple mechanisms, one of which is the alteration of the epigenome including
DNA methylation. This study aims to identify differentially methylated CpG sites
associated with trimester-specific maternal Pb exposure in umbilical cord blood
(UCB) leukocytes. Eighty-nine mother-child dyads from the Early Life Exposure in
Mexico to Environmental Toxicants (ELEMENT) longitudinal birth cohorts with
available UCB samples were selected for DNA methylation analysis via the
Infinium Methylation EPIC BeadChip, which quantifies methylation at >850 000
CpG sites. Maternal blood lead levels (BLLs) during each trimester (T1:
6.56 ± 5.35 µg/dL; T2: 5.93 ± 5.00 µg/dL; T3: 6.09 ± 4.51 µg/dL), bone Pb
(patella: 11.8 ± 9.25 µg/g; tibia: 11.8 ± 6.73 µg/g), a measure of cumulative Pb
exposure, and UCB Pb (4.86 ± 3.74 µg/dL) were measured. After quality control
screening, data from 786 024 CpG sites were used to identify differentially
methylated positions (DMPs) and differentially methylated regions (DMRs) by Pb
biomarkers using separate linear regression models, controlling for sex and
estimated UCB cell-type proportions. We identified 3 DMPs associated with
maternal T1 BLL, 2 with T3 BLL, and 2 with tibia bone Pb. We identified one DMR
within PDGFRL associated with T1 BLL, one located at
chr6:30095136-30095295 with T3 BLL, and one within TRHR with
tibia bone Pb (adjusted P-value < .05). Pathway analysis
identified 15 overrepresented gene pathways for differential methylation that
overlapped among all 3 trimesters with the largest overlap between T1 and T2
(adjusted P-value < .05). Pathways of interest include nodal
signaling pathway and neurological system processes. These data provide evidence
for differential methylation by prenatal Pb exposure that may be
trimester-specific.
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Affiliation(s)
- Christine A Rygiel
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Dana C Dolinoy
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.,Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Wei Perng
- Department of Epidemiology, University of Colorado School of Public Health, Denver, CO, USA
| | - Tamara R Jones
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | - Howard Hu
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
| | | | - Karen E Peterson
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.,Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Jaclyn M Goodrich
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
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11
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Chettle DR, McNeill FE. Elemental analysis in living human subjects using biomedical devices. Physiol Meas 2019; 40:12TR01. [PMID: 31816604 DOI: 10.1088/1361-6579/ab6019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Today, patients undergoing dialysis are at low risk for aluminum-induced dementia. Workers are unlikely to experience cadmium-induced emphysema and the public's exposure to lead is an order of magnitude lower than in 1970. The research field of in vivo elemental analysis has played a role in these occupational and environmental health improvements by allowing the effects of people's chronic exposure to elements to be studied using non-invasive, painless, and relatively low-cost technology. From the early 1960s to the present day, researchers have developed radiation-based systems to measure the elemental content of organs at risk or storage organs. This reduces the need for (sometimes painful) biopsy and the risk of infection. Research and development has been undertaken on forty-nine in vivo measurement system designs. Twenty-nine different in vivo elemental analysis systems, measuring 22 different elements, have been successfully taken from design and testing through to human measurement. The majority of these systems employ either neutron activation analysis or x-ray fluorescence analysis as the basis of the measurement. In this review, we discuss eight of the successful systems, explaining the rationale behind their development, the methodology, the health data that has resulted from application of these tools, and provide our opinion on potential future technical developments of these systems. We close by discussing four technologies that may lead to new directions and advances in the whole field.
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Affiliation(s)
- David R Chettle
- Department of Physics and Astronomy, McMaster University, 1280 Main St West, Hamilton, Ontario, L8S 4M1, Canada
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12
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Wang X, Kim D, Tucker KL, Weisskopf MG, Sparrow D, Hu H, Park SK. Effect of Dietary Sodium and Potassium Intake on the Mobilization of Bone Lead among Middle-Aged and Older Men: The Veterans Affairs Normative Aging Study. Nutrients 2019; 11:nu11112750. [PMID: 31766133 PMCID: PMC6893449 DOI: 10.3390/nu11112750] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 10/31/2019] [Accepted: 11/07/2019] [Indexed: 01/25/2023] Open
Abstract
Bone is a major storage site as well as an endogenous source of lead in the human body. Dietary sodium and potassium intake may play a role in the mobilization of lead from bone to the circulation. We examined whether association between bone lead and urinary lead, a marker of mobilized lead in plasma, was modified by dietary intake of sodium and potassium among 318 men, aged 48–93 years, in the Veterans Affairs (VA) Normative Aging Study. Dietary sodium and potassium were assessed by flame photometry using 24-h urine samples, and a sodium-to-potassium ratio was calculated from the resulting measures. Patella and tibia bone lead concentrations were measured by K-shell-x-ray fluorescence. Urinary lead was measured by inductively coupled plasma mass spectroscopy in 24-h urine samples. Linear regression models were used to regress creatinine clearance-corrected urinary lead on bone lead, testing multiplicative interactions with tertiles of sodium, potassium, and sodium-to-potassium ratio, separately. After adjustment for age, body mass index, smoking, vitamin C intake, calcium, and total energy intake, participants in the highest tertile of sodium-to-potassium ratio showed 28.1% (95% CI: 12.5%, 45.9%) greater urinary lead per doubling increase in patella lead, whereas those in the second and lowest tertiles had 13.8% (95% CI: −1.7%, 31.7%) and 5.5% (95% CI: −8.0%, 21.0%) greater urinary lead, respectively (p-for-interaction = 0.04). No statistically significant effect modification by either sodium or potassium intake alone was observed. These findings suggest that relatively high intake of sodium relative to potassium may play an important role in the mobilization of lead from bone into the circulation.
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Affiliation(s)
- Xin Wang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (X.W.); (D.K.)
| | - Douglas Kim
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (X.W.); (D.K.)
| | - Katherine L. Tucker
- Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts at Lowell, Lowell, MA 01854, USA;
| | - Marc G. Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
| | - David Sparrow
- Normative Aging Study, Veterans Affairs Boston Healthcare System, and Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA;
| | - Howard Hu
- School of Public Health, University of Washington, Seattle, WA 98195, USA;
| | - Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (X.W.); (D.K.)
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
- Correspondence: ; Tel.: +1-(734)-936-1719; Fax: +1-(734)-936-2084
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13
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Colicino E, Hazeltine DB, Schneider KM, Zilverstand A, Bachi K, Alia-Klein N, Goldstein RZ, Todd AC, Horton MK. Cocaine addiction severity exacerbates the negative association of lifetime lead exposure with blood pressure levels: Evidence from a pilot study. ENVIRONMENTAL DISEASE 2019; 4:75-80. [PMID: 33490759 PMCID: PMC7822570 DOI: 10.4103/ed.ed_21_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND High blood pressure (BP) is associated independently with cocaine use and lead exposure. It is not known whether cocaine use and lead exposure act jointly to disrupt cardiovascular health. OBJECTIVE To determine whether cocaine use modifies the association between cumulative lead levels and elevated BP. MATERIALS AND METHODS We measured cumulative tibia lead levels in 35 adults: 20 with cocaine use disorder (CUD) and 15 non-CUD controls using in vivo K-shell X-ray fluorescence. Generalized estimating equation regression determined associations between log2-transformed lead and BP (systolic, diastolic, and mean arterial pressure) and assessed the modifying association of cocaine use (as addiction severity) on the lead-BP relationship, adjusting for age, sex, smoking, and education. Sensitivity analyses included correction for potential selection bias. RESULTS Cases and controls differed by sex (%male: 90% vs. 67%), age (50.7 vs. 39.9 years), education (12.8 vs. 14.4 years), and tibia lead (3.50 vs. 2.35 μg/g). Lead was positively associated with systolic (P = 0.01) and diastolic BP (P = 0.01). We observed an interaction between lead and addiction severity on BP (P values for systolic BP: 0.01, diastolic BP: 0.003, and mean arterial BP: <0.0001); the association was stronger among individuals with more severe cocaine addiction: Systolic BP: Est.: 17.89, 95% confidence interval (CI): 9.52; 26.26, diastolic BP Est.: 17.89, 95% CI: 7.33; 13.79, mean arterial BP: Est.: 13.09, 95% CI: 10.34; 15.83. CONCLUSIONS Lead was adversely associated with BP. This association was strongest among individuals with more severe cocaine addiction. The results from this small pilot study suggest that the interaction between lead and cocaine should be considered in studies of substance abuse-related health outcomes.
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Affiliation(s)
- Elena Colicino
- Department of Environmental Medicine and Public Health, New York, NY, USA
| | | | - Kelly M. Schneider
- Department of Environmental Medicine and Public Health, New York, NY, USA
| | | | | | | | - Rita Z. Goldstein
- Department of Psychiatry; Department of Neuroscience Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andy C. Todd
- Department of Environmental Medicine and Public Health, New York, NY, USA
| | - Megan K. Horton
- Department of Environmental Medicine and Public Health, New York, NY, USA
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Abstract
Millions of Americans now entering midlife and old age were exposed to high levels of lead, a neurotoxin, as children. Evidence from animal-model and human observational studies suggest that childhood lead exposure may raise the risk of adult neurodegenerative disease, particularly dementia, through a variety of possible mechanisms including epigenetic modification, delayed cardiovascular and kidney disease, direct degenerative CNS injury from lead remobilized from bone, and lowered neural and cognitive reserve. Within the next ten years, the generation of children with the highest historical lead exposures, those born in the 1960s, 1970s, and 1980s, will begin to enter the age at which dementia symptoms tend to emerge. Many will also enter the age in which lead stored in the skeleton may be remobilized at greater rates, particularly for women entering menopause and men and women experiencing osteoporosis. Should childhood lead exposure prove pro-degenerative, the next twenty years will provide the last opportunities for possible early intervention to forestall greater degenerative disease burden across the aging lead-exposed population. More evidence is needed now to characterize the nature and magnitude of the degenerative risks facing adults exposed to lead as children and to identify interventions to limit long-term harm.
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Affiliation(s)
- Aaron Reuben
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
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15
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Wang X, Mukherjee B, Batterman S, Harlow SD, Park SK. Urinary metals and metal mixtures in midlife women: The Study of Women's Health Across the Nation (SWAN). Int J Hyg Environ Health 2019; 222:778-789. [PMID: 31103473 PMCID: PMC6583796 DOI: 10.1016/j.ijheh.2019.05.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/29/2019] [Accepted: 05/02/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Little is known about the extent of exposure to metals and metal mixtures among midlife women. OBJECTIVES We assessed exposure to multiple metals in the Study of Women's Health Across the Nation (SWAN), a multi-site, multi-racial/ethnic cohort of women at midlife. METHODS We measured urinary concentrations of 21 metals (arsenic, barium, beryllium, cadmium, cobalt, chromium, cesium, copper, mercury, manganese, molybdenum, nickel, lead, platinum, antimony, tin, thallium, uranium, vanadium, tungsten and zinc) using high-resolution inductively coupled plasma-mass spectrometry among 1335 white, black, Chinese and Japanese women aged 45-56 years at the third SWAN annual visit (1999-2000). Least squared geometric mean concentrations were compared across race/ethnicity, education, financial hardship, smoking, secondhand smoking, seafood intake and rice intake groups. Overall exposure patterns of multiple metals were derived using k-means clustering method. RESULTS The percentage of women with detectable concentrations of metals ranged from 100% for arsenic, cesium, molybdenum and zinc, to less than 5% for platinum; 15 metals had detection rates of 70% or more. Asian women, both Chinese and Japanese, had higher urinary concentrations of arsenic, cadmium, copper, mercury, molybdenum, lead and thallium, compared with other race/ethnic groups, independent of sociodemographic, lifestyle, dietary, and geographic characteristics. Seafood and rice intake were important determinants of urinary arsenic, cesium, mercury, molybdenum and lead levels. Two distinct overall exposure patterns- "high" vs. "low" -- were identified. Women in the "high" overall exposure pattern were more likely to be Asians, current smokers, and to report high consumption of seafood and rice. Black women were less likely to have the high exposure pattern. CONCLUSIONS Metal exposure of midlife women differs by racial/ethnic, sociodemographic, lifestyle, dietary, and geographic characteristics. Asian women may be experiencing the highest exposures to multiple metals compared with other racial/ethnic groups in the United States.
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Affiliation(s)
- Xin Wang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Bhramar Mukherjee
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Stuart Batterman
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Siobán D Harlow
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
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16
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Fang F, Peters TL, Beard JD, Umbach DM, Keller J, Mariosa D, Allen KD, Ye W, Sandler DP, Schmidt S, Kamel F. Blood Lead, Bone Turnover, and Survival in Amyotrophic Lateral Sclerosis. Am J Epidemiol 2017; 186:1057-1064. [PMID: 29020133 DOI: 10.1093/aje/kwx176] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 12/21/2016] [Indexed: 12/16/2022] Open
Abstract
Blood lead and bone turnover may be associated with the risk of amyotrophic lateral sclerosis (ALS). We aimed to assess whether these factors were also associated with time from ALS diagnosis to death through a survival analysis of 145 ALS patients enrolled during 2007 in the National Registry of Veterans with ALS. Associations of survival time with blood lead and plasma biomarkers of bone resorption (C-terminal telopeptides of type I collagen (CTX)) and bone formation (procollagen type I amino-terminal peptide (PINP)) were estimated using Cox models adjusted for age at diagnosis, diagnostic certainty, diagnostic delay, site of onset, and score on the Revised ALS Functional Rating Scale. Hazard ratios were calculated for each doubling of biomarker concentration. Blood lead, plasma CTX, and plasma PINP were mutually adjusted for one another. Increased lead (hazard ratio (HR) = 1.38; 95% confidence interval (CI): 1.03, 1.84) and CTX (HR = 2.03; 95% CI: 1.42, 2.89) were both associated with shorter survival, whereas higher PINP was associated with longer survival (HR = 0.59; 95% CI: 0.42, 0.83), after ALS diagnosis. No interactions were observed between lead or bone turnover and other prognostic indicators. Lead toxicity and bone metabolism may be involved in ALS pathophysiology.
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17
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Wang X, Ding N, Tucker KL, Weisskopf MG, Sparrow D, Hu H, Park SK. A Western Diet Pattern Is Associated with Higher Concentrations of Blood and Bone Lead among Middle-Aged and Elderly Men. J Nutr 2017; 147:1374-1383. [PMID: 28592514 PMCID: PMC5483966 DOI: 10.3945/jn.117.249060] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 03/13/2017] [Accepted: 05/08/2017] [Indexed: 12/15/2022] Open
Abstract
Background: Little is known about the effects of overall dietary pattern on lead concentration.Objective: We examined the association of overall dietary patterns, derived from a semiquantitative food frequency questionnaire, with bone and blood lead concentrations.Methods: These longitudinal analyses included mostly non-Hispanic white, middle-aged-to-elderly men from the Veterans Affairs Normative Aging Study. Long-term lead exposures were measured as tibia and patella lead concentrations by using K-shell-X-ray fluorescence. Short-term lead exposures were measured as blood lead concentrations by using graphite furnace atomic absorption spectroscopy. Dietary pattern scores were derived by using factor analysis. Linear mixed-effects models were utilized to predict blood lead concentrations among 983 men, aged 44-92 y at baseline, with a total of 3273 observations (during 1987-2008). We constructed linear regression models to determine the relations between dietary patterns and bone lead concentrations among 649 participants with an age range of 49-93 y.Results: Two major dietary patterns were identified: a prudent dietary pattern, characterized by high intakes of fruit, legumes, vegetables, whole grains, poultry, and seafood; and a Western dietary pattern, characterized by high intakes of processed meat, red meat, refined grains, high-fat dairy products, French fries, butter, and eggs. After adjusting for age, smoking status, body mass index, total energy intake, education, occupation, neighborhood-based education and income level, men in the highest tertile of the Western pattern score (compared with the lowest) had 0.91 μg/dL (95% CI: 0.41, 1.42 μg/dL) higher blood lead, 5.96 μg/g (95% CI: 1.76, 10.16 μg/g) higher patella lead, and 3.83 μg/g (95% CI: 0.97, 6.70 μg/g) higher tibia lead. No significant association was detected with the prudent dietary pattern in the adjusted model.Conclusions: These findings suggest that the Western diet is associated with a greater lead body burden among the middle-aged-to-elderly men. More studies are needed to examine the underlying mechanisms by which dietary patterns are associated with lead concentrations.
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Affiliation(s)
| | | | - Katherine L Tucker
- Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts at Lowell, Lowell, MA
| | - Marc G Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - David Sparrow
- Normative Aging Study, Veterans Affairs Boston Healthcare System, Boston, MA
- Department of Medicine, Boston University School of Medicine, Boston, MA; and
| | - Howard Hu
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - Sung Kyun Park
- Departments of Epidemiology and
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
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18
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Tsai TL, Pan WH, Chung YT, Wu TN, Tseng YC, Liou SH, Wang SL. Association between urinary lead and bone health in a general population from Taiwan. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:481-487. [PMID: 26152405 DOI: 10.1038/jes.2015.30] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 03/08/2015] [Accepted: 03/09/2015] [Indexed: 06/04/2023]
Abstract
Lead accumulates in adult bones for many decades; previous studies have shown lead's detrimental effects on osteoblast and osteoclast activity in association with bone remodeling. Osteoporosis is a disease of the bones resulting in low bone mass that induces fragile bones and hence susceptibility of fracture. We estimated the association between urinary lead (U-Pb) levels and bone health in adults participating in the third Nutrition and Health Survey in Taiwan (NAHSIT) from 2005 to 2008. A total of 398 participants were divided into normal (T-score>-1), osteopenic (T-score between -1 and -2.5), or osteoporotic (T-score<-2.5) groups according to the results of bone mineral density (BMD) measurements. Heavy metals were measured in urine specimens using inductively coupled plasma-mass spectrometry. In the multivariable logistic regression analysis, age (OR=1.08; 95% CI=1.05-1.10), former smokers (OR=2.95; 95% CI=1.22-7.11) and higher U-Pb levels than upper tertile (OR=2.30; 95% CI=1.19-4.48) were associated with osteopenia/osteoporosis. Furthermore, age (OR=1.06; 95% CI=1.02-1.10) and higher U-Pb levels (OR=2.81; 95% CI=1.13-6.97) were significantly associated with osteopenia and osteoporosis in women. These results suggest that adults, particularly in women, with higher U-Pb levels may have increased odds of osteopenia and osteoporosis.
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Affiliation(s)
- Tsung-Lin Tsai
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Wen-Harn Pan
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Yu-Teh Chung
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan
| | - Trong-Neng Wu
- College of Medicine and Nursing, Department of Nursing, Hungkuang University, Taichung, Taiwan
| | - Ying-Chih Tseng
- Department of Obstetrics and Gynecology, Hsinchu Cathay General Hospital, Hsinchu, Taiwan
| | - Saou-Hsing Liou
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan
| | - Shu-Li Wang
- Department of Public Health, China Medical University, Taichung, Taiwan
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan
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19
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Wong AKO, Beattie KA, Bhargava A, Cheung M, Webber CE, Chettle DR, Papaioannou A, Adachi JD. Bone lead (Pb) content at the tibia is associated with thinner distal tibia cortices and lower volumetric bone density in postmenopausal women. Bone 2015; 79:58-64. [PMID: 25986335 PMCID: PMC5092152 DOI: 10.1016/j.bone.2015.05.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 03/27/2015] [Accepted: 05/08/2015] [Indexed: 11/17/2022]
Abstract
Conflicting evidence suggests that bone lead or blood lead may reduce areal bone mineral density (BMD). Little is known about how lead at either compartment affects bone structure. This study examined postmenopausal women (N=38, mean age 76 ± 8, body mass index (BMI): 26.74 ± 4.26 kg/m(2)) within the Hamilton cohort of the Canadian Multicentre Osteoporosis Study (CaMos), measuring bone lead at 66% of the non-dominant leg and at the calcaneus using (109)Cadmium X-ray fluorescence. Volumetric BMD and structural parameters were obtained from peripheral quantitative computed tomography images (200 μm in-plane resolution, 2.3 ± 0.5mm slice thickness) of the same 66% site and of the distal 4% site of the tibia length. Blood lead was measured using atomic absorption spectrometry and blood-to-bone lead partition coefficients (PBB, log ratio) were computed. Multivariable linear regression examined each of bone lead at the 66% tibia, calcaneus, blood lead and PBB as related to each of volumetric BMD and structural parameters, adjusting for age and BMI, diabetes or antiresorptive therapy. Regression coefficients were reported along with 95% confidence intervals. Higher amounts of bone lead at the tibia were associated with thinner distal tibia cortices (-0.972 (-1.882, -0.061) per 100 μg Pb/g of bone mineral) and integral volumetric BMD (-3.05 (-6.05, -0.05) per μg Pb/g of bone mineral). A higher PBB was associated with larger trabecular separation (0.115 (0.053, 0.178)), lower trabecular volumetric BMD (-26.83 (-50.37, -3.29)) and trabecular number (-0.08 (-0.14, -0.02)), per 100 μg Pb/g of bone mineral after adjusting for age and BMI, and remained significant while accounting for diabetes or use of antiresorptives. Total lead exposure activities related to bone lead at the calcaneus (8.29 (0.11, 16.48)) and remained significant after age and antiresorptives-adjustment. Lead accumulated in bone can have a mild insult on bone structure; but greater partitioning of lead in blood versus bone revealed more dramatic effects on both microstructure and volumetric BMD.
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Affiliation(s)
- Andy K O Wong
- Osteoporosis Program, University Health Network, Toronto, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada.
| | - Karen A Beattie
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Aakash Bhargava
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Marco Cheung
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Colin E Webber
- Department of Nuclear Medicine, McMaster University, Hamilton, ON, Canada
| | - David R Chettle
- Department of Medical Physics & Applied Radiation Sciences, McMaster University, Hamilton, ON, Canada
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20
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García-Esquinas E, Navas-Acien A, Pérez-Gómez B, Artalejo FR. Association of lead and cadmium exposure with frailty in US older adults. ENVIRONMENTAL RESEARCH 2015; 137:424-431. [PMID: 25622281 DOI: 10.1016/j.envres.2015.01.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/14/2015] [Accepted: 01/16/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Environmental lead and cadmium exposure is associated with higher risk of several age-related chronic diseases, including cardiovascular disease, chronic kidney disease and osteoporosis. These diseases may lead to frailty, a geriatric syndrome characterized by diminished physiologic reserve in multiple systems with decreased ability to cope with acute stressors. However, no previous study has evaluated the association between lead or cadmium exposure and frailty. METHODS Cross-sectional study among individuals aged ≥ 60 years who participated in the third U.S. National Health and Nutrition Examination Survey and had either blood lead (N=5272) or urine cadmium (N=4887) determinations. Frailty was ascertained with a slight modification of the Fried criteria, so that individuals meeting ≥ 3 of 5 pre-defined criteria (exhaustion, low body weight, low physical activity, weakness and slow walking speed), were considered as frail. The association between lead and cadmium with frailty was evaluated using logistic regression with adjustment for relevant confounders. RESULTS Median (intertertile range) concentrations of blood lead and urine cadmium were 3.9 µg/dl (2.9-4.9) and 0.62 µg/l (0.41-0.91), respectively. The prevalence of frailty was 7.1%. The adjusted odds ratios (95% confidence interval) of frailty comparing the second and third to the lowest tertile of blood lead were, respectively, 1.40 (0.96-2.04) and 1.75 (1.33-2.31). Lead concentrations were also associated with the frequency of exhaustion, weakness and slowness. The corresponding odds ratios (95% confidence interval) for cadmium were, respectively, 0.97 (0.68-1.39) and 1.55 (1.03-2.32), but this association did not hold after excluding participants with reduced glomerular filtration rate: 0.70 (0.43-1.14) and 1.09 (0.56-2.11), respectively. CONCLUSIONS In the US older adult population, blood lead but not urine cadmium concentrations showed a direct dose-response relationship with frailty. These findings support that lead exposure increases frailty in older adults.
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Affiliation(s)
- Esther García-Esquinas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPAZ, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Beatriz Pérez-Gómez
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Environmental Epidemiology and Cancer Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Fernando Rodríguez Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPAZ, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Jennrich P. The Influence of Arsenic, Lead, and Mercury on the Development of Cardiovascular Diseases. ACTA ACUST UNITED AC 2013. [DOI: 10.5402/2013/234034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
As a group, cardiovascular disease (CVD) is the leading cause of death worldwide. It killed twice as many people as infectious and parasitic disease and three times as many people as all forms of cancer. There are other crucial risk factors next to the major risk factors identified by the Framingham Heart Study. In the last few years, detailed studies showed the correlation between environmental pollution and the development of CVD. The question, which environmental toxin is particularly harmful, is answered by CERCLA Priority List of Hazardous Substances with the following toxins: arsenic, lead, and mercury. The effect of these potential toxic metals on the development of cardiovascular diseases includes pathomechanisms as the accumulation of free radicals, damage of endothelial nitric oxide synthase, lipid peroxidation, and endocrine influences. This leads to the damage of vascular endothelium, atherosclerosis, high blood pressure, and an increased mortality from cardiovascular diseases. The cardiovascular effects of arsenic, lead, and mercury exposure and its impact on cardiovascular mortality need to be included in the diagnosis and the treatment of CVD.
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Affiliation(s)
- Peter Jennrich
- Clinical Metal Toxicologist (IBCMT), Marienstraße 1, 97070 Wuerzburg, Germany
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Roschger A, Hofstaetter JG, Pemmer B, Zoeger N, Wobrauschek P, Falkenberg G, Simon R, Berzlanovich A, Thaler HW, Roschger P, Klaushofer K, Streli C. Differential accumulation of lead and zinc in double-tidemarks of articular cartilage. Osteoarthritis Cartilage 2013; 21:1707-15. [PMID: 23835117 DOI: 10.1016/j.joca.2013.06.029] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 06/26/2013] [Accepted: 06/27/2013] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Long-term exposure to increased lead (Pb) concentrations is associated with several chronic diseases. The divalent cation zinc (Zn) is essential for numerous enzymes. In a recent study we found remarkably elevated concentrations of Pb and Zn in the tidemark (TM), which is the mineralization front of human articular cartilage. OBJECTIVE Duplication or multiplication of TMs occurs with advancing age or degeneration. We hypothesized that trace elements accumulate in TMs as a function of time. Thus, in cases of double TMs, the deep (older) TM should contain higher Pb and Zn concentrations than the superficial (younger) TM. DESIGN Undecalcified tissue from articular cartilage and subchondral bone of femoral heads and patellae was examined by synchrotron radiation induced confocal micro X-ray fluorescence analysis and by quantitative backscattered electron imaging to determine the local distribution of Ca, Zn, and Pb in this tissue. RESULTS The evaluation of X-ray fluorescence intensities in double TMs revealed in average a 2.6-fold higher Pb level in the deep TM compared to the superficial TM while Zn concentrations were similar. Pb and Zn contents were significantly enhanced in the deep TM (Pb: 35-fold, Zn: five-fold) and in the superficial TM (Pb: 12-fold, Zn: five-fold) compared to the bone level. CONCLUSION For the first time a differential accumulation of Pb and Zn is documented in regions with double TMs revealing various timescales for the accumulation of these elements. Increased amounts of Pb are present in the TMs (up to the 62-fold of the bone level) featuring a potential source of internal Pb release if the TM region is destroyed.
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Affiliation(s)
- A Roschger
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria; Atominstitut, Technische Universitaet Wien, Stationallee 2, 1020 Vienna, Austria.
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Pemmer B, Roschger A, Wastl A, Hofstaetter J, Wobrauschek P, Simon R, Thaler H, Roschger P, Klaushofer K, Streli C. Spatial distribution of the trace elements zinc, strontium and lead in human bone tissue. Bone 2013; 57:184-93. [PMID: 23932972 PMCID: PMC3807669 DOI: 10.1016/j.bone.2013.07.038] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 07/25/2013] [Accepted: 07/30/2013] [Indexed: 11/15/2022]
Abstract
Trace elements are chemical elements in minute quantities, which are known to accumulate in the bone. Cortical and trabecular bones consist of bone structural units (BSUs) such as osteons and bone packets of different mineral content and are separated by cement lines. Previous studies investigating trace elements in bone lacked resolution and therefore very little is known about the local concentration of zinc (Zn), strontium (Sr) and lead (Pb) in BSUs of human bone. We used synchrotron radiation induced micro X-ray fluorescence analysis (SR μ-XRF) in combination with quantitative backscattered electron imaging (qBEI) to determine the distribution and accumulation of Zn, Sr, and Pb in human bone tissue. Fourteen human bone samples (10 femoral necks and 4 femoral heads) from individuals with osteoporotic femoral neck fractures as well as from healthy individuals were analyzed. Fluorescence intensity maps were matched with BE images and correlated with calcium (Ca) content. We found that Zn and Pb had significantly increased levels in the cement lines of all samples compared to the surrounding mineralized bone matrix. Pb and Sr levels were found to be correlated with the degree of mineralization. Interestingly, Zn intensities had no correlation with Ca levels. We have shown for the first time that there is a differential accumulation of the trace elements Zn, Pb and Sr in BSUs of human bone indicating different mechanisms of accumulation.
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Affiliation(s)
- B. Pemmer
- Atominstitut, Technische Universitaet Wien, Stadionallee 2, 1020 Vienna, Austria
- Corresponding author at: TU Wien, Atominstitut, Radiation physics, Stadionallee 2, 1020 Vienna, Austria. Fax: + 43 1 58801 14199.
| | - A. Roschger
- Atominstitut, Technische Universitaet Wien, Stadionallee 2, 1020 Vienna, Austria
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria
| | - A. Wastl
- Atominstitut, Technische Universitaet Wien, Stadionallee 2, 1020 Vienna, Austria
| | - J.G. Hofstaetter
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria
- 2nd Department, Orthopaedic Hospital Vienna-Speising, Austria
| | - P. Wobrauschek
- Atominstitut, Technische Universitaet Wien, Stadionallee 2, 1020 Vienna, Austria
| | - R. Simon
- Karlsruhe Institute of Technology, Institute for Synchrotron Radiation, Hermann-von-Helmholtz-Platz 1, D-76344 Eggenstein-Leopoldshafen, Germany
| | | | - P. Roschger
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria
| | - K. Klaushofer
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria
| | - C. Streli
- Atominstitut, Technische Universitaet Wien, Stadionallee 2, 1020 Vienna, Austria
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Scinicariello F, Buser MC, Mevissen M, Portier CJ. Blood lead level association with lower body weight in NHANES 1999-2006. Toxicol Appl Pharmacol 2013; 273:516-23. [PMID: 24099784 DOI: 10.1016/j.taap.2013.09.022] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 09/16/2013] [Accepted: 09/23/2013] [Indexed: 01/22/2023]
Abstract
BACKGROUND Lead exposure is associated with low birth-weight. The objective of this study is to determine whether lead exposure is associated with lower body weight in children, adolescents and adults. METHODS We analyzed data from NHANES 1999-2006 for participants aged ≥3 using multiple logistic and multivariate linear regression. Using age- and sex-standardized BMI Z-scores, overweight and obese children (ages 3-19) were classified by BMI ≥85 th and ≥95 th percentiles, respectively. The adult population (age ≥20) was classified as overweight and obese with BMI measures of 25-29.9 and ≥30, respectively. Blood lead level (BLL) was categorized by weighted quartiles. RESULTS Multivariate linear regressions revealed a lower BMI Z-score in children and adolescents when the highest lead quartile was compared to the lowest lead quartile (β (SE)=-0.33 (0.07), p<0.001), and a decreased BMI in adults (β (SE)=-2.58 (0.25), p<0.001). Multiple logistic analyses in children and adolescents found a negative association between BLL and the percentage of obese and overweight with BLL in the highest quartile compared to the lowest quartile (OR=0.42, 95% CI: 0.30-0.59; and OR=0.67, 95% CI: 0.52-0.88, respectively). Adults in the highest lead quartile were less likely to be obese (OR=0.42, 95% CI: 0.35-0.50) compared to those in the lowest lead quartile. Further analyses with blood lead as restricted cubic splines, confirmed the dose-relationship between blood lead and body weight outcomes. CONCLUSIONS BLLs are associated with lower body mass index and obesity in children, adolescents and adults.
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Affiliation(s)
- Franco Scinicariello
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA 30341, USA.
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25
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Nelson AE, Chaudhary S, Kraus VB, Fang F, Chen JC, Schwartz TA, Shi XA, Renner JB, Stabler TV, Helmick CG, Caldwell K, Poole AR, Jordan JM. Whole blood lead levels are associated with biomarkers of joint tissue metabolism in African American and white men and women: the Johnston County Osteoarthritis Project. ENVIRONMENTAL RESEARCH 2011; 111:1208-14. [PMID: 21839992 PMCID: PMC3210895 DOI: 10.1016/j.envres.2011.08.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Revised: 07/29/2011] [Accepted: 08/02/2011] [Indexed: 05/14/2023]
Abstract
PURPOSE To examine associations between biomarkers of joint tissue metabolism and whole blood lead (Pb), separately for men and women in an African American and Caucasian population, which may reflect an underlying pathology. METHODS Participants in the Johnston County Osteoarthritis Project Metals Exposure Sub-Study (329 men and 342 women) underwent assessment of whole blood Pb and biochemical biomarkers of joint tissue metabolism. Urinary cross-linked N telopeptide of type I collagen (uNTX-I) and C-telopeptide fragments of type II collagen (uCTX-II), serum cleavage neoepitope of type II collagen (C2C), serum type II procollagen synthesis C-propeptide (CPII), and serum hyaluronic acid (HA) were measured using commercially available kits; the ratio of [C2C:CPII] was calculated. Serum cartilage oligomeric matrix protein (COMP) was measured by an in-house assay. Multiple linear regression models were used to examine associations between continuous blood Pb and biomarker outcomes, adjusted for age, race, current smoking status, and body mass index. Results are reported as estimated change in biomarker level for a 5-unit change in Pb level. RESULTS The median Pb level among men and women was 2.2 and 1.9μg/dL, respectively. Correlations were noted between Pb levels and the biomarkers uNTX-I, uCTX-II, and COMP in women, and between Pb and uCTX-II, COMP, CPII, and the ratio [C2C:CPII] in men. In adjusted models among women, a 5-unit increase in blood Pb level was associated with a 28% increase in uCTX-II and a 45% increase in uNTX-I levels (uCTX-II: 1.28 [95% CI: 1.04-1.58], uNTX-I: 1.45 [95% CI:1.21-1.74]). Among men, levels of Pb and COMP showed a borderline positive association (8% increase in COMP for a 5-unit change in Pb: 1.08 [95% CI: 1.00-1.18]); no other associations were significant after adjustment. CONCLUSIONS Based upon known biomarker origins, the novel associations between blood Pb and biomarkers appear to be primarily reflective of relationships to bone and calcified cartilage turnover among women and cartilage metabolism among men, suggesting a potential gender-specific effect of Pb on joint tissue metabolism that may be relevant to osteoarthritis.
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Affiliation(s)
- Amanda E Nelson
- Thurston Arthritis Research Center, Department of Radiology, University of North Carolina, 3300 Thurston Bldg, Chapel Hill, NC 27599, USA.
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Bone lead level prediction models and their application to examine the relationship of lead exposure and hypertension in the Third National Health and Nutrition Examination Survey. J Occup Environ Med 2010; 51:1422-36. [PMID: 19952788 DOI: 10.1097/jom.0b013e3181bf6c8d] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We developed prediction models for bone lead using blood lead levels and other standard covariates in a community-based cohort of older men. METHODS Participants having bone lead levels measured by K X-ray fluorescence were included in the model selection process (n = 825). Predictors of each tibia and patella lead were identified in three quarters of the population and then predicted the bone lead levels in the remaining one quarter and in the Community Lead Study. RESULTS Eighteen predictors were selected for tibia (blood lead, age, education, occupation, smoking status, pack-years of cigarette, serum levels of phosphorus, uric acid, calcium, creatinine and total and high-density lipoprotein cholesterols, hematocrit, body mass index, systolic and diastolic blood pressure, and diagnoses of cancer and diabetes; R2 = 0.32) and 16 for patella lead (among the predictors included in the tibia model diagnosis of cancer, serum levels of calcium, and total cholesterol were not included in patella lead model, but diagnosis of hypertension was included; R2 = 0.34), respectively. The correlation coefficients between the observed and predicted values were 0.43 to 0.50 for tibia and 0.52 to 0.58 for patella lead in internal and external validation. We applied these predicted bone lead models to the Third National Health and Nutrition Examination Survey (NHANES-III) to examine associations with hypertension and found relatively more significant associations compared with blood lead. CONCLUSIONS This study suggests that the prediction equations may be used to predict bone lead levels in other community-based cohorts with reasonable accuracy.
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Bone lead and endogenous exposure in an environmentally exposed elderly population: the normative aging study. J Occup Environ Med 2009; 51:848-57. [PMID: 19528829 DOI: 10.1097/jom.0b013e3181aa0106] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study is to investigate the mobilization of lead from bone to blood (endogenous exposure) in a large epidemiologic population. METHODS Study subjects were 776 participants in the Normative Aging Study. The subjects had their tibia lead, patella lead, blood lead, and urinary N-telopeptide (NTx) levels measured 1 to 4 times from 1991 to 2002. Regression models were estimated to quantify the association between tibia and patella lead and blood lead. We studied nonlinearity of the association, and explored possible factors that may modify it, including age and NTx levels. RESULTS AND CONCLUSIONS There is significant association between bone lead and blood lead, and the association is nonlinear. The nonlinear associations between blood lead and bone lead are not significantly modified by age and NTx.
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Hsieh TJ, Chen YC, Li CW, Liu GC, Chiu YW, Chuang HY. A proton magnetic resonance spectroscopy study of the chronic lead effect on the Basal ganglion and frontal and occipital lobes in middle-age adults. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:941-945. [PMID: 19590687 PMCID: PMC2702410 DOI: 10.1289/ehp.0800187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2008] [Accepted: 02/09/2009] [Indexed: 05/28/2023]
Abstract
BACKGROUND Lead is known to be a health hazard to the human brain and nervous system based on data from epidemiologic studies. However, few studies have examined the mechanism or biochemical changes caused by lead in the human brain, although recently some have used magnetic resonance spectroscopy (MRS) to test brain metabolism in vivo. OBJECTIVES In this study, we used 3-T MRS to investigate brain metabolism in workers chronically exposed to lead and matched nonexposed controls. METHODS Twenty-two workers at a lead paint factory served as chronically exposed subjects of this study. These workers did not have any clinical syndromes. Eighteen age- and sex-matched nonexposed healthy volunteers served as controls. We measured blood and bone lead and used a 3-T MRS to measure their levels of brain N-acetyl aspartate (NAA), choline (Cho), and total creatine (tCr). A structural questionnaire was used to collect demographic, work, and health histories and information about their life habits. RESULTS All the MRS measures were lower in the lead-exposed group. Increased blood and bone lead levels correlated with declines in Cho:tCr ratios, especially in the occipital lobe, where changes in all gray, subcortical, and white matter were significant. Increases in blood and patella lead in every layer of the frontal lobe correlated with significant decreases in NAA:tCr ratios. One of the strongest regression coefficients was -0.023 (SE = 0.005, p < 0.001), which was found in the NAA:tCr ratio of frontal gray matter. DISCUSSION We conclude that chronic exposure to lead might upset brain metabolism, especially NAA:tCr and Cho:tCr ratios. Brain NAA and Cho are negatively correlated to blood and bone lead levels, suggesting that lead induces neuronal and axonal damage or loss. The most significant changes occurred in frontal and occipital lobes, areas in which previous neurobehavioral studies have shown memory and visual performance to be adversely affected by lead toxicity.
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Affiliation(s)
| | - Yi-Chun Chen
- Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Chun-Wei Li
- Department of Medical Imaging and Radiation Technology, College of Health Sciences and
| | - Gin-Chang Liu
- Department of Medical Imaging and
- Department of Radiology, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Yu-Wen Chiu
- Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Hung-Yi Chuang
- Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
- Department of Public Health, College of Health Sciences, and Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
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Relationship of blood lead levels to incident nonspine fractures and falls in older women: the study of osteoporotic fractures. J Bone Miner Res 2008; 23:1417-25. [PMID: 18410230 PMCID: PMC2683156 DOI: 10.1359/jbmr.080404] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Lead is stored in the skeleton and can serve as an endogenous source for many years. Lead may influence the risk of fracture, through direct effects on bone strength or indirectly by disturbing neuromuscular function and increasing the risk of falls. The objective of this analysis is to test the hypothesis that women with higher blood lead levels experience higher rates of falls and fracture. This was a prospective cohort study of 533 women 65-87 yr of age enrolled in the Study of Osteoporotic Fractures at two U.S. research centers (Baltimore, MD; Monongahela Valley, PA) from 1986 to 1988. Blood lead levels (in microg/dl) were measured in 1990-1991 by atomic absorption spectrophotometry and classified as "low" (<or=3; lower 15th percentile, referent); "medium" (4-7); or "high" (>or=8; upper 15th percentile). Total hip BMD was measured by DXA twice, 3.55 yr apart. Information on falls was collected every 4 mo for 4 yr. Incident nonspine fractures were identified and confirmed over 10 yr. Cox proportional hazards models were used to estimate the hazard ratio (HR) and 95% CI of fracture. Generalized estimating equations were used to calculate the incident rate ratio of falls (95% CI). The mean blood lead level was 5.3 +/- 2.3 (SD) microg/dl (range, 1-21 microg/dl). Baseline BMD was 7% lower in total hip and 5% lower in femoral neck in the highest compared with lowest blood lead group (p < 0.02). Hip bone loss tended to be greater in the high lead group, but differences were not significant. In multivariable adjusted models, women with high blood lead levels had an increased risk of nonspine fracture (HR = 2.50; 95% CI = 1.25, 5.03; p trend = 0.016) and higher risk of falls (incident rate ratio = 1.62; 95% CI = 1.07, 2.45; p trend = 0.014) compared with women with lowest lead level. Blood lead levels are associated with an increased risk of falls and fractures, extending the negative health consequences of lead to include osteoporotic fractures.
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Weaver VM, Ellis LR, Lee BK, Todd AC, Shi W, Ahn KD, Schwartz BS. Associations between patella lead and blood pressure in lead workers. Am J Ind Med 2008; 51:336-43. [PMID: 18320594 DOI: 10.1002/ajim.20573] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND To compare associations of patella lead, a lead pool that may capture aspects of both current bioavailable and cumulative lead dose thus offering advantages over tibia or blood lead, with blood lead in models of blood pressure and hypertension and to examine effect modification by age, sex and polymorphisms of the genes encoding for the vitamin D receptor (VDR) and delta-aminolevulinic acid dehydratase (ALAD). METHODS Cross-sectional data in 652 current and former lead workers were analyzed. RESULTS Blood lead, but not patella lead, was positively associated with systolic blood pressure. Neither lead measure was associated with diastolic blood pressure or hypertension status. There was no evidence of effect modification. CONCLUSIONS In these workers, blood lead was more relevant to elevations in blood pressure than was patella lead. Additional research will be required to determine whether patella lead assessment provides unique information on vascular risk from lead exposure.
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Affiliation(s)
- Virginia M Weaver
- Division of Occupational and Environmental Health, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
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Schwartz BS, Stewart WF. Lead and cognitive function in adults: a questions and answers approach to a review of the evidence for cause, treatment, and prevention. Int Rev Psychiatry 2007; 19:671-92. [PMID: 18092244 DOI: 10.1080/09540260701797936] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Lead has been extensively used worldwide in gasoline, consumer products, commercial applications, and industrial settings. Its use in gasoline and paint has been particularly hazardous to public health leading to widespread population exposure and substantial lifetime cumulative doses in most Americans over age 40 years. Cumulative lead dose can be estimated by measuring the current concentration of lead in tibia bone by X-ray fluorescence. A growing literature has documented that tibia lead levels are associated with decrements in cognitive function and declines in cognitive function over time. Furthermore, there are several interesting lines of biochemical and epidemiological investigation that have demonstrated potential links of lead to neurodegenerative diseases. These studies support the inference that a proportion of what has been termed 'normal' age-related cognitive decline may, in fact, be due to exposure to neurotoxicants such as lead. Well-designed studies of cumulative lead dose and Alzheimer's disease risk should be conducted to follow-up on these leads. The strong and compelling body of literature on lead and cognitive dysfunction and decline also supports a need for intervention studies to prevent lead-related cognitive decline.
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Affiliation(s)
- Brian S Schwartz
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Hu H, Shih R, Rothenberg S, Schwartz BS. The epidemiology of lead toxicity in adults: measuring dose and consideration of other methodologic issues. ENVIRONMENTAL HEALTH PERSPECTIVES 2007; 115:455-62. [PMID: 17431499 PMCID: PMC1849918 DOI: 10.1289/ehp.9783] [Citation(s) in RCA: 143] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2006] [Accepted: 12/20/2006] [Indexed: 05/14/2023]
Abstract
We review several issues of broad relevance to the interpretation of epidemiologic evidence concerning the toxicity of lead in adults, particularly regarding cognitive function and the cardiovascular system, which are the subjects of two systematic reviews that are also part of this mini-monograph. Chief among the recent developments in methodologic advances has been the refinement of concepts and methods for measuring individual lead dose in terms of appreciating distinctions between recent versus cumulative doses and the use of biological markers to measure these parameters in epidemiologic studies of chronic disease. Attention is focused particularly on bone lead levels measured by K-shell X-ray fluorescence as a relatively new biological marker of cumulative dose that has been used in many recent epidemiologic studies to generate insights into lead's impact on cognition and risk of hypertension, as well as the alternative method of estimating cumulative dose using available repeated measures of blood lead to calculate an individual's cumulative blood lead index. We review the relevance and interpretation of these lead biomarkers in the context of the toxico-kinetics of lead. In addition, we also discuss methodologic challenges that arise in studies of occupationally and environmentally exposed subjects and those concerning race/ethnicity and socioeconomic status and other important covariates.
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Affiliation(s)
- Howard Hu
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA.
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Dorsey CD, Lee BK, Bolla KI, Weaver VM, Lee SS, Lee GS, Todd AC, Shi W, Schwartz BS. Comparison of patella lead with blood lead and tibia lead and their associations with neurobehavioral test scores. J Occup Environ Med 2006; 48:489-96. [PMID: 16688005 DOI: 10.1097/01.jom.0000199678.86629.3b] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Lead exposure in adults is associated with worse cognitive function in cross-sectional and longitudinal studies. Previous studies have mainly examined relations with blood lead or cortical bone lead; few have examined trabecular bone lead. METHODS We performed a cross-sectional analysis of the relations of patella lead and other lead biomarkers with measures of neurobehavioral and peripheral nervous system function in 652 lead workers. RESULTS Patella lead was found to be associated with worse performance on seven of 19 tests of manual dexterity, sensory vibration threshold, and depressive symptoms. The associations of patella lead with cognitive function were essentially similar to those with blood lead or tibia lead but of somewhat lower magnitude. CONCLUSIONS In this study, measurement of patella lead did not aid causal inference regarding cognitive effects when compared with blood lead and tibia lead.
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Affiliation(s)
- Carrie D Dorsey
- Division of Occupational and Environmental Health, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Zoeger N, Roschger P, Hofstaetter JG, Jokubonis C, Pepponi G, Falkenberg G, Fratzl P, Berzlanovich A, Osterode W, Streli C, Wobrauschek P. Lead accumulation in tidemark of articular cartilage. Osteoarthritis Cartilage 2006; 14:906-13. [PMID: 16678451 DOI: 10.1016/j.joca.2006.03.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2005] [Accepted: 03/05/2006] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Determination of the spatial distribution of the toxic element lead (Pb) and other trace elements in normal articular cartilage and subchondral bone from adult humans with no history of work-related exposure to Pb. METHODS Four macroscopically normal femoral heads and three patellas were harvested from randomly selected forensic autopsies. All subjects died of acute illnesses, had no history of work-related exposure to Pb and had no metabolic bone disease. The elemental distribution of lead (Pb) together with zinc (Zn), strontium (Sr) and calcium (Ca) in the chondral and subchondral region was detected using high resolution synchrotron radiation induced micro X-ray fluorescence (SR mu-XRF) analysis. SR mu-XRF line scans in conventional and SR mu-XRF area scans in confocal geometry were correlated to backscattered electron (BE) images visualizing the mineralized tissue. RESULTS In all samples, we found a highly specific accumulation of Pb in the tidemark, the transition zone between calcified and non-calcified articular cartilage. Pb fluorescence intensities in the tidemark, which is thought to be a metabolically active mineralization front, were 13-fold higher when compared to subchondral bone. Pb intensities in the subchondral region were strongly correlated with Zn, but were distinctly different from Ca and Sr. CONCLUSIONS The finding of the highly specific accumulation of lead in the tidemark of human articular cartilage is novel. However at this point, the exact mechanisms of the local Pb accumulation as well as its clinical implications are unknown.
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Affiliation(s)
- N Zoeger
- Vienna University of Technology, Atominstitut, Stadionallee 2, 1020 Vienna, Austria.
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Abstract
Bone mineral composition, crystallinity, and bone mineral content of osteoporotic patients are different from those of normal subjects. We review the evidence that these mineralization parameters contribute to the strength (fracture resistance) of bone and the methods that have been used to examine them. A specific example is provided from analysis of biopsies from the Multiple Outcomes in Raloxifene Evaluation trial. For the analyses, randomly selected biopsies from placebo, low-dose, and high-dose groups (n = 5 per group) obtained at time zero and 2 years after treatment were examined by infrared imaging spectroscopy. In all cases, comparable increases in mineral content were found, but there were no significant variations in mineral crystallinity.
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Affiliation(s)
- Dan Faibish
- Musculoskeletal Integrity Program, Hospital for Special Surgery, New York, NY 10021, USA
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36
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Gerhardsson L, Akantis A, Lundström NG, Nordberg GF, Schütz A, Skerfving S. Lead concentrations in cortical and trabecular bones in deceased smelter workers. J Trace Elem Med Biol 2005; 19:209-15. [PMID: 16325538 DOI: 10.1016/j.jtemb.2005.06.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2004] [Accepted: 06/30/2005] [Indexed: 11/23/2022]
Abstract
The aim of the study was to compare bone lead concentrations in cortical and trabecular bones in long-term exposed primary copper and lead smelter workers, and to relate the measured concentrations to the previous lead exposure of the workers. Lead concentrations in seven bones (trabecular: sternum, vertebrae, iliac crest, rib; cortical: femur, left forefinger, and temporal bone) were determined by electrothermal atomic absorption spectrometry in 32 male, long-term exposed copper and lead smelter workers, and compared with levels in 10 male occupationally unexposed reference persons. A time-integrated blood lead index (cumulative blood lead index, CBLI) was calculated for each worker. The lead levels in the seven studied bones were all significantly higher in active and retired lead workers as compared with the reference group (p<or=0.003). The highest lead concentrations among the workers were observed in finger bone (median 106 microg/g), followed in order by vertebrae, iliac crest and sternum. The highest quotients between median bone lead concentrations of workers vs. reference group were observed for trabecular bones (sternum 12.3, iliac crest 11.8, rib 8.8 and vertebrae 8.5). In retired workers, strong positive correlations were noted between lead levels in sternum and iliac crest (rs=0.91; p<0.001) and femur and temporal bone (rs=0.88, p<0.001). Neither CBLI nor exposure-time was related to the bone lead concentrations in any of the studied groups. The findings indicate similarities in the metabolism for bones with the same basic structure. The highest lead concentrations were found in finger bone, which can be used for retrospective exposure evaluations in lead exposed populations, e.g. through XRF-measurements.
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Affiliation(s)
- Lars Gerhardsson
- Environmental Medicine, Department of Public Health and Clinical Medicine, University of Umeå, SE-901 87 Umeå, and Department of Occupational and Environmental Medicine, University Hospital, SE-221 85 Lund, Sweden.
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Osterode W, Winker R, Bieglmayer C, Vierhapper H. Effects of parathyroidectomy on lead mobilization from bone in patients with primary hyperparathyroidism. Bone 2004; 35:942-7. [PMID: 15454101 DOI: 10.1016/j.bone.2004.05.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2004] [Accepted: 05/27/2004] [Indexed: 11/25/2022]
Abstract
Since lead (Pb) accrued from environmental exposure accumulates in bone with a half life time between 6 and 10 years, a release of bone Pb into the circulation and/or urine (PbU) should be expected in diseases with increased bone metabolism such as hyperparathyroidism. We studied 60 patients with primary hyperparathyroidism (pHPT, 50 women, 10 men, aged 61.4 +/- 10.6 and 64.1 +/- 9.9 years, respectively) (a) before, (b) 1-6 months, and (c) 6-12 months after parathyroidectomy. Besides lead in blood (PbB) and lead in 24-h urine samples (PbU), parathyroid hormone (PTH), serum Ca2+, osteocalcin (OC), phosphate (PO4), and serum pyridinoline cross-linked telopeptide (cTP) were determined. Control data were determined in 20 healthy age-matched subjects. As expected, Ca2+ decreased after parathyroidectomy. Mean PbB in patients with pHPT was in the same range as in controls. A decrease of PbB after parathyroidectomy was found in the interval beyond 6 months. In contrast, mean PbU initially increased after surgery (3.05 +/- 1.94 vs. 4.25 +/- 2.65 microg/l, P = 0.004) and was not different beyond 6 months in comparison with preoperative values at (c). Investigating only patients with PTH < 150 ng/l, no significant PbB or PbU alterations were detected before and after parathyroidectomy. In patients with PTH > 150 ng/l, the decrease of PbB at (c) was more pronounced as was the increase of PbU at (b). In these patients, PbB and OC as well as PbB and cTP were correlated preoperatively. In conclusion, our data show that in environmentally lead-exposed (by food or by pollution) hyperparathyroid individuals, there is no hazardous PbB release from bone. The preoperative correlation between PbB and OC in pHPT patients with PTH > 150 ng/l provides evidence that in fact there is a Pb release from bone into the blood-pool by bone remodeling. The increase of PbU after parathyroidectomy is suspected to be caused by PTH-dependent Pb accumulation in the kidney, which seems to be restored with decreasing PTH. Moreover, our data confirm prior findings that bone remodeling seems to be normalized 6 months after parathyroidectomy.
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Affiliation(s)
- W Osterode
- Universitätsklinik für Innere Medizin IV, Klinische Abteilung für Arbeitsmedizin, A-1090 Wien, Austria.
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Aldridge JE, Gibbons JA, Flaherty MM, Kreider ML, Romano JA, Levin ED. Heterogeneity of toxicant response: sources of human variability. Toxicol Sci 2003; 76:3-20. [PMID: 12883075 DOI: 10.1093/toxsci/kfg204] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
While risk assessment models attempt to predict human risk to toxicant exposure, in many cases these models cannot account for the wide variety of human responses. This review addresses several primary sources of heterogeneity that may affect individual responses to drug or toxicant exposure. Consideration was given to genetic polymorphisms, age-related factors during development and senescence, gender differences associated with hormonal function, and preexisting diseases influenced by toxicant exposure. These selected examples demonstrate the need for additional steps in risk assessment that are needed to more accurately predict human responses to toxicants and drugs.
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Affiliation(s)
- Justin E Aldridge
- Integrated Toxicology Program, Duke University Medical Center, Durham, North Carolina 27710, USA
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Dye BA, Hirsch R, Brody DJ. The relationship between blood lead levels and periodontal bone loss in the United States, 1988-1994. ENVIRONMENTAL HEALTH PERSPECTIVES 2002; 110:997-1002. [PMID: 12361924 PMCID: PMC1241025 DOI: 10.1289/ehp.02110997] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
An association between bone disease and bone lead has been reported. Studies have suggested that lead stored in bone may adversely affect bone mineral metabolism and blood lead (PbB) levels. However, the relationship between PbB levels and bone loss attributed to periodontal disease has never been reported. In this study we examined the relationship between clinical parameters that characterize bone loss due to periodontal disease and PbB levels in the U.S. population. We used data from the Third National Health and Nutritional Examination Survey (NHANES III), 1988-1994, for the analyses. A total of 10,033 participants 20-69 years of age who completed a periodontal examination and had whole blood tested for lead were examined. Four types of periodontal disease measures were used to indicate oral bone loss: periodontal pocket depth, attachment loss extent, attachment loss severity, and the presence of dental furcations. We found that dental furcations were the best periodontal bone loss indicator for PbB levels (p = 0.005) in a multivariate linear regression model adjusting for sex, age, race/ethnicity, educational attainment, poverty status, smoking, and age of home. Furthermore, after additional modeling, we found a smoking and dental furcation interaction (p = 0.034). Subsequent stratified analyses indicated that current and past smoking is an effect modifier for dental furcations on PbB levels. These findings indicate that increased PbB levels may be associated with advanced periodontal bone loss, particularly among people with a history of smoking.
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Affiliation(s)
- Bruce A Dye
- Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Maryland 20782, USA.
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