Abstract
BackgroundHigh blood lead (Pb) and hyperhomocysteinemia have been found to be associated with cardiovascular disease (CVD). Mean blood Pb and mean plasma homocysteine levels have been reported to be high in Pakistani population. The objective of the present study was to assess the relationship of blood Pb to the risk of hyperhomocysteinemia in a low income urban population of Karachi, Pakistan.Methodology/Principal FindingsIn a cross sectional survey, 872 healthy adults (355 males, 517 females; age 18–60 years) were recruited from a low income urban population of Karachi. Fasting venous blood was obtained and assessed for blood Pb and plasma/serum homocysteine, folate, pyridoxal phosphate (PLP, a coenzymic form of vitamin B6) and vitamin B12. The study population had median (IQR) blood Pb of 10.82 µg/dL (8.29–13.60). Prevalence of high blood Pb (levels >10 µg/dL) was higher in males compared to females (62.5% males vs 56% females; p value = 0.05). Mean ± SD/median (IQR) value of plasma homocysteine was significantly higher in the highest quartile of blood Pb compared to the lowest quartile 16.13±11.2 µmol/L vs 13.28±9.7µmol/L/13.15 (10.33–17.81) µmol/L vs 11.09 (8.65 14.31) µmol/L (p value<0.001). Daily consumption of fruit juice had a positive influence on both levels of plasma homocysteine and blood Pb. Compared with the lowest quartile of blood Pb, the OR for hyperhomocysteinemia was 1.69 (95% CI, 1.00 to 2.85) for the fourth quartile when the model was adjusted for age, gender, folate and vitamin B12.Conclusions/SignificanceThis study showed a relationship between blood Pb and hyperhomocysteinemia in a general population of Karachi, Pakistan. The harmful effect of Pb on cardiovascular system could be due to its association with hyperhomocysteinemia.
Highlights
Lead (Pb) accumulates in blood and other tissues when one gets exposed to it
Blood Pb was higher in subjects who are students or working in open environment compared to house wives/unemployed individuals; (p value,0.001) using Bonferroni test; Table 1
While studies have been carried out in developed countries to investigate the risk of cardiovascular disease (CVD) with mild hyperhomocysteinemia and blood Pb [1,19,20], there is hardly any report from the developing countries on relationship between plasma homocysteine and blood Pb at the community level
Summary
Lead (Pb) accumulates in blood and other tissues when one gets exposed to it. There are no safe levels of lead within the body and the threshold for Pb levels in the blood has been reviewed over the past several years. It has been reported that blood Pb level of even 2 mg/dL are associated with high rates of cardiovascular disease (CVD) and Pb level of 3.6 mg/dL could be responsible for 89% increase in mortality from cardiac disease [1]. Hyperhomocysteinemia (levels of plasma homocysteine .15 mmol/L) has been shown to be associated with development of atherosclerosis and greater risk for CVD. Several studies have reported high levels of plasma homocysteine in Pakistani healthy adults and patients with coronary artery disease (CAD), [4,5,6,7]. High blood lead (Pb) and hyperhomocysteinemia have been found to be associated with cardiovascular disease (CVD). Mean blood Pb and mean plasma homocysteine levels have been reported to be high in Pakistani population. The objective of the present study was to assess the relationship of blood Pb to the risk of hyperhomocysteinemia in a low income urban population of Karachi, Pakistan
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