Abstract
BackgroundBiomarkers can aid in detecting and preventing clinical disease through the recognition of change in biological samples. The objective of this case-control study was to further the knowledge on the use of big toenail and hair samples as biomarkers for fluoride exposure.MethodsA total of 48 participants from an endemic (IC) and a non-endemic (SC) fluorosis region were included. Big toenail and hair samples were collected from each participant and the fluoride concentration was determined. The results of 42 participants were reported: 21 participants (11 males and 10 females, mean age 15.66 + 2.61 years) from IC and 21 participants (11 males and 10 females, mean age 15.06 + 0.79 years) from SC.ResultsThe mean fluoride concentration of big toenail (2.34 ± 0.26 mg/kg) and hair (0.24 ± 0.04 mg/kg) in the endemic region was significantly higher than the mean fluoride concentration of big toenail (0.98 ± 0.08 mg/kg) and hair (0.14 ± 0.02 mg/kg) in the non-endemic region (p < 0.001 and p = 0.004, respectively). The Receiver Operating Characteristic (ROC) analysis showed that the Area Under the Curve (AUC) value was 0.889 for big toenail (p < 0.001) and 0.762 for hair (p = 0.004) samples. The fluoride assay for big toenails exhibits greater observed accuracy than does the fluoride assay for hair.ConclusionNail and hair samples can serve as biomarkers to detect biological fluoride exposure according to the data of this pilot study. Nevertheless, hair is less sensitive and specific as a biomarker when AUC values of big toenail and hair samples were compared.
Highlights
Biomarkers can aid in detecting and preventing clinical disease through the recognition of change in biological samples
The mean fluoride concentration collected from nail clippings of the residents of Isparta city (IC) was 2.34 + 0.26 mg/kg, while it was 0.98 + 0.08 mg/kg for those from Samsun city (SC) (Table 2)
Hair sample analysis of the participants from IC displayed a fluoride concentration of 0.24 + 0.04 mg/ kg, while it was 0.14 + 0.04 mg/kg for those from SC (Table 2)
Summary
Biomarkers can aid in detecting and preventing clinical disease through the recognition of change in biological samples. Biomarkers, i.e. biological markers, can aid in detecting and preventing clinical disease through the recognition of change in biological systems or samples [1] They have been defined as “cellular, biochemical, or molecular alterations which are measurable in biological media such as human tissues, cells, or fluids and are indicative of exposure to environmental chemicals” [1], such as fluoride. Less invasive methods, using body fluid samples, such as plasma, saliva and urine have been considered in the literature to analyze body fluoride concentration [5,6,7]. These body fluids are affected by a number of variables, such as fluoride intake within the last few hours. These body fluids present short-term, i.e. ‘snapshot’, information only [3, 7]
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