Blood Lead Levels In Patients Research Articles

Blood lead level in patients with irritable bowel syndrome

Irritable bowel syndrome and elevated blood lead level share certain gastrointestinal symptoms. We measured blood lead levels in IBS patients, comparing them with IBS severity. This cross-sectional study included 324 patients with newly diagnosed IBS and 147 healthy subjects as control. All participants completed a questionnaire on their current gastrointestinal symptoms and a blood sample was taken so as to determine the blood lead level via atomic absorption spectrophotometer technique. Patients were subsequently assessed in terms of IBS severity. Mean blood lead level was significantly higher in the IBS group compared to the control group (7.5 ± 5.4 mcg/dL vs. 5.8 ± 3.4 mcg/dL, P = 0.001). Moreover, 59% of IBS patients and 44% of the healthy subjects had blood lead level > 5 mcg/dL ( P = 0.004). Only 38% of patients with diarrhea alone versus 59–83% in the other groups had high blood lead levels ( P < 0.001). Mean IBS-SSS was 241 ± 92.6 in IBS patients, who with elevated blood lead level had significantly higher grades compared to those with blood lead levels < 5 mcg/dL. Linear regression analysis indicated a positive correlation between blood lead level and severity of gastrointestinal manifestations measured by IBS-SSS (ß = 7.2; 95% CI: 5.5–8.9; P < 0.001). High blood lead level may be a concern in IBS patients, particularly in IBS-C and unclassified IBS groups and those with severe gastrointestinal manifestations.

Comparison of Blood Lead Levels in Patients With Alzheimer's Disease and Healthy People.

It is argued that breakdown of β-amyloid in the brain causes deposition of senescent plaques and therefore Alzheimer's disease (AD). One of the influential factors for increasing level of this protein is exposure to lead. Our aim was to compare blood lead levels (BLLs) between patients with AD and healthy controls. This case-control study was performed on all patients with cognitive impairment who were referred to the Neurological Clinic of Birjand in 2016 to 2017. Patients were referred to the laboratory for measurement of their serum levels of lead. The controls and patients were matched by age and sex. In the AD case group, the average BLL was 22.22 ± 28.57 μg/dL. Mann-Whitney U test showed that BLLs were significantly higher in the patients than in the controls. The unadjusted odds ratio for BLL among the patients was 1.05 (95% confidence interval: 1.01-1.09; P = .01) compared to the controls. In the present study, BLL was associated with AD.

Positive correlation between environmental PM&lt;sub&gt;2.5&lt;/sub&gt; and blood lead levels in patients undergoing maintenance hemodialysis

Patients undergoing hemodialysis (HD) have significantly higher mean blood lead levels (BLLs) than those in healthy individuals. Because elementary lead can be found in particulate matter with a diameter of <2.5 μm (PM2.5), this cross-sectional study was conducted to assess the effect of environmental PM2.5 exposure and other clinical variables on BLLs in patients receiving HD. We recruited 921 patients on maintenance HD (MHD) who had undergone HD for at least 6 months and who had previously participated in a BLL study. Mean PM2.5 concentrations in living environments in the previous 12 and 24 months were analyzed using a blood lead test. From a multivariate analysis, after adjustment for related factors, the mean PM2.5 concentrations in the previous 12 and 24 months were positively associated with log BLLs. In addition, days with PM2.5 levels exceeding the standard level during the previous 12 and 24 months were positively associated with log BLLs. Patients exposed to higher PM2.5 concentrations and more days with PM2.5 levels exceeding the standard level exhibited a higher prevalence of high and high-normal BLLs and a lower prevalence of low-normal BLLs. After adjustment for related variables, the BLLs exhibited a significantly positive association with environmental PM2.5 in patients undergoing MHD.

Negative Relationship between Erythropoietin Dose and Blood Lead Level in Patients Undergoing Maintenance Hemodialysis

The adverse effects of increased blood lead levels have been well discussed. Several antioxidant agents have been reported to offer protection from lead toxicity and to reduce blood lead levels (BLL). Given that erythropoietin (EPO) also has antioxidant properties, the aim of this cross-sectional study was to assess the role of EPO and other clinical variables on BLL in hemodialysis (HD) patients. We recruited 931 maintenance hemodialysis (MHD) patients who had undergone HD for at least 6 months and who had ever received blood lead level (BLL) study. Use of erythropoiesis-stimulating agents followed the The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) Clinical Practice Guideline. We estimated demographic, hematological, nutritional, inflammatory, biochemical, and dialysis-related data based on this study. In the group with EPO, 7% had high BLL. In the group without EPO, 22% had high BLL. From the stepwise liner regression, urban areas, hemodialysis duration, and clearance of urea (KT/Vurea) were positively associated with log BLL. In contrast, diabetes (DM), and monthly EPO dose were negatively associated with log BLL. This study showed that EPO dose might be negatively associated with blood lead levels in patients on maintenance hemodialysis.

Parathyroidectomy leads to decreased blood lead levels in patients with refractory secondary hyperparathyroidism

ObjectiveSecondary hyperparathyroidism (SHPT) is characterized by high bone turnover and may result in increased release of lead (Pb) from bone stores. Parathyroidectomy (PTX) drastically changes bone remodeling. This study investigated the effects of PTX on the levels of blood lead (blood Pb) in patients with refractory SHPT. MethodsThe study included 30 patients on long-term hemodialysis (HD) who underwent PTX in the nephrology units of two Taiwanese hospitals. Changes in serum levels of intact parathyroid hormone (iPTH), bone-specific alkaline phosphatase (BAP), type 5b tartrate-resistant acid phosphatase (TRAP), total calcium (tCa), and blood Pb were analyzed. ResultsAfter PTX, serum iPTH was markedly decreased while serum BAP was progressively increased and peaked 2weeks after PTX. Serum TRAP levels were progressively decreased during the 4week follow-up period. Serum tCa and blood Pb levels decreased sharply immediately after PTX. There was a positive correlation between the percentage of decrease in tCa and blood Pb at one day after PTX. Further analysis indicated a significant positive correlation between levels of blood Pb and serum iPTH (r=0.378, p<0.001), blood Pb and serum TRAP (r=0.180, p<0.05), and a negative correlation between blood Pb and serum BAP (r=−0.205, p<0.05). ConclusionPTX effectively suppressed the elevated levels of blood Pb and serum bone remodeling markers, which are common features of SHPT. In addition to decreased Pb release from bone, an increased store of Pb in bone may play a role in decreasing serum blood Pb levels. These findings suggest that patients undergoing PTX for refractory SHPT should strictly avoid environmental exposure to Pb.

Blood lead levels in patients with lead shot retained in the appendix

Blood lead levels in patients with lead shot retained in the appendix

Blood lead levels in patients with lead shot retained in the appendix

Seven patients with one or two lead shots retained in the appendix were identified by radiography. For each case, two sex- and age-matched control patients without lead shot in the appendix were found. None of the 7 patients with lead shot in the appendix had blood lead levels (median 0.55 mumol/l) approaching the toxic levels, but they averaged almost twice the levels of the controls (median 0.29 mumol/l). Thus, lead shots may add to individual lead exposures, and blood lead analysis should be performed, at least when more than a few lead shots are present.

Blood-lead levels in patients with chronic liver diseases.

Blood-lead concentrations (Pb-B) were measured in 318 adult inpatients with chronic liver diseases. The Pb-B was highest (387 +/- 96 micrograms/l) in 102 patients with alcoholic liver disease without cirrhosis. The Pb-B was still high, but significantly lower in 60 patients with compensated alcoholic cirrhosis (342 +/- 100 micrograms/l) and in 72 patients with decompensated alcoholic cirrhosis (312 +/- 97 micrograms/l). This difference was in part due to a significant decrease of the hematocrit which fell from 44.4 +/- 4.9% to 42.4 +/- 27.2% and to 39.2 +/- 7.4% respectively. In patients with viral or cryptogenic liver diseases the Pb-B was 211 +/- 69 micrograms/l in 11 patients with chronic persistent hepatitis, 219 +/- 72 micrograms/l in 19 with chronic active hepatitis, 206 +/- 94 micrograms/l in 28 with compensated cirrhosis, and 226 +/- 98 micrograms/l in 26 with decompensated cirrhosis, without any significant difference. The Pb-B of the male patients showed no correlation to age, with the exception of 25 male patients with chronic persistent and active hepatitis (r = 0.626, P less than 0.001).