DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20192510

Urinary calcium: a promising predictive biomarker for early recognition of environmental lead exposure in children

Nnenna L. Nwobi, Solomon K. Adedapo, Opebiyi A. Oyinlade, Olugbemi Olukolade, Ikeoluwa A. Lagunju, Nnodimele O. Atulomah, Ikechukwu A. Nwazuoke, John I. Anetor

Abstract


Background: In the continuous search for accessible, reliable and sensitive biomarkers for early detection of environmental lead exposure, authors determined the interaction between blood lead level (BLL), the conventional marker of lead exposure, and the indices of calcium and bone metabolism in children.

Methods: This cross-sectional study involved 309 apparently healthy children from eight public primary schools in Ibadan, Nigeria who were classified as Elevated BLL (EBLL) and control based on standard cut-off for childhood BLL. BLL, serum Ca (tCa), phosphate, magnesium (Mg), 25-hydroxy-Vitamin D, alkaline phosphatase (ALP), urinary calcium (uCa) and urinary deoxypyridinoline (uDPD) were determined using AAS, HPLC and ELISA as appropriate. Bone-specific ALP (B-ALP) and ionized calcium (iCa) were calculated using standard formulae. Data analyses involved Student’s t-test, Pearson correlation and multivariate regression analysis. p<0.05 was considered statistically significant.

Results: BLL and 25-OH-Vitamin D levels were increased in EBLL (0.4±0.1 µmol/L and 60.1±10.7 mmol/L) compared with control (0.2±0.0 µmol/L and 55.1±14.3 mmol/L) p <0.05. No significant differences existed in the levels of ALP, B-ALP, uCa, uDPD, tCa, iCa, phosphate and Mg in both groups (p>0.05). BLL had significant positive correlation with uCa (r=0.176, p=0.002) (p<0.05) but no significant correlation with uDPD, ALP, B-ALP, tCa, iCa, phosphate, Mg and 25-OH-Vitamin D (p>0.05). BLL could be accounted for by uCa by applying the equation, BLL=0.329+0.324uCa.

Conclusions: Urinary calcium could be a promising predictive biomarker for early recognition of significant environmental lead exposure in children.


Keywords


Bone metabolism, Calcium metabolism, Environmental lead exposure

Full Text:

PDF

References


World Health Organisation. Lead exposure in african children, 2015. Available at: Http://Apps.Who.Int/Iris/Bitstream/10665/200168/1/9780869707876.Pdf. Accessed 12 January 2017.

Anetor JI, Igharo OG, Anetor GO, Nwobi NL, Iyanda AA. The Zamfara lead poisoning episode in Nigeria: an indication for childrens environmental toxicology and micronutrient centre. Toxicol Digest. 2016;1:23-33.

Ogunseitan OA, Smith TR. The cost of environmental lead poisoning in Nigeria. Afr. J. Environ. Sci. Technol 2007;1(2):27-36.

Kordas K. The “Lead Diet”: Can dietary approaches prevent or treat lead exposure?. J Pediatr. 2017:1-8.

Sommar JN, Hedmer M, Lundh T, Nilsson L, Skerfving S, Bergdahl IA. Investigation of lead concentrations in whole blood, plasma and urine as biomarkers for biological monitoring of lead exposure. J Expos Sci Environ Epid. 2014;24(1):51-7.

Veldurthy V, Wei R, Oz L, Dhawan P, Jeon YH, Christakos S. Vitamin D, calcium homeostasis and aging. Bone research. 2016;4:16041.

Mazumdar I, Goswami K, Suhrab A. Status of serum calcium, vitamin d and parathyroid hormone and hematological indices among lead exposed jewelry workers in Dhaka, Bangladesh. Ind J Clin Biochem. 2017;32(1):110-6.

Rodriguez-Ortiz ME, Canalejo A, Herencia C, Martínez-Moreno JM, Peralta-Ramírez A, Perez-Martinez P. Magnesium modulates parathyroid hormone secretion and upregulates parathyroid receptor expression at moderately low calcium concentration. Nephrol. Dial. Transplant. 2014;29.2:282-9.

Kirberger M, Yang JJ. Structural differences between Pb2+- and Ca2+- binding sites in proteins: Implications with respect to toxicity. J Inorg Biochem. 2008;102(10):1901-09.

Alkbal A, Tutkun E, Yılmaz H. Lead exposure is a risk for worsening bone mineral density in middle-aged male workers. Aging Male. 2004;17(3):189-93.

Haryanto B, Sutrisna B, Djaja IM. Effect of calcium supplementation on school children’s blood lead levels in Indonesia. Int J Sci Res. 2015;4(5):1620-25.

Monir A, Gundberg C, Yagerman S, Meulen M, Budell W, Boskey A, Dowd T. The effect of lead on bone mineral properties from female adult C57/Bl6 Mice. Bone. 2000;47(5):888-94.

Licata AA. Biochemical markers of bone turnover: useful but underused. Cleve Clin J Med. 2008;75(10):751-52.

Čepelak I, Čvorišćec D. Biochemical markers of bone remodeling-review. Biochem Med. 2009;19(1):17-35.

Turan S, Topcu B, Gökçe I, Güran T, Atay Z, Omar A, et al. Serum alkaline phosphatase levels in healthy children and evaluation of alkaline phosphatase z-scores in different types of rickets. J Clin Res Pediatr Endocrinol. 2008;3(1):7-11.

Bhattarai T, Bhattacharya K, Chaudhuri P, Sengupta, P. Correlation of common biochemical markers for bone turnover, serum calcium, and alkaline phosphatase in post-menopausal women. Malays J Med Sci. 2014;21(1):58-61.

Centres for Disease Control and Prevention (CDC). Response to advisory committee on childhood lead poisoning prevention recommendations in “low level lead exposure harms children: a renewed call of primary prevention, 2012. Available at: Https://Www.Cdc.Gov/Nceh/Lead/Acclpp/Final_Document_030712.Pdf. Accessed 20 December 2016.

Miller D, Paschal D, Gunter E, Stroud P, D’Angelo J. Determination of blood lead with electrothermal atomic absorption using a L’vov platform and matrix modifier. Analyst. 1987;112:1701-04.

Sarkar BR, Chauhan U. A new method for determining micro quantities of calcium in biological materials. Anal Biochem. 1967;20(1):155-66.

Beeler MF, Catrou, PG. Interpretations in Clinical Chemistry: A Textbook Approach in Chemical Pathology. 2nd ed. American Society of Clinical Pathologist Press; Chicago, USA; 1984:34-44.

Henry RJ. Clinical Chemistry: Principles and Techniques. 2nd Ed. Harper and Row. New York, USA; 1974.

Samie L, Bayat B, Vahedi M, Farahani M, Avval MZ. Check the amount of calcium, phosphorus, magnesium, chlorine, pH, Flow rate, glucose and total protein in the saliva of pregnant and non-pregnant women at the center of the family's control at Hamadan Fatemiyeh hospital. Scholars Acad J Biosci. 2017;5(3):240-4.

Hilger J, Friedel A, Herr R, Rausch T, Roos F, Wahl D, et al. A systematic review of vitamin D status in populations worldwide. Br J Nutr. 2013;111:23.

Neyestani G and Kalayi K. Determination of serum 25-Hydroxy cholecalciferol using high-performance liquid chromatography: a reliable tool for assessment of vitamin D status. Int J Vitam Nutr Res. 2007;77(5):341-46.

Hausamen, TU, Helger R, Rick W, Gross W. Optimal conditions for the determination of serum alkaline phosphatase by a new kinetic method. Clin Chim Acta. 1967;15(2):241-45.

Fitzgerald, MX, Fennelly JJ, Mcgeeney K. The value of differential alkaline phosphatase thermostability in clinical diagnosis. Am J Clin Pathol. 1969;51(2):194-201.

Drabkin DL, Austin JH. Spectrophotometric constants for common haemoglobin derivatives in human, dog and rabbit blood. J Biol Chem. 1932;98:719-33.

Reinhold JG. Total protein, albumin and globulin. In: Reiner M., ed. Standard Methods of Clinical Chemistry. Academic Press, New York, USA; 1953:88-90.

Doumas BT, Watson WA, Biggs HG. Albumin standards and the measurement of serum albumin with bromcresol green. Clin Chim Acta. 1971;31:87-96.

Jolles S, Borrell R, Zouwail S, Heaps A, Sharp H, Moody M, et al. Calculated globulin as a screening test for antibody deficiency. Clin Exp Immunol. 2014;177(3):671-78.

Bergmeyer H, Scheibe P, Wahlefeld A. Optimization of methods for aspartate aminotransferase and alanine aminotransferase. Clin Chem. 1978;24.1:58-73.

Orlowski, M, Meister A. 1963. ¥-Glutamyl-p-nitroanilide: a new convenient substrate for determination and study of L- and D-Γ-Glutamyl transpeptidase activities. Mol Cell Biol Lipids. 1963;73(4):679-81.

Bartels H, Böhmer M, Heierli C. Serum creatinine determination without precipitation. Int J Clin Chem. 1972;37:193-97.

Sampson EJ, Baird MA. Chemical inhibition used in a kinetic urease/glutamate dehydrogenase method for urea in serum. Clin Chem. 1979;25(10):1721-29.

Rahman A, Al-Awadi AA, Khan KM. Lead Affects Vitamin D Metabolism in Rats. Nutrients. 2018;10(3):264.

Kirberger M. Pb (II) disruption of synaptic activity through Ca (II)-and Zn (II)-binding proteins. Neurotransmitter. 2017:4.

Yücebilgiç G1, Bilgin R, Tamer L, Tükel S. Effects of lead on Na(+)-K(+) ATPase and Ca(+2) ATPase activities and lipid peroxidation in blood of workers. Int J Toxicol. 2003;22(2):95-7.

Moor MB, Bonny O. Ways of calcium reabsorption in the kidney. Am J Physiol Renal Physiol. 2016;310:1337-50.

Letavernier E, Daudon M. Vitamin D, Hypercalciuria and Kidney Stones. Nutrients. 2018;10:366.