Lead, Diabetes, Hypertension, and Renal Function: The Normative Aging Study

Abstract

In this prospective study, we examined changes in renal function during 6 years of follow-up in relation to baseline lead levels, diabetes, and hypertension among 448 middle-age and elderly men, a subsample of the Normative Aging Study. Lead levels were generally low at baseline, with mean blood lead, patella lead, and tibia lead values of 6.5 μg/dL, 32.4 μg/g, and 21.5 μg/g, respectively. Six percent and 26% of subjects had diabetes and hypertension at baseline, respectively. In multivariate-adjusted regression analyses, longitudinal increases in serum creatinine (SCr) were associated with higher baseline lead levels but these associations were not statistically significant. However, we observed significant interactions of blood lead and tibia lead with diabetes in predicting annual change in SCr. For example, increasing the tibia lead level from the midpoints of the lowest to the highest quartiles (9–34 μg/g) was associated with an increase in the rate of rise in SCr that was 17.6-fold greater in diabetics than in nondiabetics (1.08 mg/dL/10 years vs. 0.062 mg/dL/10 years; p < 0.01). We also observed significant interactions of blood lead and tibia lead with diabetes in relation to baseline SCr levels (tibia lead only) and follow-up SCr levels. A significant interaction of tibia lead with hypertensive status in predicting annual change in SCr was also observed. We conclude that longitudinal decline of renal function among middle-age and elderly individuals appears to depend on both long-term lead stores and circulating lead, with an effect that is most pronounced among diabetics and hypertensives, subjects who likely represent particularly susceptible groups.

Association of lead and cadmium exposure with frailty in US older adults

“…Second, exposure to lead and cadmium has been related to a higher risk of several pathologic conditions that are also linked to frailty. Environmental exposure to lead in the elderly has been associated with cognitive decline (Bandeen-Roche et al 2009;Grashow et al 2013;Nordberg et al 2000;Power et al 2014;Shih et al 2006;van Wijngaarden et al 2011), impaired motor skills (Grashow et al 2013), increased blood pressure (Perlstein et al 2007), ischemic heart disease (Jain et al 2007), decreased renal function (Tsaih et al 2004), falls and fractures in women (Khalil et al 2008), hearing loss (Park et al 2010) and vision problems (Schaumberg et al 2004;Wu et al 2014). Cadmium, for which fewer studies have been conducted in the elderly, has also been associated with an increased risk of atherosclerotic plaques (Fagerberg et al 2012), peripheral artery disease (Tellez-Plaza et al 2013a), osteoporosis (Engstrom et al 2011;Gallagher et al 2008) and macular degeneration (Shiue 2013;Wu et al 2014).…”

Blood lead levels and bone turnover with weight reduction in women

“…However, sBPb levels as low as 5-9 mg/dl has been associated with an increased risk of death from all causes, cardiovascular disease, and cancer (Menke et al, 2006;Schober et al, 2006). Others have suggested that patients with metabolic syndrome may have a greater susceptibility for toxicity at lower blood and organ Pb levels (Tsaih et al, 2004;Park et al, 2006). Since metabolic syndrome is a criterion for weight loss surgery, a lower threshold of ''normal'' blood Pb levels may be relevant to this population.…”

Comparative metal distribution in scalp hair of Pakistani and Irish referents and diabetes mellitus patients

“…The effects of Pb poisoning in diabetic subjects have been recognised [25]. Epidemiologic studies in animals have reported Pb toxic effects at high levels of exposure may contribute to the progression of diabetes complications in dia-betic patients [26].…”