title: Association of blood lead and homocysteine levels among lead exposed subjects in Vietnam and Singapore.
abstract: OBJECTIVE
  Lead and homocysteine are both linked to cardiovascular disease. With this in mind, the authors evaluated the relation between blood lead and homocysteine in people aged 19-66 years in two Asian populations.
  
  
  METHODS
  This cross-sectional study comprised 183 workers from a lead stabiliser factory in Singapore and 323 workers from a battery factory in Vietnam. Workers were occupationally exposed to lead. Blood lead was analysed using atomic absorption spectrophotometry while plasma homocysteine was measured using high performance liquid chromatography.
  
  
  RESULTS
  Chinese subjects had the lowest blood lead levels while the Indians had the highest. Controlling for age, sex and race, an increase of 1 microg/dl in blood lead was associated with an increase of 0.04 micromol/l of homocysteine on the log scale. Gender and ethnicity seemed to be strongly associated with the relation between lead and homocysteine. The positive relation between lead and homocysteine among the Vietnamese subjects was significant (Pearson's r = 0.254, p<0.01). When blood lead levels were divided by quartiles, the correlation coefficient between blood lead levels in the 4th quartile and homocysteine among the Vietnamese was higher (r = 0.405, p<0.01). Overall, an increase of 1 microg/dl in blood lead in all the Vietnamese subjects was associated with an increase of 0.05 micromol/l increase in homocysteine on the log scale. However, in the 4th quartile, the same increase was associated with an increase of 0.41 micromol/l of homocysteine on the log scale.
  
  
  CONCLUSIONS
  Blood lead was found to be associated with homocysteine levels in this Asian sample. Although we cannot determine causality from cross-sectional data, it is sensible to consider the probability that this relation could explain one of the mechanisms of the impact of lead on the cardiovascular system. More studies would be needed to confirm this inference.
authors: Department of Community, Occupational and Family Medicine, Faculty of Medicine, National University of Singapore, Republic of Singapore. cofcse@nus.edu.sg
authors: Sin Eng
authors: SE
authors: Chia
authors: Safiyya Mohamed
authors: SM
authors: Ali
authors: Bee Lan
authors: BL
authors: Lee
authors: Gek Hsiang
authors: GH
authors: Lim
authors: Su
authors: S
authors: Jin
authors: Nguyen-Viet
authors: NV
authors: Dong
authors: Nguyen Thi Hong
authors: NT
authors: Tu
authors: Choon Nam
authors: CN
authors: Ong
authors: Kee Seng
authors: KS
authors: Chia
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007854:Lead / Q000097:blood*; D007855:Lead Poisoning / Q000097:blood* / Q000453:epidemiology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000097:blood* / Q000453:epidemiology*; D044469:Racial Groups / Q000706:statistics & numerical data; D017678:Sex Distribution; D012846:Singapore / Q000453:epidemiology; D014744:Vietnam / Q000453:epidemiology
chemical_list: D006710:Homocysteine; D007854:Lead