title: Association of high body lead store with severe intracranial carotid atherosclerosis.
abstract: OBJECTIVE
  Lead is involved in the pathogenesis of atherosclerosis and hypertensive disease and may be related to cerebrovascular disease. We studied the association of body lead level with stroke subtypes and severity of cerebral atherosclerosis in order to identify the significance of lead exposure to cerebrovascular disease.
  
  
  METHODS
  From April, 2002 to March, 2005, we studied the lead level in all patients receiving digital subtraction angiography. Diameter stenosis at extracranial carotid, intracranial carotid and vertebrobasilar system was calculated according to the NASCET criteria. A blood sample and a mobilization test of 72-h urine sample were collected for lead measurement.
  
  
  RESULTS
  In a total of 213 subjects, 19 were free of stroke (blood lead level=4.62+/-2.41 microg/dL, body lead store=39.04+/-20.91 microg) and 194 were stroke patients (4.89+/-2.75 microg/dL, 45.13+/-29.8 microg; all stroke vs. non-stroke, P>0.05). In the 153 subjects with atherosclerotic origin, body lead store but not blood lead level in the intracranial carotid system was significantly higher in > or =50% group than <50% group (blood lead: 5.61+/-3.02 microg/dL vs. 4.80+/-2.50 microg/dL, Student's t-test, P=0.129; body lead store: 51.7+/-27.0 microg vs. 41.9+/-23.5 microg, Student's t-test, P=0.038, multivariate logistic regression, odds ratio=1.02, 95% CI: 1.00-1.03, P=0.043). However, there was no significant association between lead level and stenotic severity in extracranial and vertebrobasilar systems (P>0.05).
  
  
  CONCLUSIONS
  Our study demonstrated that long-term lead exposure as measured by body lead store might carry a potential risk of intracranial carotid atherosclerosis.
authors.affiliation: Stroke Section, Department of Neurology and Stroke Center, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Tsong-Hai
authors.initials: TH
authors.lastname: Lee
authors.forename: Mei-Chun
authors.initials: MC
authors.lastname: Tseng
authors.forename: Chi-Jen
authors.initials: CJ
authors.lastname: Chen
authors.forename: Ja-Liang
authors.initials: JL
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods; D001244:Association; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000097:blood / Q000000981:diagnostic imaging / Q000652:urine*; D007854:Lead / Q000097:blood / Q000652:urine*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013054:Spectrophotometry, Atomic / Q000379:methods; D020521:Stroke / Q000097:blood / Q000145:classification / Q000000981:diagnostic imaging / Q000652:urine*
chemical_list: D007854:Lead