title: Dose-response relationship between arsenic exposure and the serum enzymes for liver function tests in the individuals exposed to arsenic: a cross sectional study in Bangladesh.
abstract: BACKGROUND
  Chronic arsenic exposure has been shown to cause liver damage. However, serum hepatic enzyme activity as recognized on liver function tests (LFTs) showing a dose-response relationship with arsenic exposure has not yet been clearly documented. The aim of our study was to investigate the dose-response relationship between arsenic exposure and major serum enzyme marker activity associated with LFTs in the population living in arsenic-endemic areas in Bangladesh.
  
  
  METHODS
  A total of 200 residents living in arsenic-endemic areas in Bangladesh were selected as study subjects. Arsenic concentrations in the drinking water, hair and nails were measured by Inductively Coupled Plasma Mass Spectroscopy (ICP-MS). The study subjects were stratified into quartile groups as follows, based on concentrations of arsenic in the drinking water, as well as in subjects' hair and nails: lowest, low, medium and high. The serum hepatic enzyme activities of alkaline phosphatase (ALP), aspartate transaminase (AST) and alanine transaminase (ALT) were then assayed.
  
  
  RESULTS
  Arsenic concentrations in the subjects' hair and nails were positively correlated with arsenic levels in the drinking water. As regards the exposure-response relationship with arsenic in the drinking water, the respective activities of ALP, AST and ALT were found to be significantly increased in the high-exposure groups compared to the lowest-exposure groups before and after adjustments were made for different covariates. With internal exposure markers (arsenic in hair and nails), the ALP, AST and ALT activity profiles assumed a similar shape of dose-response relationship, with very few differences seen in the higher groups compared to the lowest group, most likely due to the temporalities of exposure metrics.
  
  
  CONCLUSIONS
  The present study demonstrated that arsenic concentrations in the drinking water were strongly correlated with arsenic concentrations in the subjects' hair and nails. Further, this study revealed a novel exposure- and dose- response relationship between arsenic exposure metrics and serum hepatic enzyme activity. Elevated serum hepatic enzyme activities in the higher exposure gradients provided new insights into arsenic-induced liver toxicity that might be helpful for the early prognosis of arsenic-induced liver diseases.
authors: Department of Biochemistry and Molecular Biology, Rajshahi University, Rajshahi-6205, Bangladesh.
authors: Khairul
authors: K
authors: Islam
authors: Abedul
authors: A
authors: Haque
authors: Rezaul
authors: R
authors: Karim
authors: Abul
authors: A
authors: Fajol
authors: Ekhtear
authors: E
authors: Hossain
authors: Kazi Abdus
authors: KA
authors: Salam
authors: Nurshad
authors: N
authors: Ali
authors: Zahangir Alam
authors: ZA
authors: Saud
authors: Matiar
authors: M
authors: Rahman
authors: Mashiur
authors: M
authors: Rahman
authors: Rezaul
authors: R
authors: Karim
authors: Papia
authors: P
authors: Sultana
authors: Mostaque
authors: M
authors: Hossain
authors: Anwarul Azim
authors: AA
authors: Akhand
authors: Abul
authors: A
authors: Mandal
authors: Hideki
authors: H
authors: Miyataka
authors: Seiichiro
authors: S
authors: Himeno
authors: Khaled
authors: K
authors: Hossain
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D001151:Arsenic / Q000032:analysis*; D020261:Arsenic Poisoning / Q000097:blood* / Q000453:epidemiology; D001219:Aspartate Aminotransferases / Q000097:blood; D001459:Bangladesh / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D005260:Female; D006197:Hair / Q000737:chemistry; D006801:Humans; D008099:Liver / Q000201:enzymology; D008111:Liver Function Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000737:chemistry; D014874:Water Pollutants, Chemical / Q000032:analysis / Q000506:poisoning; D014881:Water Supply / Q000032:analysis
chemical_list: D015415:Biomarkers; D014874:Water Pollutants, Chemical; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001151:Arsenic