title: Elevated lactate dehydrogenase activity and increased cardiovascular mortality in the arsenic-endemic areas of southwestern Taiwan.
abstract: Arsenic ingestion has been linked to increasing global prevalence of and mortality from cardiovascular disease (CVD); arsenic can be removed from drinking water to reduce related health effects. Lactate dehydrogenase (LDH) is used for the evaluation of acute arsenic toxicity in vivo and in vitro, but it is not validated for the evaluation of long-term, chronic arsenic exposure. The present study examined the long-term effect of chronic arsenic exposure on CVD and serum LDH levels, after consideration of arsenic metabolism capacity. A total of 380 subjects from an arseniasis-endemic area and 303 from a non-endemic area of southwestern Taiwan were recruited in 2002. Various urinary arsenic species were analyzed using high-performance liquid chromatography (HPLC) and hydride generation systems. Fasting serum was used for quantitative determination of the total LDH activity. A significant dose-response relationship was observed between arsenic exposure and LDH elevation, independent of urinary arsenic profiles (P<0.001). Furthermore, abnormal LDH elevation was associated with CVD mortality after adjustment for Framingham risk scores for 10-year CVD and arsenic exposure (hazard ratio, 3.98; 95% confidence interval, 1.07-14.81). LDH was elevated in subjects with arsenic exposure in a dose-dependent manner. LDH is a marker of arsenic toxicity associated with CVD mortality. Results of this study have important implications for use in ascertaining long-term arsenic exposure risk of CVD.
authors.affiliation: Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Taiwan.
authors.forename: Ya-Tang
authors.initials: YT
authors.lastname: Liao
authors.forename: Chien-Jen
authors.initials: CJ
authors.lastname: Chen
authors.forename: Wan-Fen
authors.initials: WF
authors.lastname: Li
authors.forename: Ling-I
authors.initials: LI
authors.lastname: Hsu
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Tsai
authors.forename: Yeou-Lih
authors.initials: YL
authors.lastname: Huang
authors.forename: Chien-Wen
authors.initials: CW
authors.lastname: Sun
authors.forename: Wei J
authors.initials: WJ
authors.lastname: Chen
authors.forename: Shu-Li
authors.initials: SL
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001151:Arsenic / Q000009:adverse effects* / Q000652:urine; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000401:mortality*; D002851:Chromatography, High Pressure Liquid; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D013624:Taiwan / Q000453:epidemiology
chemical_list: D007770:L-Lactate Dehydrogenase; D001151:Arsenic