Effect Of Arsenic Poisoning On The Arsenic Speciation In Human Urine And Damage Of The Liver And Renal Function

Objective (1) To approach the relationship between the endemic arsenic poisoning and the damage of the liver and renal function. (2) Explore the effect of arsenic poisoning on the metabolism of arsenicum by detecting the arsenic speciation in human urine .Methods (1) The subjects studied were sampled from arseniasis-endemic areas of Shanxi province .Make diagnosis and clinical grading on the basis of endemic arsenic poisoning damage criterion for skin. Choose the ALT (Glutamate-pyruvate transaminase) as the indicator of the impaired hepatic function and theβ²-MG(β²-microglobulin),mALβ(Urine microdosis albumen),UNAG(Urine N-2-Acetyl-B-D-glucosaminidase) as the index of the damaging of renal function. The ALT and UNAG was acquired by method of velocity. Theβ²-MG and mALβwas detected by endpoint method.Analysis was executed between the endemic arsenic poisoning and the damage of the liver and renal function.(2) We conducted a case-control study (66 cases and 36 controls based on standard of arsenic poisoning skin damage criterion in clinic ) to explore the effect of arsenic poisoning on the arsenic speciation. Choose the urinary proportion of MMA(Mon-meth arsenic acid), DMA(dimethyl arsenic acid) and MMA/DMA as the indicator.The contents of arsenicum in drinking water and iAs³⁺,MMA,DMA,iAs⁵⁺ in urine were measured by hydride atomic fluorescence spectrometry. All the data were analyzed by SPSS13.0 statistical software. The risk factors were analyzed by nonconditional Logistic regression andχ²-test.Result (1) Doubtful people diagnosed on the basis of endemic arsenic poisoning damage criterion for skin was deleted as losses.At last, 661 people were bringed into this study by denominator.Meanage was 32.54,minimun 6 and maximun 81.308 male(meanage 32.10) and 353 female(meanage 32.87) among them.55 water samples were acquired.The concentration of arsenium minimum 0.0008mg/l and maximun0.7659mg/L,mean was 0.19±0.16mg/L.45 samples were more than 0.05 mg/L,so 81.8% exceed the the drinking water standard for arsenic.(2) Choosing the ALT (Glutamate-pyruvate transaminase) as the indicator of the impaired hepatic function and controling the confouding factor of age,the consequence showed that the endemic arsenic poisoning was not the reason of the impaired hepatic function.The occupation is the risk factor which multiplied the risk of the damage of the hepatic function (P<0.05, OR= 1.278 , OR 95% confidence interval 1.037¹.574). The detection rate of the impaired hepatic function indifferent occupations were 3.4% in students,6.8% in farmers,11.1% in managers,14.3% in workers,15.6% in others,which hint that following the sequence of student,farmers, manager,workers,others, the latter had a higher risk of the damage of the hepatic function (OR= 1.278)when compared to the former.(3) Choose theβ²-MG(β²-microglobulin),mALβ(Urine microdosis albumen),UNAG(Urine N-2-Acetyl-B-D-glucosaminidase) as the index of the harm of renal function,the result indicated there were no significant relationships between the endemic arsenic poisoning and the impaired renal function.But the consequence showedâ‘ the female has higher lever of mALβ/Ucr than male in endemic arsenic poisoning areas(P<0.05, OR=2.138 , OR 95% confidence interval 1.362³.358),but the possibly reason was that the male has higher lever of UCr (Urine creatinine) than female because the Ucr was used for correct the influence of urinary volume.â‘¡People whose urine glucose was positivehas higher lever of NAG/Ucr than negativity(P<0.05, OR=3.361 , OR 95% confidence interval 1.187⁹.518)â‘¢BMI(Body mass index)>25 which was overweight has higher lever of mALβ/Ucr than common body weight(P<0.05, OR=2.974 , OR 95% confidence interval 1.386⁶.385).The non-condition Logistic regression analysis showed BMI was the risk factor to the harm of renal function which has higher lever of mALβ/Ucr.(4)The arsenum was constitute of 10～15 % iAs Ill,iAs V,10～15 %MMA,60～80% DMA in urine of health adult.This proportion was 18.57% iAs Ill,iAs V,14.97% MMA,66.46% DMA in the urine of endemic arsenic poisoning patient and 18.12% iAs Ill,iAs V,13.58% MMA,68.31%DMA in non-patient who drinked well water; This proportion was 20.55% iAs Ill,iAs V,14.91% MMA,64.54% DMA in the urine of endemic arsenic poisoning patient and 21.67% iAs Ill,iAs V,12.41% MMA,65.93%DMA in non-patient who drinked tap water. There is no statistically difference between cases and controls in the distribution about arsenic speciation in urine.(5)Wether well water or tap water ,there was no statistically differences between male and female in the distribution about arsenic speciation in urine.what regularity found in the distribution about arsenic speciation was that the proportion of iAs Ill and MMA was bigger in male than in female;the female has higher lever of the proportion of DMA than male;there were no differences of the proportion of iAs V in male and female.The regularity was more significantly in male and female who drink well water(P<0.05).The proportion of arsenium in urine of male was 14.73% iAs Ill,iAs V,15.80% MMA,62.73% DMA in urine of male and 10.83% iAs Ill,iAs V,11.96% MMA,71.18 DMA in urine of female which suggested that arsenic methylation ability is higher in female than in male.(6)Maked the the proportion of MMA in urine into exceed 15% and not exceed 15%, the proportion of DMA into exceed 5% and not exceed 5%, explore the correlation between skin pigment loss,skin pigmentation,keratoderma and groups. Subjects with a higher percentage of MMA (MMA/total arsenic>15% ) have a significantly higher risk of skin pigment loss (OR = 4.75 95% confidence interval 1.333-16.925 ). The DMA/MMA≤5 is associated with an increased risk of skin skin pigment loss (OR, 2.04; 95% CI, 1.266–3.293) compared to a DMA/MMA>5.This consequence indicated arsenic methylation ability make important role in skin lesion caused by arseniasis-endemic.Conclusion The correlation between endemic arsenic poisoning and the damage of the liver and renal function was not statistically significant. The female has higher lever of mALβ/Ucr than male in endemic arsenic poisoning areas,but the possibly reason was that the male has higher lever of UCr (Urine creatinine) than female because the Ucr was used for correct the influence of urinary volume. There is no statistically difference between cases and controls in the distribution about arsenic speciation in urine. Arsenic methylation ability make important role in skin lesion caused by arseniasis-endemic, arsenic methylation ability is higher in women than in men who live in arseniasis-endemic areas.