The Relationship Between Residents Urinary Arsenic Pattern In Arsenic Exposure From Drinking Water And AST,ALT And HBsAg

ObjectiveArsenic is a sort of venomous metalloid elements extensively exist in the nature-confirmed carcinogen-authenticated by both CDC and IARC (International Agency for Research on Cancer). Chronic arsenic poisoning from drinking water has become a widespread concern throughout the world health issues. Inorganic arsenic in human body is metabolized mainly in the liver, distributed in kidney, spleen, lung and gastrointestinal tract, through the urine, hair, nails can also emit a small amount of arsenic. Because the liver is the largest weight of internal organs, and the first-pass effect of inorganic arsenic, the liver is the principal place for arsenic methylation, the liver may affect inorganic arsenic metabolism. Epidemiology studies and animal experiments have clearly indicated an association between chronic arsenic exposure and abnormal liver function, hepatomegaly, hepatoportal sclerosis, liver fibrosis and cirrhosis. It is important that studies between arsenic poisoning and the damage of liver cells and mitochondria. ALT (serum almandine aminotransferase) and AST (aspirate aminotransferase) was the most important in liver cell enzymes. ALT can reflect the integrity of liver cells and an early sensitive indicator of acute hepatitis. Elevated serum mAST subcellular structures can reflect the severity of the damage, the diagnosis of liver cell injury, one of the other sensitive indexes. HBsAg is the mark of hepatitis B, hepatitis B not only can directly reflect arsenic on liver damage indicator, but also an indirect indicator on damage of the immune system.In this study, residents with damage of ALT, AST and HBsAg have whether the change in urinary arsenic patterns, compared to the normal population; By total arsenic in urine as indicators of body exposure, we study the relationship on the level of body exposure and liver damage. Methods1. Study Subjects(1) Study areas:According to water quality surveys and the results of arsenic determination in Shanxi CDC in the past, we select areas of arsenic poisoning from drinking water (six villages of Tianzhen County in Datong and ying County of Shuozhou City). It is similar that their natural conditions, economic conditions, demographic composition, crop type, living habits, and so on. there was no industrial arsenic contamination in the two regions.(2) Study subjects:We select the long-term residents. We use two methods of take-home and voluntary. The adults have health examination, according to examination results, we select population with nearly 3 days without eating seafood.2. Investigation of Study(1) General situation:We use uniform printed questionnaire, uniform medical standards for the survey, direct questions and complete the questionnaires. Include: including age, sex, occupation, education level, marital status, number of children and so on. Life, and environmental factors:smoking history and smoking, drinking history and alcohol consumption, eating habits, family history, medical history and so on.(2) Physicians use a professional medical examination, including:height, weight, blood pressure, fasting blood sugar, urine sugar, and so on. Trained doctors conducted detailed physical examinations and arsenicosis identification according to the Diagnosis Standards on Arsenicosis of China (WS/T211-2001).(3) Collection of biological samplesUrine samples:We collect urine, immediately placed in ice box at 0-4℃. Saved the day and collected urine samples at-20℃. In the end, all urine samples tested until the investigation in ice box to return the laboratory, stored at-80℃.Blood samples:Blood collected 5 ml, placed in heparin tubes and reverses the mix, tested after transport back to the lab in liquid nitrogen.(4) Examination in labDetermination of arsenic metabolites:Urine samples were mix with 2 mol/L NaOH (1/1, v/v) and digested at 100℃for 3 h. Then cold trap hydride generation-atomic absorption spectrometry were applied to determine the content of iAs, MMA, dimethylated arsenic (DMA) and trimethylated arsenic (TMA). Detection limits were 1 ng with this method the three kinds of forms of arsenic, the coefficient of variation<5%. Standard material was provided for the Japanese Environmental Institute.Determination of liver indexes:ALT (alanine aminotransferase), AST (aspartate aminotransferase), and HBS-Ag (Hepatitis B Virus Surface Antigen) is determined by ACTO1 Photometer Application.4. Statistical analysisData analysis was used by SPSS software (version 16.0). for. Logarithmic transformation of data made the data normal distribution. The results express as the geometric mean. We used x2 test in gender, lifestyle distribution. We used two independent samples t test between two groups of urinary arsenic levels and arsenic methylation capacity. Statistically significant level:a=0.05.ResultsWe selected 1006 people, according to urine and blood samples taken, as well as gender, age, smoking and drinking and other related factors, the principle of excluding incomplete data, there are 166 people of abnormal liver function (AST or ALT abnormal or unusual hepatitis B patients), abnormal AST and ALT abnormalities, hepatitis B patients were 84 people,13 and 28, respectively. Excluding suffering from liver disease, high blood pressure and other chronic diseases, there are 423 healthy people. There is no significant difference in the gender, age, smoking and drinking compared all groups of abnormal liver function with the control group.1. Urinary arsenic patterns in gender, age, smoking and alcoholWith regard to gender, urinary TAs,DMA and SMR in female were significantly higher than male; urinary TAs,DMA and SMR in non-smoking group were significantly higher than smoking.2. Urinary arsenic patterns in groups of liver function abnormalities There is no significant difference compared all groups of abnormal liver function with the control group.3. The effects of arsenic exposure in body to the liverAccording to urinary arsenic values, After excluding confounding factors, urinary TAs> 50μg/g Cr was an independent risk factor for abnormal AST, the adjusted RR value of 1.94 (95% CI= 1.00-3.76), There is no significant difference compared arsenic exposure group with the control group.The study population divided into control group and arsenic exposure group. After excluding confounding factors, urinary TAs> 50μg/g Cr was an independent risk factor for abnormal AST, the adjusted OR value of 1.97 (95% CI= 1.00-3.51), showed that when the urinary TAs> 50μg/g Cr is 1.97 fold of total urinary arsenic≤50μg/g Cr. There is no significant difference compared arsenic exposure group with the control group.Conclusion1. Compared with the normal population, There is no significant difference in all groups of abnormal liver function.2. In this study, in an certain arsenic exposure, the capacity of inorganic arsenic methylation is increased when the levels of urinary TAs is increased.3. The rate of AST abnormal is increased, it suggests the risk of liver injury is increased, when urinary arsenic levels above 50μg/g Cr, there is high risk in AST abnormal.