Past adult lead exposure is linked to neurodegeneration measured by brain MRI
Past adult lead exposure is linked to neurodegeneration measured by brain MRI
复制标题
DOI：
10.1212/01.wnl.0000216138.69777.15
复制
发表时间：
2006-05-23
期刊：
影响因子：
9.9
通讯作者：
Youssem, D.
中科院分区：
文献类型：
--
作者：
Stewart, W. F.;Schwartz, B. S.;Youssem, D.
目的：确定前有机铅工人的累积铅剂量是否与白色病变（WML）和整体和结构特异性脑体积的MRI测量值相关。研究方法：磁共振成像，胫骨铅，和其他措施，获得了532名前有机铅工人的平均年龄为56岁，平均18年，因为最后一次职业接触铅。累积铅剂量通过胫骨铅测量，通过X射线荧光获得，并表示为微克铅每克骨矿物质（微克铅/克）。使用心血管健康研究分级量表评估WML。共评估了21个全局和特定脑区。结果：共有36%的个体WML等级为1至7级（0至9级）。峰值胫骨电极导线的增加与WML等级的增加相关（p = 0.004）。CHS分级为5 +（>= 5 vs < 5）时，胫骨铅增加1 μ g/g的调整OR为1.042（95% CI = 1.021，1.063）。在线性回归中，胫骨导联与所有结构的相关系数均为负。胫骨导联越高，总脑体积、额叶和总灰质体积以及顶叶白色物质体积越小。在9个较小的特定感兴趣区域中，较高的胫骨导联与扣带回和小脑体积较小相关。结论：这些数据表明，累积铅剂量与持续性脑损伤有关，并可能解释以前的认知功能进行性下降的结果。
Objective: To determine whether cumulative lead dose in former organolead workers was associated with MRI measures of white matter lesions (WML) and global and structure-specific brain volumes. Methods: MRIs, tibia lead, and other measures were obtained from 532 former organolead workers with a mean age of 56 years and a mean of 18 years since last occupational exposure to lead. Cumulative lead dose was measured by tibia lead, obtained by X-ray fluorescence, and expressed as mu g lead per gram of bone mineral (mu g Pb/g). WML were evaluated using the Cardiovascular Health Study grading scale. A total of 21 global and specific brain regions were evaluated. Results: A total of 36% of individuals had WML grade of 1 to 7 ( 0 to 9 scale). Increasing peak tibia lead was associated with increasing WML grade (p = 0.004). The adjusted OR for a 1 mu g Pb/g increase in tibia lead was 1.042 (95% CI = 1.021, 1.063) for a CHS grade of 5 + (>= 5 vs < 5). In linear regression, the coefficient for tibia lead was negative for associations with all structures. Higher tibia lead was significantly related to smaller total brain volume, frontal and total gray matter volume, and parietal white matter volume. Of nine smaller specific regions of interest, higher tibia lead was associated with smaller volumes for the cingulate gyrus and insula. Conclusions: These data suggest that cumulative lead dose is associated with persistent brain lesions, and may explain previous findings of a progressive decline in cognitive function.