ICMR - National Institute of Occupational Health, Ahmedabad, India.
ICMR - National Institute of Epidemiology, Chennai, India.
Sci Rep. 2022 Feb 3;12(1):1850. doi: 10.1038/s41598-022-05976-4.
Chronic Pb exposure associated systemic illness are partly posited to involve calcium homeostasis. Present systematic review aims to comprehensively evaluate the association between chronic lead exposure and markers of calcium homeostasis. Observational studies documenting the changes in calcium homeostasis markers (i.e. serum calcium, parathyroid hormone, vitamin D & calcitonin) between occupationally Pb exposed group and control group were systematically searched from pubmed-Medline, Scopus, and Embase digital databases since inception to September 24, 2021. The protocol was earlier registered at PROSPERO (ID: CRD42020199503) and executed adhering to PRISMA 2020 guidelines. Mean differences of calcium homeostasis markers between the groups were analysed using random-effects model. Conventional I statistics was employed to assess heterogeneity, while the risk for various biases were assessed using Newcastle Ottawa Scale. Sub-group, sensitivity and meta-regression analyses were performed where data permitted. Eleven studies including 837 Pb exposed and 739 controls were part of the present study. Pb exposed group exhibited higher mean blood lead level [i.e. 36.13 (with 95% CI 25.88-46.38) µg/dl] significantly lower serum calcium (i.e. - 0.72 mg/dl with 95% CI - 0.36 to - 1.07) and trend of higher parathyroid levels and lower vitamin D levels than controls. Heterogeneity was high (I > 90%) among the studies. Considering the cardinal role of calcium in multiple biological functions, present observations emphasis the need for periodic evaluation of calcium levels and its markers among those with known cumulative Pb exposure.
慢性铅暴露相关的系统性疾病部分被认为涉及钙稳态。本系统评价旨在全面评估慢性铅暴露与钙稳态标志物之间的关系。系统地从 pubmed-Medline、Scopus 和 Embase 数字数据库中搜索了自成立至 2021 年 9 月 24 日记录职业性 Pb 暴露组和对照组钙稳态标志物（即血清钙、甲状旁腺激素、维生素 D 和降钙素）变化的观察性研究。该方案早些时候在 PROSPERO（ID：CRD42020199503）进行了注册，并按照 PRISMA 2020 指南进行了执行。使用随机效应模型分析钙稳态标志物在组间的差异。采用常规 I 统计量评估异质性，同时使用 Newcastle Ottawa 量表评估各种偏倚的风险。在允许的情况下进行亚组、敏感性和荟萃回归分析。本研究包括 11 项研究，共 837 名 Pb 暴露者和 739 名对照者。暴露组的平均血铅水平较高[即 36.13（95%CI 25.88-46.38）µg/dl]，血清钙显著较低[即 -0.72mg/dl，95%CI -0.36 至-1.07]，甲状旁腺水平较高，维生素 D 水平较低。研究之间存在高度异质性（I>90%）。鉴于钙在多种生物学功能中的重要作用，目前的观察结果强调了需要定期评估已知累积 Pb 暴露人群的钙水平及其标志物。
