Hepatic and blood lead levels in patients with chronic liver disease.

OBJECTIVE

To investigate the relationship between lead levels in the liver and blood, liver function indices and other biological variables in patients with liver disease.

DESIGN

Prospective study.

METHOD

The levels of lead in blood and hepatic tissue was measured in 92 patients with different liver diseases and in a control group (n = 100). Lead levels were analysed by electrothermic atomic absorption spectrophotometry.

RESULTS

For controls, the mean lead level in blood was 175 +/- 87 micrograms/l. Blood lead levels were significantly linked with alcohol intake. They were raised in patients with alcoholic liver disease, including both those with cirrhosis (230 +/- 65 micrograms/l) and those with chronic non-cirrhotic liver disease (247 +/- 82 micrograms/l). The differences between these subgroups, the control group, and the patients with non-alcoholic liver disease were statistically significant. The mean hepatic lead level for patients was 2.30 +/- 1.40 micrograms/g dry weight (d.w.), and 2.15 +/- 1.71 micrograms/g d.w. for controls (not significant). Patients with alcoholic cirrhosis had higher hepatic lead levels than non-alcoholic patients (2.62 +/- 1.48 micrograms/g d.w. versus 2.07 +/- 1.14 micrograms/g d.w., respectively), although the difference was not statistically significant. There was no relationship between blood and hepatic lead levels (r = 0.27; not significant). Blood lead levels correlated with phosphorus (r = -0.36; P < 0.001), and alcohol intake (g/day; r = 0.32; P < 0.001). Blood and hepatic lead levels in patients with cirrhosis were similar for patients with Child-Pugh class A, B and C disease.

CONCLUSIONS

Increased levels of lead were found in the blood of patients who consumed alcohol and those with alcoholic liver disease. Our data suggest that both blood and hepatic lead levels are not influenced by changes in liver function.