Indian Journal of Clinical Biochemistry

, Volume 27, Issue 3, pp 246–252 | Cite as

Evaluation of Low Blood Lead Levels and Its Association with Oxidative Stress in Pregnant Anemic Women: A Comparative Prospective Study

  • Amit Kumar Mani Tiwari
  • Abbas Ali MahdiEmail author
  • Fatima Zahra
  • Sudarshna Sharma
  • Mahendra Pal Singh Negi
Original Article


To correlate blood lead levels (BLLs) and oxidative stress parameters in pregnant anemic women. A total of 175 pregnant women were found suitable and included for this study. Following WHO criteria, 50 each were identified as non-anemic, mild anemic and moderate anemic and 25 were severe anemic. The age of all study subjects ranged from 24–41 years. At admission, BLLs and oxidative stress parameters were estimated as per standard protocols and subjected with ANOVA, Pearson correlation analysis and cluster analysis. Results showed significantly (p < 0.01) high BLLs, zinc protoporphyrin (ZPP), oxidized glutathione (GSSG), lipid peroxide (LPO) levels while low delta aminolevulinic acid dehydratase (δ-ALAD), iron (Fe), selenium (Se), zinc (Zn), haemoglobin (Hb), haematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), red blood cell (RBC) count, reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT) and total antioxidant capacity (TAC) in all groups of anemic pregnant women as compared with non anemic pregnant women. In all groups of pregnant women, BLLs showed significant (p < 0.01) and direct association with ZPP, GSSG and LPO while inverse relation with δ-ALAD, Fe, Se, Zn, Hb, Hct, MCV, MCH, MCHC, RBC, GSH, SOD, CAT and TAC. Study concluded that low BLLs perturb oxidant-antioxidant balance and negatively affected hematological parameters which may eventually Pb to Fe deficiency anemia during pregnancy.


Iron deficiency anemia Pregnancy δ-ALAD ZPP Oxidative stress Cluster analysis 


  1. 1.
    Caroline Ros B, Lillian M. Lead exposure, interactions and toxicity: food for thought. Asia Pacific J Clin Nutr. 2003;12:388–95.Google Scholar
  2. 2.
    Courtois E, Marques M, Barrientos A. Lead-induced down-regulation of soluble guanylate cyclase in isolated rat aortic segments mediated by reactive oxygen species and cyclo-oxygenase-2. J Am Soc Nephrol. 2003;14:1464–70.PubMedCrossRefGoogle Scholar
  3. 3.
    Ahamed M, Verma S, Kumar A, Siddiqui MKJ. Environmental exposure to lead and its correlation with biochemical indices in children. Sci Total Environ. 2005;346:48–55.PubMedCrossRefGoogle Scholar
  4. 4.
    Donaldson WE, Knowles SO. Is lead toxicosis a reflection of altered fatty acid composition of membrane? Comp Biochem Physiol C. 1993;104:377–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Leggett RW. An age specific kinetic model of lead metabolism in humans. Environ Health Perspect. 1993;101:598–616.PubMedCrossRefGoogle Scholar
  6. 6.
    Menke A, Muntner P, Batuman P, Silbergeld EK, Guallar E. Blood lead below 0.48 μg/dl (10 μg/dl) and mortality among US adults. Circulation. 2006;114:1388–94.PubMedCrossRefGoogle Scholar
  7. 7.
    Ong CN, Phoon WO, Law HY, Tye CY, Lim HH. Concentrations of lead in maternal blood, cord blood and breast milk. Arch Dis Child. 1985;60:756–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Roels H, Hubermont G, Buchet JP, Lauwerys R. Placental transfer of lead, mercury, cadmium, and carbon monoxide in women. III. Factors influencing the accumulation of heavy metals in the placenta and the relationship between metal concentration in the placenta and in maternal and cord blood. Environ Res. 1978;16:236–47.PubMedCrossRefGoogle Scholar
  9. 9.
    Foster WG. Reproductive toxicity of chronic lead exposure in the female cynomolgus monkey. Reprod Toxicol. 1992;6:123–31.PubMedCrossRefGoogle Scholar
  10. 10.
    Sierra EM, Tiffany-Castiglioni E. Effects of low-level lead exposure on hypothalamic hormones and serum progesterone levels in pregnant guinea pigs. Toxicology. 1992;72:89–97.PubMedCrossRefGoogle Scholar
  11. 11.
    Moser R, Oberley TD, Daggett DA, Friedman AL, Johnson JA, Siegel FL. Effects of lead administration on developing rat kidney. I. Glutathione S-transferase isoenzymes. Toxicol Appl Pharmacol. 1995;131:85–93.PubMedCrossRefGoogle Scholar
  12. 12.
    Corpas I, Gaspar I, Martinez S, Codesal J, Candelas S, Antonio MT. Testicular alterations in rats due to gestational and early lactational administration of lead. Reprod Toxicol. 1995;9:307–13.PubMedCrossRefGoogle Scholar
  13. 13.
    Buchheim K, Noack S, Stoltenburg G, Lilienthal H, Winneke G. Developmental delay of astrocytes in hippocampus of rhesus monkeys reflects the effect of pre and postnatal chronic low level lead exposure. Neurotoxicology. 1994;15:665–9.PubMedGoogle Scholar
  14. 14.
    Andrews KW, Savitz DA, Hertz-Picciotto I. Prenatal lead exposure in relation to gestational age and birth weight: a review of epidemiologic studies. Am J Ind Med. 1994;26:13–32.PubMedCrossRefGoogle Scholar
  15. 15.
    Bellinger D, Leviton A, Allred E, Rabinowitz M. Pre- and postnatal lead exposure and behavior problems in school-aged children. Environ Res. 1994;66:12–30.PubMedCrossRefGoogle Scholar
  16. 16.
    Rothenberg SJ, Poblano A, Garza-Morales S. Prenatal and perinatal low level lead exposure alters brainstem auditory evoked responses in infants. Neurotoxicology. 1994;15:695–9.PubMedGoogle Scholar
  17. 17.
    West WL, Knight EM, Edwards CH, Manning M, Spurlock B, James H, et al. Maternal low level lead and pregnancy outcomes. J Nutr. 1994;124(98):1S–6S.Google Scholar
  18. 18.
    Bogden JD, Kemp FW, Han S, Murphy M, Fraiman M, Czerniach D. Dietary calcium and lead interact to modify maternal blood pressure, erythropoiesis, and fetal and neonatal growth in rats during pregnancy and lactation. J Nutr. 1995;125:990–1002.PubMedGoogle Scholar
  19. 19.
    Kristensen P, Eilertsen E, Einarsdottir E, Haugen A, Skaug V, Ovrebo S. Fertility in mice after prenatal exposure to benzo[a]pyrene and inorganic lead. Environ Health Perspect. 1995;103:588–90.PubMedCrossRefGoogle Scholar
  20. 20.
    Mahaffey KR. Environmental lead toxicity: nutritional as a component of intervention. Environ Health Perspect. 1990;89:75–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Kwong WT, Friello P, Semba RD. Interactions between iron deficiency and lead poisoning: epidemiology and pathogenesis. Sci Total Environ. 2004;330:21–37.PubMedCrossRefGoogle Scholar
  22. 22.
    Conrad ME. Newly identified iron-binding protein in human duodenal mucosa. Blood. 1992;79:244–7.PubMedGoogle Scholar
  23. 23.
    World Health Organization (WHO)/United Nations Children’s Fund/United Nations University. Iron deficiency: indicators for assessment and strategies for prevention. Geneva: WHO, 1998.Google Scholar
  24. 24.
    International Nutritional Anemia Consultative Group. Measurements of iron status. Washington: INACG; 1985.Google Scholar
  25. 25.
    Kaneko JJ, editor. Clinical biochemistry of domestic animals. 4th ed. New York: Academic; 1999.Google Scholar
  26. 26.
    Berlin A, Schaller KH. European standardized method for the determination of aminolevulinic acid dehydratase activity a blood. Zeitseh Klin Chem Klin Biochim. 1974;12:389–90.Google Scholar
  27. 27.
    Blumberg WE, Eisinger J, Lamola AA, Zuckeman DM. The hematofluorometer. Clin Chem. 1977;23:270–4.PubMedGoogle Scholar
  28. 28.
    Ellman GL. Tissue sulfhydryl groups. Arch Biochem. 1959;82:70–7.PubMedCrossRefGoogle Scholar
  29. 29.
    Ohkawa H, Oshiba N, Yagi K. Assay of lipid peroxides in animal tissue by thiobarbituric acid reaction. Anat Biochem. 1979;95:351–8.CrossRefGoogle Scholar
  30. 30.
    Aebi H. Catalase in vitro. Methods Enzymol. 1984;105:121–6.PubMedCrossRefGoogle Scholar
  31. 31.
    Mc Cord JM, Fridovich I. Superoxide dismutase: an enzyme functions for erythrocuprin. J Biol Chem. 1969;244:6049–55.Google Scholar
  32. 32.
    Lowry OH, Rosenbrough NJ, Farr AL, Randell RJ. Protein measurement with folin–phenol reagent. J Biol Chem. 1951;193:265–75.PubMedGoogle Scholar
  33. 33.
    Bernin Iris FF, Stain JJ. Ferric reducing ability of plasma [FRAP] as a measure of antioxidant power, The FRAP Assay. Anal Biochem. 1996;239:70–6.CrossRefGoogle Scholar
  34. 34.
    Austrin KH, Bishap DF, Wetmur JG, Kaul BC, Davidow B, Desnick RJ. Aminolevulinic acid dehydratase isozymes and lead toxicity. Ann NY Acad Sci. 1987;514:23–9.CrossRefGoogle Scholar
  35. 35.
    Sakai T, Morita Y. Delta-aminolevulinic acid in plasma or whole blood as a sensitive indicator of lead effects, and its relation to the other heme-related parameters. Int Arch Occup Environ Health. 1996;68:126–32.PubMedGoogle Scholar
  36. 36.
    Marcus AH, Schwartz J. Dose-response curves for erythrocyte porphyrin vs. blood lead: effects of iron status. Environ Res. 1987;44:221–7.PubMedCrossRefGoogle Scholar
  37. 37.
    Onalaja VO, Claudio L. Genetic susceptibility to lead poisoning. Environ Health Perspect. 2000;108:23–8.PubMedGoogle Scholar
  38. 38.
    Gurer-Orhan H, Sabir HU, Ozgunes H. Correlation between clinical indicator of lead poisoning and oxidative stress parameters in controls and lead exposed workers. Toxicology. 2004;195:147–54.PubMedCrossRefGoogle Scholar
  39. 39.
    Bechara EJH. Lead poisoning and oxidative stress. Institute of de Quimica, Universidade de Sao Paulo, Brazil. SFRR’s 12th biennial meeting progamme and abstracts, 5–9 May 2004, Crown Plaza, Panamericano Hotel, Buenos Aires, Argentina, S9–46, vol. 36. Free Radic Biol Med; 2004.Google Scholar
  40. 40.
    Kasperczyk S, Birkner E, Kasperczyk A, Kasperczyk J. Lipids, lipid peroxidation and 7-ketocholesterol in workers exposed to lead. Hum Exp Toxicol. 2005;24:287–95.PubMedCrossRefGoogle Scholar
  41. 41.
    Ding Y, Gonick HC, Vaziri ND. Lead promotes hydroxyl radical generation and lipid peroxidation in cultured aortic endothelial cells. Am J Hypertens. 2000;13:552–5.PubMedCrossRefGoogle Scholar
  42. 42.
    Valenzuela A, Lefauconnicer JM, Chaudiere J, Bourre JM. Effects of lead acetate on cerebral glutathione peroxidase and catalase in the suckling rat. Neurotoxicology. 1989;10:63–9.PubMedGoogle Scholar
  43. 43.
    Ahamed M, Verma S, Kumar A, Siddiqui MKJ. Delta-aminolevulinic acid dehydratase inhibition and oxidative stress in relation to blood lead among urban adolescents. Hum Exp Toxicol. 2006;25:547–53.PubMedCrossRefGoogle Scholar
  44. 44.
    Patil AJ, Bhagwat VR, Patil JA, Dongre NN, Ambekar JG, Jailkhani R, Das KK. Effect of lead (Pb) exposure on the activity of superoxide dismutase and catalase in battery manufacturing workers (BMW) of Western Maharashtra (India) with Reference to Heme Biosynthesis. Int J Environ Res Public Health. 2006;3:329–37.PubMedCrossRefGoogle Scholar
  45. 45.
    Vargas H, Castillo C, Posadas F, Escalante B. Acute lead exposure induces renal heme oxygenase-1 and decreases urinary Na+ excretion. Hum Exp Toxicol. 2003;22:237–44.PubMedCrossRefGoogle Scholar

Copyright information

© Association of Clinical Biochemists of India 2012

Authors and Affiliations

  • Amit Kumar Mani Tiwari
    • 1
  • Abbas Ali Mahdi
    • 1
    Email author
  • Fatima Zahra
    • 2
  • Sudarshna Sharma
    • 3
  • Mahendra Pal Singh Negi
    • 4
  1. 1.National Referral Centre For Lead Poisoning, UP, Department of BiochemistryC.S.M. Medical UniversityLucknowIndia
  2. 2.Department of Obstetric & GynecologyELMC & HospitalLucknowIndia
  3. 3.Department of BiochemistryBundelkhand UniversityJhansiIndia
  4. 4.Institute for Data Computing and TrainingLucknowIndia

Personalised recommendations