Correlation between lead exposure and clinical heterogeneity in patients with amyotrophic lateral sclerosis
10.3969/j.issn.1004-1648.2025.05.005
- VernacularTitle:铅暴露与肌萎缩侧索硬化患者临床异质性的相关性
- Author:
Wenxiu YU
1
;
Fangfang YU
;
Xiaochuan HUO
Author Information
1. 101118 首都医科大学附属北京安贞医院脑血管病科
- Publication Type:Journal Article
- Keywords:
amyotrophic lateral sclerosis;
lead exposure;
clinical heterogeneity;
neurodegenerative disease
- From:
Journal of Clinical Neurology
2025;38(5):334-338
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship between lead exposure and the clinical heterogeneity of amyotrophic lateral sclerosis(ALS).Methods Baseline data were collected from 49 ALS patients hospitalized at the PLA General Hospital.Blood metal levels(copper,zinc,calcium,magnesium,iron,lead)were measured by graphite furnace atomic absorption spectrometry.The Revised ALS Functional Rating Scale(ALSFRS-R)was used to assess the severity of motor function impairment.Patients were grouped by site of onset and ALSFRS-R score,then blood metal levels were compared between two groups.General linear regression,ROC curves and Logistic regression models were applied to analyze the correlation between blood lead levels and disease severity to identify risk factors affecting motor function in ALS patients,and analyze its predictive value.Results The differences of blood metal levels between bulbar onset patients and non-bulbar onset patients were no statistical significance(all P＞0.05).Blood lead levels were significantly lower in the high ALSFRS-R score group than in the low ALSFRS-R score group,and the difference was significant(P=0.02).Blood lead levels were negatively correlated with ALSFRS-R scores in ALS patients(Y=-0.1267X+45.86,R2=0.08937,P=0.04).The area under the ROC curve was 0.70,indicating that blood lead had predictive value for ALS severity.The Logistic regression model demonstrated that elevated blood lead level was an independent risk factor for the severity of ALS disease(OR=1.107,95％CI:1.006-1.219,P=0.04).Conclusions Blood lead levels in ALS patients correlated with disease severity and exhibited predictive utility.Elevated blood lead was an independent risk factor for the severity of motor function impairment in ALS.
