High Blood Lead Levels: An Increased Risk for Development of Brain Hyperintensities among Type 2 Diabetes Mellitus Patie
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High Blood Lead Levels: An Increased Risk for Development of Brain Hyperintensities among Type 2 Diabetes Mellitus Patients Hafsa Suhail Najim Al-Anbari 1 & Dawser K. Ismail 1 & Mohammed Khudair Hasan 1 & Qutaiba Ahmed Al Khames Aga 2 Pottathil Shinu 3 & Anroop B. Nair 4
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Received: 30 June 2020 / Accepted: 25 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract The current study was aimed to ascertain the effect of blood lead level on brain tissues in patients with type 2 diabetes. A total of 300 human participants ages 27 to 60 years with type 2 diabetes (n = 150) and healthy individuals (n = 150) were included in this study. The serum samples were used for measuring HbA1c and fasting blood glucose. Blood lead level was measured using flame atomic absorption spectrophotometer. Magnetic resonance imaging sub-analysis was used to assess the brain hyperintensities. Brain hyperintensities were found in 55% of patients with diabetes and 6% of non-diabetic control group subjects. The deep white matter hyperintensities were observed in 45% of diabetic patients, while the subcortical hyperintensities were noted in 10% of cases. Entorhinal cortex changes (31%) and hippocampus changes (42%) were noted in diabetic patients with brain hyperintensities. Diabetic patients with brain hyperintensities showed higher blood lead levels, HbA1c, and fasting blood sugar (p < 0.0001) as compared with healthy volunteers. A higher correlation (R2 = 0.8922) was found between deep white matter hyperintensities’ size and blood lead levels. In nutshell, persistence of high blood lead level in diabetic patients may progress to brain hyperintensities which may consequently lead to cognitive, behavioral changes and Alzheimer’s disease. Keywords Lead toxicity . Diabetic patient . Hyperintensities . Brain . HbA1c
Introduction Diabetes mellitus is a chronic metabolic disorder of multiple etiology which affects carbohydrate, fat, and protein metabolism due to a defect in either insulin production or its action or both [1]. Diabetes can be type 1 or type 2, and the causes are quite different as the first category is an autoimmune condition while type 2 is a progressive disease where the body becomes resistant to insulin [2]. In most severe forms of diabetes, patients may develop
* Qutaiba Ahmed Al Khames Aga [email protected] 1
Department of Pharmaceutical Sciences, Faculty of Pharmacy, Al Esraa University College, Baghdad 10069, Iraq
2
Department of Pharmaceutical Sciences, Faculty of Pharmacy, Philadelphia University, P.O. Box 1, Amman 19392, Jordan
3
Department of Biomedical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
4
Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
ketoacidosis and hyperglycemic hyperosmolar state, which may cause stupor and coma and may lead to death if not treated [3]. The other long-term complications of diabetes include both microvascular and macrovascu
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