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Jintana Sirivarasai, Ph.D
Division of Clinical Pharmacology and Toxicology
Department of Medicine
Faculty of Medicine Ramathibodi Hospital
December 14, 2012
EGAT 1/5 : 2012
• Lead (Pb)
• Cadmium (Cd)
• Mercury (Hg)
MMSE Test
• Orientation for time (total score : 5)
• Orientation for place (total score : 5)
• Registration (total score : 3)
• Attention/calculation (total score : 5)
• Recall (total score : 3)
•Naming (total score : 2)
•Repetition (total score : 1)
• Verbal command (total score : 3)
•Written command (total score : 1)
• Writing (total score : 1) •Visuoconstrution (total score : 1)
Inductively coupled plasma mass spectrometry (ICP-MS)
First study of heavy metals (Cd, Pb, and Hg with ICPMS) and cognitive function in Thai elderly population
Mercury (Hg)
Results
• Preliminary data : Limitation of data verifications
• Study population : 1609 cases, Male 72.4%
• Mean of age = 68.74 yr (60-82)
60-69 years 70-79 years > 79
Blood Hg (ug/L) 6.02 4.89 4.44
Blood Pb (ug/L) 3.28 3.37 4.01
Blood Cd (ug/L) 0.58 0.55 0.59
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
5.5
6
6.5
Fig 1. Means of blood Hg, Pb, and Cd levels classified by 3 age groups
Fig 2. Association between blood Hg and age
Fig 3. Association between MMSE score and age
Fig 4. Blood Hg and amalgam filling
Mercury concentrations in the occipital cortex vs. number of
amalgam fillings.
Nylander M, Friberg L, Lind B, & Kullman L: Mercury in the central nervous system correlated to dental amalgam fillings, Lakartidningen 1986 Feb 12;83(7):519-22
Fig 5. Blood Hg in each quartile and MMSE score
< 1 time/month(n=740)
1-2 day/wk(n=505)
3-4 days/wk(n=112)
> 4 days/wk (n=68)
Blood Hg (ug/L) 4.87 5.97 6.67 7.25
MMSE Score 28.61 28.77 28.27 28.56
0
5
10
15
20
25
30
35
Very low fat fish
MMSE score and blood Hg
Fig 6. Blood Hg and MMSE score, classified by very low fat-fish intake
< 1 time/month(n=644)
1-2 day/wk(n=601)
3-4 days/wk(n=137)
> 4 days/wk(n=81)
Blood Hg (ug/L) 5.11 5.64 6.1 6.55
MMSE Score 28.63 28.74 28.33 28.44
0
5
10
15
20
25
30
35
Low fat fish
Fig 7. Blood Hg and MMSE score, classified by low fat-fish intake
Fig 8. Association between blood Hg and serum Se levels
113
114
115
116
117
118
119
120
121
60-69 years 70-79 years > 79 years
Serum Se (ug/L)
0
1
2
3
4
5
6
7
60-69 years 70-79 years > 79 years
Blood Hg (ug/L)
Fig 9. Blood Hg and serum Se levels , classified by 3 age groups
Food rich in selenium
New published Paper
• Results from EGAT 2/1 and 2/3
Acknowledgement
• การไฟฟ้าฝ่ายผลิตแห่งประเทศไทย • คณะแพทยศาสตร์โรงพยาบาลรามาธิบดี มหาวทิยาลัยมหิดล • แหล่งทุนสนับสนุนโครงการวจัิยฯ. • ศาสตราจารย์ปิยะมิตร ศรีธรา • อาจารย์ นายแพทย์ปริญญ์ วาทีสาธกกิจ • เจ้าหน้าท่ีทีมท างานท้ังหมดในการเก็บข้อมูลและเก็บตัวอย่างเลือด
Jintana Sirivarasai, Ph.D
Division of Clinical Pharmacology and Toxicology
Department of Medicine
Faculty of Medicine Ramathibodi Hospital