Decreased serum bilirubin levels in children with lead poisoning

OBJECTIVE: Lead is a toxic heavy metal, which causes irreversible damage in children. Oxidative stress is the underlying mechanism of lead toxicity, and monitoring oxidative stress of lead poisoning children in vivo is important. Our study aimed to investigate blood serum levels of biochemical parameters, including albumin, bilirubin, creatinine, and uric acid, which are regarded as non-enzymatic antioxidants, in children with lead poisoning. METHODS: We studied 355 children with lead poisoning and 355 age- and sex-matched controls. We analyzed clinical characteristics and measured serum levels of total protein, globulin, albumin, bilirubin, aspartate aminotransferase (AST), alanine aminotransferase, urea, and creatinine. RESULTS: We found that albumin, bilirubin, urea, and creatinine levels were significantly lower and AST, total protein, and globulin levels were higher in children with lead poisoning than in controls. Direct bilirubin, albumin, total protein, urea, creatinine, and AST levels were associated with lead poisoning after adjustment for other covariates. Spearman analysis showed that direct bilirubin, albumin, and urea levels were independent indicators (i.e., not related to hemoglobin or weight), while creatinine levels showed a moderate correlation with weight. CONCLUSION: Lead interferes with the non-enzymatic antioxidant system in children, and lead poisoning results in a decrease in serum bilirubin levels.