Turkish Journal of Medical Sciences
Abstract
Background/aim: Occupational lead (Pb) exposure remains a significant public health concern due to its persistent presence in industrial environments and its cumulative toxic effects. Although the hematological and neurological consequences of Pb exposure are well documented, early vascular effects and the mechanisms associated with potential endothelial impairment remain unclear. This study aimed to investigate the associations between Pb exposure, erythrocytic parameters, and nitric oxide (NO)–related metabolites (asymmetric dimethylarginine [ADMA], symmetric dimethylarginine [SDMA], arginine, homoarginine, and citrulline) to identify early biomarkers that may suggest impairment in NO-related pathways.
Materials and methods: This case-control study included a strictly selected cohort of 125 occupationally Pb-exposed workers and 125 healthy controls without known occupational exposure. To minimize confounding, all participants were strict nonsmokers and nondrinkers with no history of chronic disease. Blood Pb levels, hematological parameters, and metabolic biomarkers, including arginine, ADMA, SDMA, homoarginine, and citrulline, were analyzed using standardized laboratory methods. Associations between Pb levels, erythrocyte indices, and amino acid–related metabolites were evaluated using correlation analysis.
Results: Blood Pb concentrations were significantly higher in the Pb-exposed group. Pb-exposed individuals had significantly lower hemoglobin (Hb) levels. While ADMA levels did not differ significantly between groups, SDMA levels were higher and citrulline levels were lower in the exposed workers. Ferritin levels were lower, whereas transferrin and total iron-binding capacity levels were higher in the exposed group. In multivariable analyses adjusted for age and body mass index, blood Pb levels were associated with higher SDMA levels and lower Hb, citrulline, and ferritin levels.
Conclusion: Occupational Pb exposure was associated with alterations in erythrocytic indices and NO-related metabolic markers, which may be consistent with impairment in NO-related pathways. However, because of the case-control design and the absence of direct endothelial function measurements, these findings should be interpreted as associative rather than causal
Author ORCID Identifier
MELİH GÖZÜKARA: 0000-0002-6147-4053
SERVET İRİTAŞ: 0000-0001-5283-9973
DENİZ ÖZKAN VARDAR: 0000-0003-0976-9556
LÜTFİYE TUTKUN: 0000-0002-8333-7404
ÖZLEM İRİTAŞ: 0000-0001-7163-9926
SERDAR DENİZ: 0000-0002-6941-4813
VUGAR TÜRKSOY: 0000-0002-3545-3945
ENGİN TUTKUN: 0000-0003-2215-0424
DOI
10.55730/1300-0144.6364
Keywords
asymmetric dimethylarginine, erythrocyte indices, Lead exposure, nitric oxide metabolism, symmetric dimethylarginine
First Page
1198
Last Page
1207
Publisher
The Scientific and Technological Research Council of Türkiye (TÜBİTAK)
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
GÖZÜKARA, M. G, İRİTAŞ, S. B, ÖZKAN VARDAR, D, TUTKUN, L, İRİTAŞ, Ö, DENİZ, S, TÜRKSOY, V. A, & TUTKUN, E (2026). Association of occupational lead exposure with erythrocytic parameters and nitric oxide–related metabolites: a case-control study . Turkish Journal of Medical Sciences 56 (4): 1198-1207. https://doi.org/10.55730/1300-0144.6364