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