The new population study, after adjustments for population characteristics, people with the highest blood levels of lead had a threefold risk of gout compared to those with the lowest levels. "This study documents that low-level exposure to lead... as it occurs in the general population is associated with a significantly elevated presence of gout. These data suggest that there is no such thing as a 'safe' level of exposure to lead. Further refinement in national goals for prevention, detection, and removal of lead from the environment should be pursued," wrote study authors.
However, current standards for acceptable lead exposure do not reflect the actual threshold for harm. Authors cited recent studies showing the blood lead levels under a certain amount are associated with progression of chronic kidney disease and with cardiovascular mortality. The association between lead and gout and hyperuricema is a controversial issue for lower levels of lead exposure. Population based studies have had conflicting results.
Co-author Eswar Krishnan, MD, of Stanford University, and colleagues studied whether current accepted standards for lead exposure have an association with gout. Mercury and cadmium were also included in the study. Data for the study was taken from the 2005 to 2006 and the 2007 to 2008 National Health and Nutrition Examination Survey. Researchers limited the study to adults 40 to 85 with information on serum creatinine, blood levels of heavy metals, and serum urate concentrations. Participants who had a history of renal problems or dialysis were excluded. The final number of participants was 6,153 with an even distribution between men and women.
Of the 6,153 participants, 290 had gout, 229 of the cases were men. The subgroup with gout was older and had kidney ailments.
Author of an accompanying editorial, Ashwini R. Seghal, MD, of Case Western Reserve University in Cleveland said, "Lower thresholds for toxic lead levels are desirable and feasible. Lead and its myriad uses will remain an integral part of our external environment. However, both children and adults deserve an internal environment that is as unleaded as was our evolutionary past."
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