Effect of low level lead exposure on hyperuricemia and gout among middle aged and elderly men: The normative aging study

Objective. To determine whether longterm lead accumulation is associated wi th hyperuricemia and gouty arthritis among middle aged and elderly men. Methods. In a retrospective cohort study, 777 male participants were evalua ted between August 1991 and October 1996 in the Department of Veterans Affa irs Normative Aging Study, a 35 year longitudinal study of aging. We examin ed the development of gout and an increased uric acid level in relation to lead, adjusting for other known risk factors. Lead levels were measured in blood and by K x-ray fluorescence (K-XRF) technique in tibial (cortical) an d patellar (trabecular) bone. Results. Blood lead levels in this mostly Caucasian (97%) population were l ow (mean 5.9 mu g/dl, SD 3.5). Bone lead levels were comparable to those de scribed in other general populations. In a multivariate analysis adjusting for the risk factors, age, body mass index, diastolic blood pressure, alcoh ol intake, and serum creatinine level, there was a positive association bet ween patellar bone lead and uric acid levels (p = 0.02). Of 777 participant s, 52 (6.7%) had developed gouty arthritis. In logistic regression of simil ar covariates, body mass index (p < 0.0001) and serum creatinine level (p = 0.005) were the strongest determinants of gout; neither bone nor blood lea d levels predicted gout in this cohort. Conclusion. The longterm accumulation of lead is associated with an increas ed uric acid level in middle aged and elderly men. However, this study show s no association between lend and gouty arthritis at the levels arising fro m community exposure.