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Abstract

Background Lead exposure disrupts the heme synthesis pathway by modifying the activity of Delta-Aminolevulinic Acid Dehydratase (ALAD), contributing to oxidative stress. Vitamin D has been suggested as an antioxidant to influence oxidative balance, but evidence regarding its association with ALAD activity in lead-exposed populations remains limited. This study aimed to analyze the associations between blood lead levels (BLL), serum 25-hydroxyvitamin D [25(OH)D], ALAD activity, and the 25(OH)D/BLL ratio among Indonesian male workers.

Methods A cross-sectional study was conducted among 90 male workers exposed to lead as part of either their occupation or living environment in Java, Indonesia. Serum 25(OH)D, BLL and ALAD activity were measured in the laboratory setting using ECLIA, ICP-MS, and spectrophotometry, respectively. Spearman correlation analysis was used.

Results The median age was 39 years (21-63). Median serum 25(OH)D was 22 ng/mL (8-52), median BLL was 6.8 µg/dL (2.8-58.8), and median ALAD activity was 22.3 unit/mL PRBCs (3.6-38.8). No significant association was observed between 25(OH)D and ALAD activity (r=-0.18, p=0.082). However, a significant negative correlation was found between BLL and ALAD activity (r=-0.39, p<0.001), and a positive correlation between 25(OH)D/BLL ratio and ALAD activity (r=0.28, p=0.007).

Discussion This finding highlights the potential importance of considering vitamin D status in relation to lead burden when interpreting ALAD activity among lead-exposed workers. Vitamin D status relative to lead burden may be relevant for understanding biological responses to lead exposure, although causal inferences cannot be drawn.

Conclusion Higher BLL was associated with lower ALAD activity, while a higher 25(OH)D/BLL ratio was associated with higher ALAD activity. It is necessary to conduct further investigation to determine its mechanism.

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