Association Between Chromium and Lead Exposure and Liver Injury Biomarkers Among Adults in Addis Ababa, Ethiopia

The objective of this study was to investigate the association between chromium (Cr) and lead (Pb) exposure and liver injury biomarkers in the adult population of Addis Ababa, Ethiopia. The study used cross-sectional design and collected urine and blood samples from 417 adult participants. Chromium (Cr) and Lead (Pb) levels in the urine were analyzed using Microwave Plasma-Atomic Emission Spectroscopy (MP-AES) while aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) in the serum were analyzed using COBAS 6000 automated clinical chemistry analyzer. The association between liver injury biomarkers and exposure to heavy metals was anlysed using multivariable binary logistic regression model. The findings indicate that Cr levels ranged from 12.8 to 476.7 µg/g creatinine (25th-95th percentile), while Pb levels varied from 9.5 to 80.4 µg/g creatinine (25th-95th percentile). Elevated levels of ALP, ALT and AST above the reference range were observed in 14.9%, 4.6% and 8.9% of the study participants, respectively. In addition, elevated level of AST showed a significant positive association with Cr exposure in the third and fourth quartiles showing higher odds ratio (of 5.12 and 8.83 respectively. Similarly, the elevated ALT levels were significantly associated with Pb in the third and fourth quartile (P < .05). However, there was no significant association between elevated levels of ALP and heavy metal exposure. This study observed a strong association between Cr and AST as well as between Pb and ALT. These findings highlight the potential health risks associated with heavy metal exposure and suggest the need for further investigation into the public health impacts and clinical implications of heavy metal risks in Addis Ababa city.