465 - Pediatric Sub-clinical Lead Exposure is Associated with Altered Inflammatory Landscape in Peripheral Blood

Publication Number: 465.6512

Carmen M. Dickinson-Copeland, Morehouse School of Medicine, Atlanta, GA, United States; Muhammed Yassin. Idris, Morehouse School of Medicine, Atlanta, GA, United States; Jabril Johnson, Morehouse School of Medicine, SMYRNA, GA, United States

Background: Blood lead levels (BLL) in children have been linked to early cardiovascular risk, potentially through inflammatory pathways. Although cardiovascular disease is rare in childhood, lead exposure may increase vulnerability, setting a foundation for later health complications. Complete blood counts (CBCs) have historically served as a valuable biomarker for cardiovascular disease. To date, platelet-to-lymphocyte ratio (PLR) has emerged as a potential biomarker that has been associated with systemic inflammation, which can be used to screen for cardiovascular disease risk.

Objective: This abstract explores the relationship between BLL, CBCs, specifically PLR, in children, highlighting PLR's potential as an early indicator of lead-induced cardiovascular risk.

Design/Methods: A retrospective pediatric cohort of 1,108 children from Children’s Healthcare of Atlanta was curated, including demographics, socioeconomic variables, BLLs, and hematological measures as routinely collected in a complete blood count. Multiple linear regression models were applied to assess associations between BLLs and these outcomes, adjusting for potential confounding variables.

Results: Clinical BLLs were significantly associated with PLR, but not sub-clinical BLLs. However, sub-clinical BLLs were correlated with reductions in White Blood Cell Count (WBC) (p < 0.05), Red Blood Cell Count (RBC) (p < 0.05), Hematocrit (HCT) (p < 0.01), MPV (p < 0.01), Monocyte Count (p < 0.01), Basophil Count (p < 0.01), and Absolute Count (p < 0.01), suggesting that even lower levels of lead exposure may also substantially influence these blood parameters.

Conclusion(s): Interestingly, despite the role of housing stock in developing a proinflammatory peripheral blood profile, socioeconomic factors such as poverty and educational attainment had minimal effects on blood lead measures. Our study reveals that BLL exposure significantly decreases RBC, indicating potential adverse effects on immune and oxygen-carrying capacity, even at lower lead exposure levels, which is consistent throughout the literature. However, we report sub-clinical BLLs are associated with decreased WBC despite lead exposure being associated with increased inflammatory responses. Lastly, we show that PLR is significantly associated with elevated but not sub-clinical BLLs. In summary, elevated BLLs are linked to altered inflammatory biomarkers in children, with the PLR emerging as a potential early indicator of cardiovascular disease risk. Monitoring PLR in lead-exposed children may aid in early detection and preventive care, reducing long-term health impacts.