(SLB-043) Assessment of Neurotoxicity, Cardiovascular Risk Associated with Arsenic Exposure in Endemic Areas of Bihar, India.

Background: Exposure to inorganic arsenic is a major global health concern, as it has been linked to diseases such as cancer, cognitive impairment, and cardiovascular diseases, among others, leading to low quality of life. ⁣⁣⁣

Objectives: This study evaluates neurotoxicity and cardiovascular risk associated with inorganic arsenic exposure in the Gangetic region of Bihar.

Methods: A cross-sectional study using a clustered sampling method was carried out to recruit participants from the arsenic endemic zones of the Buxar, Bhojpur, and Nalanda districts of Bihar. The arsenic analysis was done using inductively coupled mass spectrometry. The Montreal Cognitive Assessment Scale (MOCA) and the World Health Organisation (WHO) Cardiovascular Risk (CVD) calculator with lab parameters were used for the assessments of mild cognitive impairment and 10 years of cardiovascular risk. Acetylcholinesterase, butyrylcholinesterase, and alpha-synuclein biomarkers were used for neurotoxicity assessment, respectively. The continuous variables are mentioned in mean + SD. Welch’s T-test was used to compare continuous variables among arsenic-exposed and non-exposed groups.

Results: N= 79 patients with an age of 44.16 + 13.7 (mean + SD) were recruited into the study, among whom 49.4% (n = 39) are female and 50.6% (n = 40) are male participants. A total of 27.8% (n=22) of the population were exposed to arsenic >200 PPB (p < 0.01). Arsenic species: arsenic-V in 13% (n=3), arsenic-III in 59% (n=13), MMA in 31% (n=7), and DMA was found in all (n=22) samples. The elevated serum AchE (p < 0.01), BchE (p < 0.01), and alpha-synuclein (p < 0.04) were observed in the arsenic-exposed group (>200 PPB). The low MOCA scores of 11.2 + 3.7 (mean + SD) in the arsenic-exposed group compared to the non-exposed group, 26.1 + 2.3 (p < 0.01), were observed. The total cholesterol (175 + 46 mg/dl) and LDL (92 + 25 mg/dl) levels were significantly high (p < 0.05) in the arsenic-exposed group compared to the non-exposed group TC (138 + 76 mg/dl) and LDL (70 + 22.9 mg/dl).

Conclusion: The study highlights the clinical and detrimental effects of increased CVD risk & neurotoxicity associated with long-term arsenic exposure. The elevated alpha-synuclein arsenic-exposed group suggests its potential as a biomarker to assess the arsenic neurotoxicity triage programmes. Furthermore, this may help in making policies regarding targeted and personalised treatment strategies in neurodegenerative disorders accordingly for individuals exposed to arsenic toxicity.