Alteration in bilirubin excretion in individuals chronically exposed to arsenic in Mexico.

We have studied hepatic function in individuals chronically exposed to arsenic (As) via drinking water in Region Lagunera, Mexico. We studied 51 individuals living in three villages exposed to As in water. Nazareno (0.014 mgAs/l), Santa Ana (0.1 mgAs/l) and Benito Juárez (0.3 mgAs/l). We determined the serum activity of aspartate aminotransferase (SAT) and alanine aminotransferase (ALT) as indicators of hepatocellular injury and that of gamma-glutamyl-transpeptidase (GGT) and alkaline phosphatase (ALP) as indicators of cholestasic injury. Serum bilirubin was used as an indicator of organic conjugated anion transport. Total proteins, albumin and globulin fraction in serum were used as indicators of biosynthetic liver capacity. The main findings of this study were the predominantly conjugated hyperbilirubinemia and increased serum ALP activity which were related to the concentration of total arsenic (TAs) in urine, suggesting the presence of cholestasis in As-exposed individuals. No significant changes were observed in the other parameters studied.