中国维吾尔族、彝族人群VDR和HFE基因多态性分布

目的：研究不同民族的维生素D受体（VDR）基因多态性和血色素沉着症（HFE）基因突变的等位基因分布频率。方法：采用聚合酶链式反应（PCR）和Bsm I,Rsa I限制性酶切片段长度多态性（RFLP）方法，分析了206名维吾尔族人和142名彝族人的VDR基因Bsm I多态性和HFE基因C282Y突变及等位基因分布频率。结果：（1）VDR基因型分布：维吾尔族人群，bb基因型占42．0％，Bb基因型占45．4％，BB基因型占12．6％；彝族人群，bb基因型85．9％，Bb基因型占13．4％，BB基因型占0．7％。维吾尔族和彝族人群的VDR基因型分布存在非常显著性差异，维吾尔族人群的VDR B等位基因分布频率为35％，显著高于彝族人群的VDR B等位基因分布频率（7％）。（2）HFE基因型分布：维吾尔族人群中，正常基因型占97％，C282Y突变杂合子占3％，未检测到C282Y突变杂合和纯合基因型。维吾尔族和彝族人群的HFE基因型分布存在显著性差异，维吾尔族人群的HFE C282Y突变等位基因分布频率（1．5％）高于彝族人群的HFE C282Y突变等位基因分布频率（0％）。（3）ALAD基因型与VDR基因型间相关分析：维族人群上述两基因的基因型间未见明显相关，但是在彝族人群中，携带ALAD1－1基因型的个体更有可能携带VDR bb基因型（OR＝4．41，95％的可信限范围为0．60－28．22）。结论：维吾尔族人群的VDR基因Bsm I多态性等位基因和HFE基因C282Y突变等位基因分布频率与文献报道的高加索人群相近。彝族人群VDR基因Bsm I多态性等位基因和HFE基因C282Y突变等位基因分布频率与文献报道的亚洲人群相近。VDR和HFE基因在维吾尔族和彝族人群中的分布均存在明显的种族差异。彝族人群中发现ALAD基因型与VDR基因型间可能存在关联。     

维生素D受体基因Bsm1多态性与铅暴露儿童的血铅、锌原卟啉和体格发育指标的关系

在 476名严重环境铅暴露儿童中 ,研究了维生素D受体基因Bsm1位点多态性对血铅、锌原卟啉、头围、身高和体重等指标的影响。使用协方差分析校正了年龄、性别、父母文化程度和血铅等影响因素后 ,具有B等位基因儿童的头围明显大于bb基因型个体 (P =0 0 2 ) ;分层分析发现在高血铅组和男性组中Bsm1多态性明显影响头围 (P <0 0 5)。未发现Bsm1位点多态性对血铅、锌原卟啉、身高和体重的明显影响。结果表明 ,VDR基因Bsm1位点的遗传变异可修饰严重铅暴露条件下铅对儿童颅骨发育的影响。     

基因多态性与铅中毒关系的研究

就3种多态性基因是否会使某些个体对铅暴露的敏感性增强这一问题进行了讨论。这3种基因包括：δ-氨基酮戊酸脱氢酶（ALAD）基因，维生素D受体（VDR）基因和血色病基因。ALAD基因的多态性与人动物血液、骨骼和体内器官中的蓄积和分布有关。VDR基因能控制血清中的钙三醇含量，从而控制钙的吸收，并反过来影响骨骼中铅的蓄积。血色病基因可引起铁的过量蓄积而致病，也会影响到铅的吸收。     

基质γ-羧基谷氨酸蛋白和氨基乙酰丙酸脱水酶基因多态性与儿童血铅的关系

[目的]探讨基质γ-羧基谷氨酸蛋白(MGP)和氨基乙酰丙酸脱水酶(ALAD)基因多态性在儿童铅中毒发生过程中的作用。[方法]测定了345名6-12岁的中国汉族儿童的血铅水平;采用多聚酶链反应-限制性片段长度多态性法(PCR-RFLP)分析MGP和ALAD基因的多态性。[结果]在ALAD基因未发生变异的情况下,MGP基因变异导致血铅水平降低;携带ALAD1-2、ALAD2-2或MGP TT基因型儿童的血铅水平(2．32μmol/L)高于携带ALAD1-1和MGP CT、MGP CC基因型儿童(2．18μmol/L),差异有统计学意义(P=0．0091)。[结论]MGP和ALAD基因多态性可影响儿童铅中毒的易感性,ALAD1-2、ALAD2-2或MGP TT基因型可能是儿童铅中毒的易感基因型。     

ALAD基因多态性对铅的肾脏毒性易感性作用

目的探讨δ-氨基-γ-酮戊酸脱水酶(ALAD)基因多态性是否对铅肾脏毒性易感性产生影响。方法抽取某钢铁企业的142名男性铅接触炉前工作为研究对象,收集基本信息,采集外周静脉血,检测血铅及相关指标、肾功能指标(血清肌酐、肌酐清除率、血尿素氮、和氨基-乙酰-β-葡萄糖苷酶),同时采用实时定量-聚合酶链反应(RT-PCR)进行ALAD基因型测定,估计累积铅暴露,进行ALAD基因多态性与肾脏损害易感性分析。结果 142名铅接触工人中ALAD1-1基因型有120人(84.51%),ALAD1-2基因型有22人(15.49%),未发现ALAD2-2基因型。等位基因ALAD-1和ALAD-2的频率分别为92.25%和7.75%。ALAD1-2基因型组血铅水平和肌酐清除率分别高于ALAD1-1基因型组的个体,差异有统计学意义(均有P<0.05),ALAD1-2基因型组平均血清肌酐低于ALAD1-1基因型组,差异有统计学意义(P<0.05)。低累积铅暴露时,肌酐清除率随着暴露剂量的增加而升高;但高累积铅暴露时,肌酐清除率随着暴露剂量的增加而下降,而且ALAD1-2基因型个体随着暴露剂量的增加下降更为明显。结论在相同铅暴露情况下,ALAD1-2基因引起血铅升高,进而可能影响血清肌酐和肌酐清除率,而这种作用在累积铅暴露达到一定高的阈值时才显示出来,说明ALAD1-2基因多态性会增加铅慢性肾功能损害的易感性风险。     

δ-氨基乙酰丙酸脱水酶基因多态性对职业铅接触工人血铅和锌原卟啉的影响

[目的 ]研究δ 氨基乙酰丙酸脱水酶 (ALAD)基因多态性对职业铅接触工人血铅 (PbB)和锌原卟啉 (ZPP)的影响。 [方法 ]采集 170名上海市某蓄电池厂职业铅接触工人外周静脉血样 ,多聚酶链式反应 (PCR)和限制性内切酶 (MspⅠ )限制性片段长度多态性 (RFLP)方法进行ALAD基因分型分析 ,用PE 80 0型原子吸收分光光度计和ZPP 3 80 0型血液锌原卟啉测定仪分别测定PbB和ZPP含量 ,并分析其与基因型的关系。 [结果 ]①ALAD11纯合子基因型者有 15 4名 ,占90 5 9% ;ALAD12杂合子基因型者有 16名 ,占 9.41% ;未检出ALAD2 2纯合子基因型者 ;②ALAD1和ALAD2等位基因分布频率分别是 95 .2 9%和 4.71% ;③在同等外暴露条件下 ,ALAD12杂合子基因型组工人血铅水平 ( 1.0 4± 0 .48μmol/L)明显高于ALAD11纯合子基因型组工人血铅水平 ( 0 .78± 0 .3 4μmol/L) ,且差异有统计学意义 ;④ALAD12基因型工人锌原卟啉(ZPP)含量比ALAD11基因型者稍低 ,但差异没有统计学意义 ,前者为 ( 0 .42± 0 .2 4) μmol/L ,后者为 ( 0 .46± 0 .41) μmol/L。[结论 ]ALAD2等位基因频率与文献报道的亚洲人群的结果相近 ,符合Hardy Weinberg平衡 ,在同样职业铅暴露环境下 ,具有ALAD2等位基因的工人血铅水平增高 ,ALAD2等位基因可加重工人体内的铅     

δ-氨基-γ-酮戊酸脱水酶基因多态性与维吾尔族、汉族儿童铅中毒遗传易感性

目的探讨维吾尔族和汉族儿童δ-氨基-γ-酮戊酸脱水酶(ALAD)基因多态性及其与铅中毒遗传易感性的关系。方法PCR-RFLP方法对新疆乌鲁木齐市的维吾尔族443名和汉族469名儿童ALAD基因多态性进行分析。应用单因素和多因素分析探讨了维吾尔族和汉族儿童ALAD基因多态性与血铅水平的关系,及影响血铅水平的因素。结果在维吾尔族人群中,ALAD1和ALAD2等位基因频率分别为90.52%和9.48%;在汉族人群中,ALAD1和ALAD2等位基因频率分别为95.73%和4.27%;两者差异有统计学意义(P<0.01)。维族儿童血铅浓度为(55.86±2.23)μg/L,铅中毒流行率为23.25%;汉族儿童血铅浓度为(53.05±2.24)μg/L,铅中毒的流行率为23.31%,两民族血铅水平和铅中毒流行率之间均无统计学意义(P>0.05)。结论维吾尔族和汉族儿童ALAD基因多态性与血铅水平间无相关关系。     

δ-氨基-γ-酮戊酸脱水酶基因多态性与铅毒性的遗传易感性

δ-氨基-γ-酮戊酸脱水酶(ALAD)是参与血红素生物合成的关键酶之一,可催化两分子的δ-氨基-γ-酮戊酸(ALA)聚合成卟胆原(PBG)。有研究表明,AL4D基因多态性与铅中毒的易感性相关,分布存在种族差异,其等位基因AL4D1个体骨铅含量高,ALAD2个体血铅值较高。本文综述ALAD基因多态性与铅中毒易感性的研究进展。     

δ-氨基-γ-酮戊酸脱水酶基因多态性与铅毒性易感性的研究进展

环境铅污染对人类健康的损害仍然是严峻的公共卫生问题，以往的流行病学研究发现，机体的易感性可能是铅毒性作用的重要决定因素，δ-氨基-γ-酮戊酸脱水酶（ALAD）基因遗传多态性对铅毒性易感性是近年来研究的焦点。编码人类ALAD的基因位于染色体9q34，ALAD酶是亚铁血红素生物合成通路中的第2个关键酶，ALAD基因具有多态性。ALAD编码区第177位碱基处发现了G→C颠换，产生ALAD—1和ALAD-22个共显性等位基因，并且与铅毒性易感性有关。目前为止，由于对人群ALAD基因多态性尚未有效检测，尚没有确切的证据证明在环境暴露水平上，ALAD基因型与铅毒性有关。     

铅神经毒性相关基因多态性的研究进展

长期铅暴露可对人体多个器官和系统造成损伤,其神经毒性效应尤为突出。在相同的铅暴露水平下,因遗传易感性的个体差异,不同人群的铅中毒损伤程度和临床症状不尽相同。该差异可能与δ-氨基乙酰丙酸脱水酶(Deltaaminolevulinic acid dehydratase,ALAD)、维生素D受体(Vitamin D receptor,VDR)、N-甲基D-天冬氨酸受体(N-methyl-Daspartate receptor,NMDAR)及多巴胺受体D2(Dopamine receptor D2,DRD2)等基因多态性有关。该文回顾近年来国内外铅神经毒性相关基因多态性的研究,对铅的神经毒性、相关基因多态性与铅神经毒性的关系进行综述。     

δ-氨基乙酰丙酸脱水酶基因多态性与血铅和锌原卟啉的关系

目的　探讨δ 氨基乙酰丙酸脱水酶 (ALAD)基因多态性与血铅和锌原卟啉之间的关系。方法　采样分析 370名严重铅污染区儿童的血铅、锌原卟啉和ALAD基因型。结果　ALAD1 2 / 2 2 基因型的血铅水平 (2 6 2 1± 0 5 6 1) μmol/L高于ALAD1 1基因型 (2 36 0± 0 5 96 ) μmol/L ;而锌原卟啉水平也增高 ,前者 (13 0 7± 9 38) μmol/L ,后者 (9 90± 6 30 ) μmol/L。 结论　在同样的高铅暴露条件下 ,ALAD1 2 / 2 2 基因型可影响儿童体内铅负荷水平以及铅所致血液毒性效应     

Interaction of blood lead and delta-aminolevulinic acid dehydratase genotype on markers of heme synthesis and sperm production in lead smelter workers.

The gene that encodes gamma-aminolevulinic acid dehydratase (ALAD) has a polymorphism that may modify lead toxicokinetics and ultimately influence individual susceptibility to lead poisoning. To evaluate the effect of the ALAD polymorphism on lead-mediated outcomes, a cross-sectional study of male employees from a lead-zinc smelter compared associations between blood lead concentration and markers of heme synthesis and semen quality with respect to ALAD genotype. Male employees were recruited via postal questionnaire to donate blood and urine for analysis of blood lead, zinc protoporphyrin (ZPP), urinary coproporphyrin (CPU), and ALAD genotype, and semen samples for semen analysis. Of the 134 workers who had ALAD genotypes completed, 114 (85%) were ALAD1-1 (ALAD1) and 20 (15%) were ALAD1-2 (ALAD2). The mean blood lead concentrations for ALAD1 and ALAD2 were 23.1 and 28.4 microg/dl (p = 0.08), respectively. ZPP/heme ratios were higher in ALAD1 workers (68.6 vs. 57.8 micromol/ml; p = 0.14), and the slope of the blood lead ZPP linear relationship was greater for ALAD1 (2.83 vs. 1.50, p = 0.06). No linear relationship between CPU and blood lead concentration was observed for either ALAD1 or ALAD2. The associations of blood lead concentration with ZPP, CPU, sperm count, and sperm concentration were more evident in workers with the ALAD1 genotype and blood lead concentrations >/= 40 microg/dl. The ALAD genetic polymorphism appears to modify the association between blood lead concentration and ZPP. However, consistent modification of effects were not found for CPU, sperm count, or sperm concentration.     

Lead and delta-aminolevulinic acid dehydratase polymorphism: where does it lead? A meta-analysis

BACKGROUND: Lead poisoning affects many organs in the body. Lead inhibits delta-aminolevulinic acid dehydratase (ALAD), an enzyme with two co-dominantly expressed alleles, ALAD1 and ALAD2. OBJECTIVE: Our meta-analysis studied the effects of the ALAD polymorphism on a) blood and bone lead levels and b) indicators of target organ toxicity. DATA SOURCE: We included studies reporting one or more of the following by individuals with genotypes ALAD1-1 and ALAD1-2/2-2: blood lead level (BLL), tibia or trabecular lead level, zinc protoporphyrin (ZPP), hemoglobin, serum creatinine, blood urea nitrogen (BUN), dimercaptosuccinic acid-chelatable lead, or blood pressure. DATA EXTRACTION: Sample sizes, means, and standard deviations were extracted for the genotype groups. DATA SYNTHESIS: There was a statistically significant association between ALAD2 carriers and higher BLL in lead-exposed workers (weighted mean differences of 1.93 microg/dL). There was no association with ALAD carrier status among environmentally exposed adults with BLLs < 10 microg/dL. ALAD2 carriers were potentially protected against adverse hemapoietic effects (ZPP and hemoglobin levels), perhaps because of decreased lead bioavailability to heme pathway enzymes. CONCLUSION: Carriers of the ALAD2 allele had higher BLLs than those who were ALAD1 homozygous and higher hemoglobin and lower ZPP, and the latter seems to be inversely related to BLL. Effects on other organs were not well delineated, partly because of the small number of subjects studied and potential modifications caused by other proteins in target tissues or by other polymorphic genes.     

Associations of blood lead, dimercaptosuccinic acid-chelatable lead, and tibia lead with polymorphisms in the vitamin D receptor and [delta]-aminolevulinic acid dehydratase genes

A cross-sectional study was performed to evaluate the influence of polymorphisms in the [delta]-aminolevulinic acid dehydratase (ALAD) and vitamin D receptor (VDR) genes on blood lead, tibia lead, and dimercaptosuccinic acid (DMSA)-chelatable lead levels in 798 lead workers and 135 controls without occupational lead exposure in the Republic of Korea. Tibia lead was assessed with a 30-min measurement by (109)Cd-induced K-shell X-ray fluorescence, and DMSA-chelatable lead was estimated as 4-hr urinary lead excretion after oral administration of 10 mg/kg DMSA. The primary goals of the analysis were to examine blood lead, tibia lead, and DMSA-chelatable lead levels by ALAD and VDR genotypes, controlling for covariates; and to evaluate whether ALAD and VDR genotype modified relations among the different lead biomarkers. There was a wide range of blood lead (4-86 microg/dL), tibia lead (-7-338 microg Pb/g bone mineral), and DMSA-chelatable lead (4.8-2,103 microg) levels among lead workers. Among lead workers, 9.9% (n = 79) were heterozygous for the ALAD(2) allele and there were no homozygotes. For VDR, 10.7% (n = 85) had the Bb genotype, and 0.5% (n = 4) had the BB genotype. Although the ALAD and VDR genes are located on different chromosomes, lead workers homozygous for the ALAD(1) allele were much less likely to have the VDR bb genotype (crude odds ratio = 0.29, 95% exact confidence interval = 0.06-0.91). In adjusted analyses, subjects with the ALAD(2) allele had higher blood lead levels (on average, 2.9 microg/dL, p = 0.07) but no difference in tibia lead levels compared with subjects without the allele. In adjusted analyses, lead workers with the VDR B allele had significantly (p < 0.05) higher blood lead levels (on average, 4.2 microg/dL), chelatable lead levels (on average, 37.3 microg), and tibia lead levels (on average, 6.4 microg/g) than did workers with the VDR bb genotype. The current data confirm past observations that the ALAD gene modifies the toxicokinetics of lead and also provides new evidence that the VDR gene does so as well.     

Amyotrophic lateral sclerosis,lead, and genetic susceptibility: polymorphisms in the delta-aminolevulinic acid dehydratase and vitamin D receptor genes

Previous studies have suggested that lead exposure may be associated with increased risk of amyotrophic lateral sclerosis (ALS). Polymorphisms in the genes for delta-aminolevulinic acid dehydratase (ALAD) and the vitamin D receptor (VDR) may affect susceptibility to lead exposure. We used data from a case-control study conducted in New England from 1993 to 1996 to evaluate the relationship of ALS to polymorphisms in ALAD and VDR and the effect of these polymorphisms on the association of ALS with lead exposure. The ALAD 2 allele (177G to C; K59N) was associated with decreased lead levels in both patella and tibia, although not in blood, and with an imprecise increase in ALS risk [odds ratio (OR) = 1.9; 95% confidence interval (95% CI), 0.60-6.3]. We found a previously unreported polymorphism in ALAD at an Msp1 site in intron 2 (IVS2+299G>A) that was associated with decreased bone lead levels and with an imprecise decrease in ALS risk (OR = 0.35; 95% CI, 0.10-1.2). The VDR B allele was not associated with lead levels or ALS risk. Our ability to observe effects of genotype on associations of ALS with occupational exposure to lead or with blood or bone lead levels was limited. These findings suggest that genetic susceptibility conferred by polymorphisms in ALAD may affect ALS risk, possibly through a mechanism related to internal lead exposure.     

Associations of blood pressure and hypertension with lead dose measures and polymorphisms in the vitamin D receptor and delta-aminolevulinic acid dehydratase genes

Evidence suggests that lead and selected genes known to modify the toxicokinetics of lead--namely, those for the vitamin D receptor (VDR) and delta-aminolevulinic acid dehydratase (ALAD)--may independently influence blood pressure and hypertension risk. We report the relations among ALAD and VDR genotypes, three lead dose measures, and blood pressure and hypertension status in 798 Korean lead workers and 135 controls without occupational exposure to lead. Lead dose was assessed by blood lead, tibia lead measured by X-ray fluorescence, and dimercaptosuccinic acid (DMSA)-chelatable lead. Among lead workers, 9.9% (n = 79) were heterozygous for the ALAD(2) allele, and there were no ALAD(2) homozygotes; 11.2% (n = 89) had at least one copy of the VDR B allele, and 0.5% (n = 4) had the BB genotype. In linear regression models to control for covariates, VDR genotype (BB and Bb vs. bb), blood lead, tibia lead, and DMSA-chelatable lead were all positive predictors of systolic blood pressure. On average, lead workers with the VDR B allele, mainly heterozygotes, had systolic blood pressures that were 2.7-3.7 mm Hg higher than did workers with the bb genotype. VDR genotype was also associated with diastolic blood pressure; on average, lead workers with the VDR B allele had diastolic blood pressures that were 1.9-2.5 mm Hg higher than did lead workers with the VDR bb genotype (p = 0.04). VDR genotype modified the relation of age with systolic blood pressure; compared to lead workers with the VDR bb genotype, workers with the VDR B allele had larger elevations in blood pressure with increasing age. Lead workers with the VDR B allele also had a higher prevalence of hypertension compared to lead workers with the bb genotype [adjusted odds ratio (95% confidence interval) = 2.1 (1.0, 4.4), p = 0.05]. None of the lead biomarkers was associated with diastolic blood pressure, and tibia lead was the only lead dose measure that was a significant predictor of hypertension status. In contrast to VDR, ALAD genotype was not associated with the blood pressure measures and did not modify associations of the lead dose measures with any of the blood pressure measures. To our knowledge, these are the first data to suggest that the common genetic polymorphism in the VDR is associated with blood pressure and hypertension risk. We speculate that the BsmI polymorphism may be in linkage disequilibrium with another functional variant at the VDR locus or with a nearby gene.     

δ-Aminolevulinic acid dehydratase activity,urinary δ-aminolevulinic acid concentration and zinc protoporphyrin level among people with low level of lead exposure

To evaluate the relationship of δ-aminolevulinic acid dehydratase (ALAD) activity, urinary δ-aminolevulinic acid (ALAU) level and blood zinc protoporphyrin (ZPP) concentration to low blood lead (PbB) levels, these biomarkers were determined for all subjects enrolled from a rural area of southeast China where people had low levels of exposure to lead. The mean values of PbB, ALAD, ALAU and ZPP were 67.11 μg/L (SD: 1.654, range: 10.90-514.04), 339.66 nmol ml⁻¹ h⁻¹ (1.419, 78.33-793.13), 20.64 μg/L (1.603, 2.00-326.00), and 0.14 μmol/L (3.437, 0.01-2.26), respectively. ALAD was inversely associated with low levels of PbB. ZPP was inversely related to low levels of PbB but positively related to relatively higher levels of PbB. Alcohol drinking contributed to low ALAD in men. Women had higher ZPP than men. ALAU had no significant association with PbB. In conclusion, ALAD possibly has a non-linear relation with low to moderate levels of PbB. At moderate levels of PbB, ZPP increases with increasing levels of PbB. ALAU is not suitable as an indicator for low levels of lead exposure.     

Associations of lead biomarkers and delta-aminolevulinic acid dehydratase and vitamin D receptor genotypes with hematopoietic outcomes in Korean lead workers.

OBJECTIVES: This study compares and contrasts associations of dimercaptosuccinic acid (DMSA)-chelatable lead, tibia lead, and blood lead with five hematopoietic outcomes and evaluates the effect modification of these relations by polymorphisms in the delta-aminolevulinic acid dehydratase (ALAD) and vitamin D receptor (VDR) genes. METHODS: A cross-sectional study of 798 lead workers and 135 unexposed referents was performed. RESULTS: The DMSA-chelatable lead, tibia lead, and blood lead levels ranged in the lead (Pb) workers from 4.8 to 2103 g, -7 to 338 g Pb/g bone mineral, and 4 to 86 g/dl, respectively. The mean of the hemoglobin, hematocrit, zinc protoporphyrin (ZPP), and urinary (ALAU) and plasma (ALAP) delta-aminolevulinic acid levels of the lead workers were 14.2 (SD 1.4) g/dl, 42.4 (SD 4.4)%, 80.2 (SD 63.5) g/dl, 2.1 (SD 3.7) mg/l, and 17.7 (20.6) g/ml, respectively. After adjustment for the covariates, tibia lead was associated with all five hematopoietic outcomes, while blood lead and DMSA-chelatable lead were associated only with ZPP, ALAP, and ALAU. A comparison of the regression coefficients, total model adjusted R2 values, and delta R2 values revealed that blood lead was the best predictor of ZPP, ALAP, and ALAU. Only tibia lead was significantly associated with hemoglobin and hematocrit levels, but the additional variance explained by tibia lead was (<1%). No clear effect modification of the relations between the lead biomarkers and hematopoietic outcomes studied was caused by ALAD or VDR genotype. CONCLUSIONS: Lead must have a chronic, cumulative effect on hemoglobin and hematocrit levels, and any speculated mechanism cannot merely involve short-term plasma or target organ lead levels.     

Effect modification by delta-aminolevulinic acid dehydratase, vitamin D receptor, and nitric oxide synthase gene polymorphisms on associations between patella lead and renal function in lead workers

Genetic polymorphisms that affect lead toxicokinetics or toxicodynamics may be important modifiers of risk for adverse outcomes in lead-exposed populations. We recently reported associations between higher patella lead, which is hypothesized to represent a lead pool that is both bioavailable and cumulative, and adverse renal outcomes in current and former Korean lead workers. In the present study, we assessed effect modification by polymorphisms in the genes encoding for delta-aminolevulinic acid dehydratase (ALAD), the vitamin D receptor (VDR), and endothelial nitric oxide synthase on those associations. Similar analyses were conducted with three other lead biomarkers. Renal function was assessed via blood urea nitrogen, serum creatinine, measured and calculated creatinine clearances, urinary N-acetyl-beta-D-glucosaminidase, and retinol-binding protein. Mean (SD) blood, patella, tibia, and dimercaptosuccinic acid-chelatable lead values were 30.9 (16.7) microg/dl, 75.1 (101.1)and 33.6 (43.4) microg Pb/g bone mineral, and 0.63 (0.75) microg Pb/mg creatinine, respectively, in 647 lead workers. Little evidence of effect modification by genotype on associations between patella lead and renal outcomes was observed. The VDR polymorphism did modify associations between the other lead biomarkers and the serum creatinine and calculated creatinine clearance. Higher lead dose was associated with worse renal function in participants with the variant B allele. Models in two groups, dichotomized by median age, showed that this effect was present in the younger half of the population. Limited evidence of effect modification by ALAD genotype was observed; higher blood lead levels were associated with higher calculated creatinine clearance among participants with the ALAD(1-2) genotype. In conclusion, VDR and/or ALAD genotypes modified associations between all the lead biomarkers, except patella lead, and the renal outcomes.