Lithium content in the population of the Aktobe region of the Republic of Kazakhstan and the relationship with mental illness: a cross-sectional study

The article presents data on the study of the content of lithium in the hair of the adult population of the Aktobe region of the Republic of Kazakhstan and the relationship with mental illness. The aim of the study is to assess the content of lithium in the biosubstrates of the adult population and its relationship with the morbidity of the population of the Aktobe region.
Materials and methods: A one-stage cross-sectional study was carried out on the territory of the Aktobe region of the Republic of Kazakhstan. The study included 340 residents aged 18-60 years permanently residing in the study area using the method of simple random sampling. The lithium content in hair was determined by inductively coupled plasma mass spectrometry on a NexION 300D spectrometer (PerkinElmer Inc., USA) equipped with an ESI SC-2 DX4 sampler (Elemental Scientific Inc., USA). The morbidity rates were studied according to the ICD-10 classes per 100 thousand population. To assess the relationship between the Li content in the hair and the morbidity rates, the Spearman rank correlation coefficient was calculated.
Results: According to the results of the study, significant deviations from the reference values were observed for the lithium content in the Aktobe region. There is an excess of lithium for 80.59% (CI: 76.38; 84.79) of the subjects, the norm is 19.41% (CI: 15.21; 23.62). Excess lithium is more common in men than in women (χ2  =11.07 df=1; p=0.001). Considering the districts of the Aktobe region, the highest content of Li (Me (q25-q75)) was found in the Aitekebi district (0.084 (0.022 -0.134)) mcg/g, in the Kobda district 0.069 (0.060- 0.076) mcg/g, in the Mugalzhar district 0.046 (0.019-0.066) mcg/g, in the Oiyl district 0.044 (0.021-0.0762) mcg/g, in the Alga district 0.040 (0.024-0.090) mcg/g. Spearman’s correlation rank analysis showed a weak positive association of Li content with age (r=0.20, p =0.0001), no association with body mass index was found (r=0.10, p =0.06). The correlation analysis established a direct inverse average relationship between the content of Li and morbidity in the class of diseases “Mental disorders and behavioral disorders” (r=-0.62; p= 0.044).
Conclusions: The high prevalence of excess lithium content in the hair of the population and its relationship with mental illness requires further research. The study of the bioelement status of the population can serve as an indicator of environmental pollution, and also aims at monitoring the ecological situation in the region.

1. Polyakov AV. Prospects for the development of the Aktobe region. Vestnik Kazahsko-Russkogo Mezhdunarodnogo universiteta. 2017; 4(21):202-207. (In Russ.).

2. Radilov AS, Kombarova MYu, Pavlova AA, Gorbunov AYu, Gulyaev DV, Karmanov EYu. Element content in hair of population living in the city of Armyansk (Crimea republik) during thr environmental emergency. Medicina ekstremal’nyh situacij. 2020; 22(1):53-59. (In Russ.).

3. Samojlov VI. Natural mineralized waters as an important industrial source of lithium and methods of their halurgical processing. Gornyj informacionno-analiticheskij byulleten’ (nauchno-tekhnicheskij zhurnal). 2006; 6:70-76. (In Russ.).

4. Sataeva LG, Kareva NN, Garankina RYu. Dynamics of regional incidence of mental illness in Kazakhstan. Vestnik Kazahskogo nacional’nogo medicinskogo universiteta. 2016; 2:348-350. (In Russ.).

5. Skal’nyj AV. Reference values of the concentration of chemical elements in hair, obtained by the ICPAES method (ANO Center for Biotic Medicine. Mikroelementy v medicine. 2003; 4(1):55-56. (In Russ.).

6. Skal’nyj AV, Miroshnikov SA, Notova SV. etc. Regional features of elemental homeostasis as an indicator of ecological and physiological adaptation. Ekologiya cheloveka. 2014; 9:14-17. (In Russ.).

7. Литий (Li) в Республике Казахстан [kazspecgeo. com]. kazspecgeo; 2021 [обновлено 22 февраля 2020; процитировано 2 апреля 2021]. Доступно: http://kazspecgeo.com/article/litij.html

8. Concha G, Broberg K, Grandér M, Cardozo A, Palm B, Vahter M. High-level exposure to lithium, boron, cesium, and arsenic via drinking water in the Andes of northern Argentina. Environ Sci Technol. 2010; 44(17):6875-6880. https://doi.org/10.1021/es1010384

9. Iyengar V, Woittiez J. Trace elements in human clinical specimens: evaluation of literature data to identify reference values. Clinical chemistry.1988; 34(3):474-481.

10. Figueroa L, Barton S, Schull W, Razmilic B, Zu- maeta O, Young A, Kamiya Y, Hoskins J, Ilgren E. Environmental lithium exposure in the North of Chile--I. Natural water sources. Biol Trace Elem Res. 2012; 149(2):280-90. https://doi.org/10.1007/s12011-012-9417-6

11. Goldstein MR, Mascitelli L. Is violence in part a lithium deficiency state? Med Hypotheses. 2016; 89:40-42. https://doi.org/10.1016/j.mehy

12. Harari F, Ronco AM, Concha G, Llanos M, Grandér M, Castro F, Palm B, Nermell B, Vahter M. Early-life exposure to lithium and boron from drinking water. Reprod Toxicol. 2012; 34(4):552-60. https://doi.org/10.1016/j.reprotox

13. López Steinmetz RL, Fong SB, Boyer E, López Steinmetz LC, Tejerina NE, Meuric V. Lithium and Boron in Calcified Tissues of Vicuna and Their Relation to Chronic Exposure by Water Ingestion in The Andean Lithium Triangle. Environ Toxicol Chem. 2020; 39(1):200-209. https://doi.org/10.1002/etc.4608

14. Semenova Y, Zhunussov Y, Pivina L, Abisheva A, Tinkov A, Belikhina T, Skalny A, Zhanaspayev M, Bulegenov T, Glushkova N, Lipikhina A, Dauletyarova M, Zhunussova T, Bjørklund G. Trace element biomonitoring in hair and blood of occupationally unexposed population residing in polluted areas of East Kazakhstan and Pavlodar regions. J Trace Elem Med Biol. 2019; 56:31-37. https://doi.org/10.1016/j.jtemb

15. Skalny AV, Kaminskaya GA, Krekesheva TI, Abikenova SK, Skalnaya MG, Berezkina ES, Grabeklis AR, Tinkov AA. The level of toxic and essential trace elements in hair of petrochemical workers involved in different technological processes. Environ Sci Pollut Res Int. 2017; 24(6):5576-5584. https://doi.org/10.1007/s11356-016-8315-4

16. Vosahlikova M, Svoboda P. Lithium—therapeutic tool endowed with multiple beneficiary effects caused by multiple mechanisms. Acta Neurobiol Exp (Wars). 2016; 76(1):1-19. https://doi.org/10.21307/ane-2017-001

17. Wigle DT, Arbuckle TE, Turner MC, Bérubé A, Yang Q, Liu S, Krewski D. Epidemiologic evidence of relationships between reproductive and child health outcomes and environmental chemical contaminants. J Toxicol Environ Health B Crit Rev. 2008; 11(5-6):373-517. https://doi.org/10.1080/10937400801921320