HBD and Arrhythmia: Our study suggests that fluoride exposure is associated with the risk of serum CK and CK-MB elevation; however, it is not associated with myocardial ischemia, arrhythmia, serum lactate dehydrogenase (LDH), serum alpha-hydroxybutyrate dehydrogenase (α-HBD), or serum aspartate aminotransferase (AST).