Iron, copper and zinc levels in urine: relationship to various individual factors

Advances of Iron and Ferroptosis in Diabetic Kidney Disease

Diabetes mellitus presents a significant threat to human health because it disrupts energy metabolism and gives rise to various complications, including diabetic kidney disease (DKD). Metabolic adaptations occurring in the kidney in response to diabetes contribute to the pathogenesis of DKD. Iron metabolism and ferroptosis, a recently defined form of cell death resulting from iron-dependent excessive accumulation of lipid peroxides, have emerged as crucial players in the progression of DKD. In this comprehensive review, we highlight the profound impact of adaptive and maladaptive responses regulating iron metabolism on the progression of kidney damage in diabetes. We summarize the current understanding of iron homeostasis and ferroptosis in DKD. Finally, we propose that precise manipulation of iron metabolism and ferroptosis may serve as potential strategies for kidney management in diabetes.

Sex Differences in Copper Concentrations during a Sports Season in Soccer Players

Physical training produces changes in the concentrations of trace mineral elements. Sex differences in copper (Cu) concentrations in athletes are scarce. The objectives of this study were (i) to analyze changes in intracellular (erythrocytes and platelets) and extracellular (plasma and urine) Cu concentrations during a sports season in soccer players and (ii) to analyze sex differences. A total of 46 soccer players (22 men and 24 women) participated in the study. Three assessments were performed throughout the sports season. Anthropometry, body composition, nutritional intake, physical condition, female hormones (menstrual cycle) and hematology were evaluated, as well as Cu determination (plasma, urine, erythrocytes, and platelets). Regarding longitudinal differences, there were discrepancies in plasma, urine, absolute erythrocyte, and absolute platelet Cu concentrations (p < 0.05). There were differences between sexes in Cu concentrations in urine, erythrocytes relative to cell number and in platelets relative to cell number (p < 0.05). During a sports season, there are changes in Cu concentrations in soccer players. Likewise, there could be sex differences in urinary, erythrocyte and platelet Cu concentrations.

Oxidative Stress Biomarkers in Urine of Metal Carpentry Workers Can Be Diagnostic for Occupational Exposure to Low Level of Welding Fumes from Associated Metals

Urinary concentrations of 16 different exposure biomarkers to metals were determined at the beginning and at the end of a working shift on a group of workers in the metal carpentry industry. Five different oxidative stress biomarkers were also measured, such as the oxidation products of RNA and DNA metabolized and excreted in the urine. The results of workers exposed to metals were compared to those of a control group. The metal concentrations found in these workers were well below the occupational exposure limit values and exceeded the mean concentrations of the same metals in the urine of the control group by a factor of four at maximum. Barium (Ba), mercury (Hg), lead (Pb) and strontium (Sr) were correlated with the RNA oxidative stress biomarker, 8-oxo-7, 8-dihydroguanosine (8-oxoGuo), which was found able to discriminate exposed workers from controls with a high level of specificity and sensitivity. The power of this early diagnostic technique was assessed by means of the ROC curve. Ba, rubidium (Rb), Sr, tellurium (Te), and vanadium (V) were correlated with the level of the protein oxidation biomarker 3-Nitrotyrosine (3-NO₂Tyr), and Ba, beryllium (Be), copper (Cu), and Rb with 5-methylcytidine (5-MeCyt), an epigenetic marker of RNA damage. These effect biomarkers can help in identifying those workers that can be defined as "occupationally exposed" even at low exposure levels, and they can provide information about the impact that such doses have on their health.

Biocompatibility of Bacterial Magnetosomes as MRI Contrast Agent: A Long-Term In Vivo Follow-Up Study

Derived from magnetotactic bacteria (MTB), magnetosomes consist of magnetite crystals enclosed within a lipid bilayer membrane and are known to possess advantages over artificially synthesized nanoparticles because of the narrow size distribution, uniform morphology, high purity and crystallinity, single magnetic domain, good biocompatibility, and easy surface modification. These unique properties have increasingly attracted researchers to apply bacterial magnetosomes (BMs) in the fields of biology and medicine as MRI imaging contrast agents. Due to the concern of biosafety, a long-term follow-up of the distribution and clearance of BMs after entering the body is necessary. In this study, we tracked changes of BMs in major organs of mice up to 135 days after intravenous injection using a combination of several techniques. We not only confirmed the liver as the well-known targeted organs of BMs, but also found that BMs accumulated in the spleen. Besides, two major elimination paths, as well as the approximate length of time for BMs to be cleared from the mice, were revealed. Together, the results not only confirm that BMs have high biocompatibility, but also provide a long-term in-vivo assessment which may further help to forward the clinical applications of BMs as an MRI contrast agent.

Evidence of chronic cadmium exposure identified in the critically endangered Christmas Island flying-fox (Pteropus natalis)

The Christmas Island flying-fox (Pteropus natalis) is the last native mammal on Christmas Island and its population is in decline. Phosphate mining occurs across much of the eastern side of Christmas Island. The phosphate deposits are naturally rich in cadmium, and potentially other metals, which may be threatening the Christmas Island flying-fox population. To test this, concentrations of metals (cadmium, copper, iron, mercury, lead, and zinc) were measured in fur and urine collected from Christmas Island flying-foxes and interpreted concurrently with urinalysis and serum biochemistry data. In addition, metal concentrations in liver and kidney samples from two Christmas Island flying-foxes and associated histological findings from one of these individuals are reported. Fur cadmium concentrations were significantly higher in the Christmas Island flying-fox compared to concentrations found in flying-foxes in mainland Australia. Additionally, 30% of Christmas Island flying-foxes had urine cadmium concentrations exceeding maximum concentrations previously reported in flying-foxes in mainland Australia. Glucosuria and proteinuria were identified in two Christmas Island flying-foxes, suggestive of renal dysfunction. In one aged flying-fox, kidney cadmium concentrations were four-fold higher than toxic thresholds reported for domestic mammals. Microscopic evaluation of this individual identified bone lesions consistent with those described in laboratory animals with chronic cadmium poisoning. These results suggest that Christmas Island flying-foxes are being exposed to cadmium and identification of these sources is recommended as a focus of future research. Unexpectedly, urine iron concentrations in Christmas Island flying-foxes were higher compared to previous studies of Australian mainland flying-foxes, which suggests that urinary excretion of iron may be an important aspect of iron homeostasis in this species whose diet is iron rich.

YdiV regulates Escherichia coli ferric uptake by manipulating the DNA-binding ability of Fur in a SlyD-dependent manner

Iron is essential for all bacteria. In most bacteria, intracellular iron homeostasis is tightly regulated by the ferric uptake regulator Fur. However, how Fur activates the iron-uptake system during iron deficiency is not fully elucidated. In this study, we found that YdiV, the flagella gene inhibitor, is involved in iron homeostasis in Escherichia coli. Iron deficiency triggers overexpression of YdiV. High levels of YdiV then transforms Fur into a novel form which does not bind DNA in a peptidyl-prolyl cis-trans isomerase SlyD dependent manner. Thus, the cooperation of YdiV, SlyD and Fur activates the gene expression of iron-uptake systems under conditions of iron deficiency. Bacterial invasion assays also demonstrated that both ydiV and slyD are necessary for the survival and growth of uropathogenic E. coli in bladder epithelial cells. This reveals a mechanism where YdiV not only represses flagella expression to make E. coli invisible to the host immune system, but it also promotes iron acquisition to help E. coli overcome host nutritional immunity.

Effect of an Acute Exercise Until Exhaustion on the Serum and Urinary Concentrations of Cobalt, Copper, and Manganese Among Well-Trained Athletes

The current information about the effect of physical exercise on the body concentrations of several minerals is still limited, both in the acute (short-term) and adaptive (long-term) responses. So, this manuscript aims, on the one hand, to assess the possible differences on basal levels of cobalt (Co), copper (Cu), and manganese (Mn) concentrations in serum and urine between athletes and sedentary participants and, on the other hand, to evaluate the effect of an acute progressive physical exercise until voluntary exhaustion on the serum and urinary concentrations of Co, Cu, and Mn. Two groups participated in this survey, one was formed by untrained, sedentary males (CG; n = 26), and the other group was constituted by national endurance (long and middle distances) athletes (AG; n = 21). All participants were from the same region of Spain. Participants of both groups performed a physical test on a treadmill, reaching voluntary exhaustion. Blood and urine samples of each participant were collected before and at after the tests. Once obtained and processed, the concentrations of Co, Cu, and Mn elements were analyzed by inductively coupled plasma mass spectrometry (ICP-MS). The differences in the studied variables were evaluated using a mixed model by means of an ANOVA and Bonferroni post hoc tests. In the comparison of the pre-test values between groups, the results showed that serum concentrations of Mn were significantly lower in CG than in AG (p < 0.01). In urine, Co and Mn levels were significantly higher among CG participants (p < 0.01) than among AG ones, while in the case of Cu, the values were lower (p < 0.01) in the CG than in the AG. Regarding the effects of the effort tests, no significant changes were found among the participants of the CG. It was observed that the serum concentrations of Co (p < 0.05) and Cu (p < 0.01) decreased after the test among the AG participants. Also, the results showed that there were no statistical differences in Co and Mn values (expressed in μg/g creatinine). However, the urinary post-test Cu concentrations were lower (p < 0.05) among AG participants. In basal conditions, serum concentrations of Mn were significantly lower in CG than in AG. In urine, Co and Mn levels were significantly higher among CG participants and Cu level was significantly lower in CG, a fact which may reflect adaptive responses to exercise. An incremental exercise to exhaustion in AG produces a decrease in Co and Cu serum concentrations, as well as in urinary excretion of Cu.

A Review of Biomarkers Used for Assessing Human Exposure to Metals from E-Waste

Electronic waste recycling presents workers and communities with a potential for exposures to dangerous chemicals, including metals. This review examines studies that report on blood, hair, and urine biomarkers of communities and workers exposed to metals from e-waste. Our results from the evaluation of 19 publications found that there are consistently elevated levels of lead found in occupationally and non-occupationally exposed populations, in both the formal and the informal e-waste recycling sectors. Various other metals were found to be elevated in different exposure groups assessed using various types of biomarkers, but with less consistency than found in lead. Antimony and cadmium generally showed higher concentrations in exposed groups compared to reference group(s). Mercury and arsenic did not show a trend among exposure groups due to the dietary and environmental considerations. Observed variations in trends amongst exposure groups within studies using multiple biomarkers highlights the need to carefully select appropriate biomarkers. Our study concludes that there is a need for more rigorous research that moves past cross-sectional study designs, involves more thoughtful and methodical selection of biomarkers, and a systematic reporting standard for exposure studies to ensure that results can be compared across studies.

Hydrogen Gas Alleviates Chronic Intermittent Hypoxia-Induced Renal Injury through Reducing Iron Overload

Iron-induced oxidative stress has been found to be a central player in the pathogenesis of kidney injury. Recent studies have indicated H₂ can be used as a novel antioxidant to protect cells. The present study was designed to investigate the protective effects of H₂ against chronic intermittent hypoxia (CIH)-induced renal injury and its correlation mechanism involved in iron metabolism. We found that CIH-induced renal iron overloaded along with increased apoptosis and oxidative stress. Iron accumulates mainly occurred in the proximal tubule epithelial cells of rats as showed by Perl’s stain. Moreover, we found that CIH could promote renal transferrin receptor and divalent metal transporter-1 expression, inhibit ceruloplasmin expression. Renal injury, apoptosis and oxidative stress induced by CIH were strikingly attenuated in H₂ treated rats. In conclusion, hydrogen may attenuate CIH-induced renal injury at least partially via inhibiting renal iron overload.

Iron uptake by ZIP8 and ZIP14 in human proximal tubular epithelial cells

In patients with iron overload disorders, increasing number of reports of renal dysfunction and renal iron deposition support an association between increased iron exposure and renal injury. In systemic iron overload, elevated circulating levels of transferrin-bound (TBI) and non-transferrin-bound iron (NTBI) are filtered to the renal proximal tubules, where they may cause injury. However, the mechanisms of tubular iron handling remain elusive. To unravel molecular renal proximal tubular NTBI and TBI handling, human conditionally immortalized proximal tubular epithelial cells (ciPTECs) were incubated with ⁵⁵Fe as NTBI and fluorescently labeled holo-transferrin as TBI. Ferrous iron importers ZIP8 and ZIP14 were localized in the ciPTEC plasma membrane. Whereas silencing of either ZIP8 or ZIP14 alone did not affect ⁵⁵Fe uptake, combined silencing significantly reduced ⁵⁵Fe uptake compared to control (p < 0.05). Furthermore, transferrin receptor 1 (TfR1) and ZIP14, but not ZIP8, colocalized with early endosome antigen 1 (EEA1). TfR1 and ZIP14 also colocalized with uptake of fluorescently labeled transferrin. Furthermore, ZIP14 silencing decreased ⁵⁵Fe uptake after ⁵⁵Fe-Transferrin exposure (p < 0.05), suggesting ZIP14 could be involved in early endosomal transport of TBI-derived iron into the cytosol. Our data suggest that human proximal tubular epithelial cells take up TBI and NTBI, where ZIP8 and ZIP14 are both involved in NTBI uptake, but ZIP14, not ZIP8, mediates TBI-derived iron uptake. This knowledge provides more insights in the mechanisms of renal iron handling and suggests that ZIP8 and ZIP14 could be potential targets for limiting renal iron reabsorption and enhancing urinary iron excretion in systemic iron overload disorders.

Determination of major and trace element variability in healthy human urine by ICP-QMS and specific gravity normalisation

Sixty five urine samples obtained during one or two non-consecutive days from 10 healthy individuals were analysed for major (Na, Mg, K, Ca) and trace (Co, Cu, Zn, As, Rb, Sr, Mo and Pb) element concentrations. Following microwave digestion, the analyses were carried out using ICP-QMS (inductively coupled plasma quadrupole mass spectrometry) incorporating a collision/reaction cell. Repeat analyses of quality control samples show that the procedure produces unbiased results and is well suited for routine urinalysis of the investigated elements. Concentrations were normalised using specific gravity (SG) and the resultant decrease in variability supports previous conclusions that SG-normalisation appropriately corrects for differences in urine dilution. The elemental concentrations of the individual urine samples show large differences in dispersion. Most variable are As, Co and Zn, with CVs (coefficients of variation) of >75%. The major elements as well as Rb, Sr and Mo display intermediate variability, whilst Cu and Pb have the least elemental dispersion with CV values of about 30%. A detailed assessment shows that the overall elemental variability is governed both by differences between individuals and variations for a single individual over time. Spot urine samples exhibit elemental concentrations that, on average, resemble the daily mean values to within about 30% for all elements except K and Rb. Diet-related changes in urinary element concentration are most prominent for Mg, K, Co, Rb and Pb. The concentrations of Co, As and Rb appear to vary systematically with gender but this may primarily reflect co-variance with specific diets.

Urinary element concentrations were quantified by ICP-QMS and variations over time, between individuals and with gender and diet were assessed.

Zinc Supplementation in a Randomized Controlled Trial Decreased ZIP4 and ZIP8 mRNA Abundance in Peripheral Blood Mononuclear Cells of Adult Women

Zinc plays an integral role in numerous cellular processes including regulation of gene expression. This randomized placebo-controlled trial in adult women evaluated the effects of 20 mg Zn for 23 days. The mRNA abundance of zinc transporters (ZnT1/ZIP3/ZIP4/ZIP8) and metallothionein (MT1) from peripheral blood mononuclear cells was determined by real-time quantitative polymerase chain reaction. In paired samples (n = 6-9), the ZIP4 (P = 0.036) and ZIP8 (P = 0.038) mRNA abundance decreased following zinc supplementation. ZnT1, ZIP3, and MT1 mRNA abundance did not change significantly. The mean ± standard deviation plasma zinc concentration (by inductively coupled plasma mass spectrometry) at baseline was 680 ± 110 μg/L for the zinc group (n = 24) and 741 ± 92 μg/L for the placebo group (n = 23). At endpoint, plasma zinc in the zinc group increased to 735 ± 80 μg/L (P < 0.01) while in the placebo group (717 ± 100 μg/L) it did not change significantly from baseline. The change in mRNA abundance highlights the importance of further investigating ZIP4 and ZIP8 mRNA abundance as potential zinc status biomarkers.

Impact of aging on urinary excretion of iron and zinc

PROJECT

Data about the influence of aging on urinary excretion of iron and zinc are scarce. The objective of the present study was to compare the concentration of zinc and iron in the urine of healthy elderly subjects and younger adults.

PROCEDURE

Seven healthy elderly subjects and seven younger adults were selected and submitted to biochemical, clinical, and nutritional tests. After a fasting period, 12-hour urine was collected for the determination of iron and zinc concentrations by graphite furnace atomic absorption spectrophotometry.

RESULTS

Urinary zinc and iron concentrations of the elderly subjects were not significantly different from that of younger adults. However, the total zinc and iron urinary clearance in 24 hours for the elderly was significantly higher compared with that of younger adults.

CONCLUSION

There is an increase in urinary iron and zinc clearance with aging. The values reported in this manuscript may be used as references in future studies.

What do the trace metal contents of urine and toenail samples from Qatar׳s farm workers bioindicate?

Qatar׳s farm workers provide a unique population for exposure study: they are young, healthy males. This study combined trace element profiles in urine and toenail with survey information from 239 farm workers to assess the extent to which the biomarkers provide complementary exposure information. Urinary Mo levels (average=114 µg/L) were elevated; average urinary values (µg/L) for all other elements were: V (1.02), Cr (0.55), Mn (2.15), Fe (34.1), Co (0.47), Ni (2.95), Cu (15.0), As (47.8), Se (25.7), Cd (1.09), Ba (22.5), Pb (2.50) and U (0.15). Average toenail concentrations (mg/kg) were: Mn (2.48), Cu (4.43), As (0.26), Se (0.58), Mo (0.07), Cd (0.03), Ba (1.00), Pb (0.51) and U (0.02). No significant association was found between corresponding elements in urine and toenails. Elemental profiles suggest groundwater (with the exception of Mo) and soil-dust-crop exposure pathways cannot account for elemental variations. The main factors moderating trace element contents are related to depuration processes involving participants׳ trace element body burden prior to work in Qatar, and interactions of trace element metabolic cycles which over-ride the exposure footprint. Toenail and urine need to be carefully validated before reliable use as biomarkers of exposure in general populations for most elements in the study.

Assessment of exposure to trace metals in a cohort of pregnant women from an urban center by urine analysis in the first and third trimesters of pregnancy

Prenatal exposure to trace metals, whether they are essential, non-essential, or toxic, must be assessed for their potential health effects in the offspring. Herein is reported an approach to this end which involved collection of urine samples during the first and third trimesters of pregnancy from 489 mothers from Sabadell (Catalonia, Spain), a highly industrialized town. These samples were analyzed for cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), selenium (Se), arsenic (As), molybdenum (Mo), cadmium (Cd), antimonium (Sb), cesium (Cs), thallium (Tl), and lead (Pb). An acid digestion method was developed and validated for inductively coupled plasma quadruple mass spectrometry (Q-ICP-MS) analysis of these 12 metals. The median concentrations of metals ranged from 0.13 to 290 μg/g creatinine, the highest levels were found for Zn and the lowest for Th. The mean concentrations of most metals except As, Ni, Th, and Pb showed statistically significant differences between both trimesters. The concentrations of Mo, Se, Cd, Cs, and Sb were higher in the first than in the third trimester, whereas the opposite was found for Co, Cu, and Zn. The concentrations of all metals in both sampling periods showed statistically significant correlations (p<0.01 for Mo and Cu, p<0.001 for the others). The significant correlations of metal urine concentrations in the first and third trimesters of pregnancy suggest that the observed differences between both periods are related to physiological changes. Accordingly, the measured urine concentrations during either the first or third trimesters can be used as estimates of exposure during pregnancy and can serve as markers for prenatal intake of these metals in the studied cohort.

Rapidly exchangeable pool study of zinc in free-living or institutionalized elderly women

OBJECTIVE

We evaluated the effect of age and institutionalization on zinc metabolism by using a stable isotope technique.

METHODS

This was a randomized case-control study. Three groups were recruited: nine young women (group 1, ages 36+/-1 y) as controls, nine free-living elderly women (group 2, ages 72+/-2 y), and nine institutionalized women (group 3, ages 73+/-2 y). Only women were recruited to obtain homogeneous groups. The study was set in a Valence hospital (France) in the geriatric department (headed by Dr. Ferry). The experimental design of the study was reviewed and approved by the local ethical committee, and all participants signed a consent form. No subject dropped out of the study. A zinc stable isotope label (0.73 mg of (70)Zn) was injected intravenously into patients and measured by inductively coupled plasma mass spectrometry.

RESULTS

Decay curves of the plasma (70)Zn followed a one-compartment kinetic leading to the determination of one pool. The size of this pool suggested that it corresponded to the liver compartment. The size of this pool was significantly smaller in elderly people. (70)Zn plasma resident time was significantly longer in elderly individuals, and shorter in institutionalized than in free-living elderly subjects.

CONCLUSION

These data suggest that the zinc metabolism of elderly women is related to lifestyle or its consequences and to age. Moreover, we have demonstrated that kinetic studies using stable isotopes of zinc can provide novel information on exchangeable zinc pools in clinical situations.

Predictive value of human biomonitoring in environmental medicine: experiences at the outpatient unit of environmental medicine (UEM) of the University Hospital Aachen, Germany

There is little data on the distribution of biomonitoring parameters in patients at outpatient Units of Environmental Medicine (UEM). We evaluated the biomonitoring parameters of 646 UEM outpatients from our University Hospital 1988-1998. Few patients were exposed to specific substances. Data of patients who were not obviously exposed was analysed statistically (geometric mean, standard deviation, median, 95th percentile). Results were compared with reference values in literature. Normal distribution of biomonitoring parameters was rare. 95th percentiles for arsenic, chromium, selenium, zinc, phenol and toluene were below standard, 95th percentiles for copper and mercury above, and 95th percentiles for lead, cadmium, pentachlorophenol, lindane, and beta-hexachlorocyclohexane were within the published range of reference values. Thallium as well as most volatile organic compounds analyzed were below detection levels. Aluminum and fluorine exposure was rarely analysed. In view of these results, it is concluded that the indication for biomonitoring needs to be stringent as levels of biomonitoring parameters are generally not risen in patients of the UEM.

A search for calcium, magnesium and zinc levels in fingernails of 135 patients with osteogenesis imperfecta

Calcium (Ca), magnesium (Mg) and zinc (Zn) levels of fingernails were measured in 135 patients with osteogenesis imperfecta (OI) and compared with the sex- and age-matched healthy controls. Zinc levels in OI nails were significantly higher than that in normal subjects, but in cases and controls Ca and Mg levels were not significantly different. The ratios of Ca/Zn and Mg/Zn in OI nails differed significantly from those in controls, but a similar Ca/Mg ratio was found in nails of both groups. These results suggest that Zn levels in fingernails may reflect abnormal Zn metabolism in OI. To determine Zn metabolism changes in OI, further studies are needed.