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Politis MD, Gutiérrez-Avila I, Just A, Pizano-Zárate ML, Tamayo-Ortiz M, Greenberg JH, Téllez-Rojo MM, Sanders AP, Rosa MJ. Recent ambient temperature and fine particulate matter (PM 2.5) exposure is associated with urinary kidney injury biomarkers in children. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 907:168119. [PMID: 37884142 PMCID: PMC10842020 DOI: 10.1016/j.scitotenv.2023.168119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/10/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Limited research has examined associations between exposure to ambient temperature, air pollution, and kidney function or injury during the preadolescent period. We examined associations between exposure to ambient temperature and particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5) with preadolescent estimated glomerular filtration rate (eGFR) and urinary kidney injury biomarkers. METHODS Participants included 437 children without cardiovascular or kidney disease enrolled in the Programming Research in Obesity, Growth, Environment and Social Stressors birth cohort study in Mexico City. eGFR and urinary kidney injury biomarkers were assessed at 8-12 years. Validated satellite-based spatio-temporal models were used to estimate mean daily temperature and PM2.5 levels at each participant's residence 7- and 30-days prior to the date of visit. Linear regression and distributed lag nonlinear models (DLNM) were used to examine associations between daily mean temperature and PM2.5 exposure and kidney outcomes, adjusted for covariates. RESULTS In single linear regressions, higher seven-day average PM2.5 was associated with higher urinary alpha-1-microglobulin and eGFR. In DLNM analyses, higher temperature exposure in the seven days prior to date of visit was associated with a decrease in urinary cystatin C of -0.56 ng/mL (95 % confidence interval (CI): -1.08, -0.04) and in osteopontin of -0.08 ng/mL (95 % CI: -0.15, -0.001). PM2.5 exposure over the seven days prior to date of visit was associated with an increase in eGFR of 1.77 mL/min/1.73m2 (95 % CI: 0.55, 2.99) and urinary cystatin C of 0.19 ng/mL (95 % CI: 0.03, 0.35). CONCLUSIONS Recent exposure to ambient temperature and PM2.5 were associated with increased and decreased urinary kidney injury biomarkers that may reflect subclinical glomerular or tubular injury in children. Further research is required to assess environmental exposures and worsening subclinical kidney injury across development.
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Affiliation(s)
- Maria D Politis
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Iván Gutiérrez-Avila
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Allan Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Epidemiology and Department of Earth, Environmental, and Planetary Sciences, Brown University, Providence, RI, United States
| | - María Luisa Pizano-Zárate
- Nutrition and Bioprogramming Coordination, National Institute of Perinatology, Mexico City, Mexico; UMF 4, South Delegation of the Federal District, Mexican Social Security Institute (IMSS), Mexico City, Mexico
| | - Marcela Tamayo-Ortiz
- Occupational Health Research Unit, Mexican Social Security Institute, Mexico City, Mexico; Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, NY, United States
| | - Jason H Greenberg
- Department of Pediatrics, Section of Nephrology, Yale University School of Medicine, New Haven, CT, United States
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Alison P Sanders
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Maria José Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
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Kuiper JR, O’Brien KM, Welch BM, Barrett ES, Nguyen RH, Sathyanarayana S, Milne GL, Swan SH, Ferguson KK, Buckley JP. Combining Urinary Biomarker Data From Studies With Different Measures of Urinary Dilution. Epidemiology 2022; 33:533-540. [PMID: 35473917 PMCID: PMC9585883 DOI: 10.1097/ede.0000000000001496] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Guidance is lacking for how to combine urinary biomarker data across studies that use different measures of urinary dilution, that is, creatinine or specific gravity. METHODS Among 741 pregnant participants from four sites of The Infant Development and Environment Study (TIDES) cohort, we assessed the relation of maternal urinary di-2-ethylhexyl phthalate (DEHP) concentrations with preterm birth. We compared scenarios in which all sites measured either urinary creatinine or specific gravity, or where measure of dilution differed by site. In addition to a scenario with no dilution adjustment, we applied and compared three dilution-adjustment approaches: a standard regression-based approach for creatinine, a standard approach for specific gravity (Boeniger method), and a more recently developed approach that has been applied to both (covariate-adjusted standardization method). For each scenario and dilution-adjustment method, we estimated the association between a doubling in the molar sum of DEHP (∑DEHP) and odds of preterm birth using logistic regression. RESULTS All dilution-adjustment approaches yielded comparable associations (odds ratio [OR]) that were larger in magnitude than when we did not perform dilution adjustment. A doubling of ∑DEHP was associated with 9% greater odds of preterm birth (OR = 1.09, 95% confidence interval [CI] = 0.91, 1.30) when applying no dilution-adjustment method, whereas dilution-adjusted point estimates were higher, and similar across all scenarios and methods: 1.13-1.20 (regression-based), 1.15-1.18 (Boeniger), and 1.14-1.21 (covariate-adjusted standardization). CONCLUSIONS In our applied example, we demonstrate that it is possible and straightforward to combine urinary biomarker data across studies when measures of dilution differ.
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Affiliation(s)
- Jordan R. Kuiper
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Katie M. O’Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC
| | - Barrett M. Welch
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC
| | - Emily S. Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute, Piscataway, NJ
| | - Ruby H.N. Nguyen
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington and Seattle Children’s Research Institute, Seattle, WA
| | - Ginger L. Milne
- Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN
| | - Shanna H. Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kelly K. Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC
| | - Jessie P. Buckley
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
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Kuiper JR, O'Brien KM, Ferguson KK, Buckley JP. Urinary specific gravity measures in the U.S. population: Implications for the adjustment of non-persistent chemical urinary biomarker data. ENVIRONMENT INTERNATIONAL 2021; 156:106656. [PMID: 34062395 PMCID: PMC8380693 DOI: 10.1016/j.envint.2021.106656] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 05/19/2023]
Abstract
BACKGROUND Urinary biomarkers are often corrected for sample dilution using creatinine, which is influenced by sociodemographic factors and certain health conditions. It is unknown whether these factors similarly influence specific gravity. OBJECTIVES To identify predictors of specific gravity and creatinine and compare methods for correcting estimated chemical concentrations for sample dilution using these measures. METHODS We assessed predictors of urinary specific gravity and creatinine among NHANES 2007-2008 participants (n = 7257). We corrected concentrations of mono-n-butyl phthalate (MnBP) for dilution using two methods, each applied to both specific gravity and creatinine: correction using a sample mean of the dilution indicator (i.e., specific gravity or creatinine) and covariate-adjusted standardization. We compared distributions and assessed the agreement of uncorrected or corrected concentrations visually using Bland-Altman plots and statistically by Kendall's τa. We stratified all analyses by age category (i.e., 6-19 or 20+ years of age). RESULTS Gender, race/ethnicity, body mass index, and height were associated with urinary specific gravity and creatinine. Distributions of corrected MnBP concentrations were comparable for both methods and dilution indicators, but agreement between methods was greater for specific gravity. Additionally, specific gravity- and creatinine-corrected MnBP concentrations had slightly greater agreement with each other when corrected using a covariate-adjusted standardization method. DISCUSSION Specific gravity, like creatinine, is associated with sociodemographic and body composition variables. Accounting for these factors as part of the dilution correction method may be important to minimize bias.
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Affiliation(s)
- Jordan R Kuiper
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Katie M O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Kelly K Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Jessie P Buckley
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Taylor LW, French JE, Robbins ZG, Nylander-French LA. Epigenetic Markers Are Associated With Differences in Isocyanate Biomarker Levels in Exposed Spray-Painters. Front Genet 2021; 12:700636. [PMID: 34335698 PMCID: PMC8318037 DOI: 10.3389/fgene.2021.700636] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/21/2021] [Indexed: 12/30/2022] Open
Abstract
Isocyanates are respiratory and skin sensitizers that are one of the main causes of occupational asthma globally. Genetic and epigenetic markers are associated with isocyanate-induced asthma and, before asthma develops, we have shown that genetic polymorphisms are associated with variation in plasma and urine biomarker levels in exposed workers. Inter-individual epigenetic variance may also have a significant role in the observed biomarker variability following isocyanate exposure. Therefore, we determined the percent methylation for CpG islands from DNA extracted from mononuclear blood cells of 24 male spray-painters exposed to 1,6-hexamethylene diisocyanate (HDI) monomer and HDI isocyanurate. Spray-painters’ personal inhalation and skin exposure to these compounds and the respective biomarker levels of 1,6-diaminohexane (HDA) and trisaminohexyl isocyanurate (TAHI) in their plasma and urine were measured during three repeated industrial hygiene monitoring visits. We controlled for inhalation exposure, skin exposure, age, smoking status, and ethnicity as covariates and performed an epigenome-wide association study (EWAS) using likelihood-ratio statistical modeling. We identified 38 CpG markers associated with differences in isocyanate biomarker levels (Bonferroni < 0.05). Annotations for these markers included 18 genes: ALG1, ANKRD11, C16orf89, CHD7, COL27A, FUZ, FZD9, HMGN1, KRT6A, LEPR, MAPK10, MED25, NOSIP, PKD1, SNX19, UNC13A, UROS, and ZFHX3. We explored the functions of the genes that have been published in the literature and used GeneMANIA to investigate gene ontologies and predicted protein-interaction networks. The protein functions of the predicted networks include keratinocyte migration, cell–cell adhesions, calcium transport, neurotransmitter release, nitric oxide production, and apoptosis regulation. Many of the protein pathway functions overlap with previous findings on genetic markers associated with variability both in isocyanate biomarker levels and asthma susceptibility, which suggests there are overlapping protein pathways that contribute to both isocyanate toxicokinetics and toxicodynamics. These predicted protein networks can inform future research on the mechanism of allergic airway sensitization by isocyanates and aid in the development of mitigation strategies to better protect worker health.
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Affiliation(s)
- Laura W Taylor
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - John E French
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Zachary G Robbins
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Leena A Nylander-French
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Taylor LW, French JE, Robbins ZG, Boyer JC, Nylander-French LA. Influence of Genetic Variance on Biomarker Levels After Occupational Exposure to 1,6-Hexamethylene Diisocyanate Monomer and 1,6-Hexamethylene Diisocyanate Isocyanurate. Front Genet 2020; 11:836. [PMID: 32973864 PMCID: PMC7466756 DOI: 10.3389/fgene.2020.00836] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/10/2020] [Indexed: 12/15/2022] Open
Abstract
We evaluated the impact of genetic variance on biomarker levels in a population of workers in the automotive repair and refinishing industry who were exposed to respiratory sensitizers 1,6-hexamethylene diisocyanate (HDI) monomer and one of its trimers, HDI isocyanurate. The exposures and respective urine and plasma biomarkers 1,6-diaminohexane (HDA) and trisaminohexyl isocyanurate (TAHI) were measured in 33 workers; and genome-wide microarrays (Affymetrix 6.0) were used to genotype the workers' single-nucleotide polymorphisms (SNPs). Linear mixed model analyses have indicated that interindividual variations in both inhalation and skin exposures influenced these biomarker levels. Using exposure values as covariates and a false discovery rate < 0.10 to assess statistical significance, we observed that seven SNPs were associated with HDA in plasma, five were associated with HDA in urine, none reached significance for TAHI in plasma, and eight were associated with TAHI levels in urine. The different genotypes for the 20 significant SNPs accounted for 4- to 16-fold changes observed in biomarker levels. Associated gene functions include transcription regulation, calcium ion transport, vascular morphogenesis, and transforming growth factor beta signaling pathway, which may impact toxicokinetics indirectly by altering inflammation levels. Additionally, in an expanded analysis using a minor allele cutoff of 0.05 instead of 0.10, there were biomarker-associated SNPs within three genes that have been associated with isocyanate-induced asthma: ALK, DOCK2, and LHPP. We demonstrate that genetic variance impacts the biomarker levels in workers exposed to HDI monomer and HDI isocyanurate and that genetics can be used to refine exposure predictions in small cohorts when quantitative personal exposure and biomarker measurements are included in the models.
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Affiliation(s)
- Laura W. Taylor
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - John E. French
- Nutrition Research Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Zachary G. Robbins
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jayne C. Boyer
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Leena A. Nylander-French
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Exposures and urinary biomonitoring of aliphatic isocyanates in construction metal structure coating. Int J Hyg Environ Health 2020; 226:113495. [PMID: 32120250 DOI: 10.1016/j.ijheh.2020.113495] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Isocyanates are highly reactive chemicals used widely in metal structure coating applications in construction. Isocyanates are potent respiratory and skin sensitizers and a leading cause of occupational asthma. At present, there is no cure for isocyanate asthma and no biomarkers of early disease. Exposure reduction is considered the most effective preventive strategy. To date, limited data are available on isocyanate exposures and work practices in construction trades using isocyanates, including metal structure coatings. OBJECTIVES The primary objectives of this work were: i) to characterize isocyanate inhalation and dermal exposures among painters during metal structure coating tasks in construction; and ii) to assess the adequacy of existing work practices and exposure controls via urinary biomonitoring pre- and post-shift. METHODS Exposures to aliphatic isocyanates based on 1,6-hexamethylene diisocyanate (1,6-HDI) and its higher oligomers (biuret, isocyanurate and uretdione) were measured among 30 workers performing painting of bridges and other metal structures in several construction sites in the Northeastern USA. Exposure assessment included simultaneous measurement of personal inhalation exposures (n = 20), dermal exposures (n = 22) and body burden via urinary biomonitoring pre- and post-shift (n = 53). Contextual information was collected about tasks, processes, materials, work practices, personal protective equipment (PPEs) and exposure controls, work histories, and environmental conditions. RESULTS Breathing zone concentrations were the highest for biuret (median, 18.4 μg/m3), followed by 1,6-HDI monomer (median, 3.5 μg/m3), isocyanurate (median, 3.4 μg/m3) and uretdione (median, 1.7 μg/m3). The highest exposures, measured during painting inside an enclosed bridge on a hot summer day, were: 10,288 μg/m3 uretdione; 8,240 μg/m3 biuret; and 947 μg/m3 1,6-HDI. Twenty percent of samples were above the NIOSH ceiling exposure limit for 1,6- HDI (140 μg/m3) and 35% of samples were above the UK-HSE ceiling for total isocyanate group (70 μg NCO/m3). Isocyanate loading on the gloves was generally high, with a median of 129 μg biuret/pair and maximum of 60.8 mg biuret/pair. The most frequently used PPEs in the workplace were half-face organic vapor cartridge (OVC) respirators, disposable palmar dip-coated polymer gloves, and cotton coveralls. However, 32% of workers didn't wear any respirator, 47% wore standard clothing with short-sleeve shirts and 14% didn't wear any gloves while performing tasks involving isocyanates. Based on biomonitoring results, 58.4% of urine samples exceeded the biological monitoring guidance value (BMGV) of 1 μmol hexamethylene diamine (HDA)/mol creatinine. Post-shift geometric mean HDA normalized to specific gravity increased by 2.5-fold compared to pre-shift (GM, 4.7 vs. 1.9 ng/mL; p value, < 0.001), and only 1.4-fold when normalized to creatinine. CONCLUSIONS Exposure and biomonitoring results, coupled with field observations, support the overall conclusions that (i) substantial inhalation and dermal exposures to aliphatic isocyanates occur during industrial coating applications in construction trades; that (ii) the current work practices and exposure controls are not adequately protective. High urinary creatinine values in the majority of workers, coupled with significant cross-shift increases and filed observations, point to the need for further investigations on possible combined effects of heat stress, dehydration, and nutritional deficiencies on kidney toxicity. Implementation of comprehensive exposure control programs and increased awareness are warranted in order to reduce isocyanate exposures and associated health risks among this cohort of construction workers.
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Megahed AA, Grünberg W, Constable PD. Clinical utility of urine specific gravity, electrical conductivity, and color as on-farm methods for evaluating urine concentration in dairy cattle. J Vet Intern Med 2019; 33:1530-1539. [PMID: 31025445 PMCID: PMC6524117 DOI: 10.1111/jvim.15502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 04/03/2019] [Indexed: 11/26/2022] Open
Abstract
Background Urine concentration (UC) provides clinically useful information concerning hydration status and renal function of animals. Objectives To characterize the clinical performance of urine specific gravity measured by optical refractometry (USG‐R) or Multistix‐SG urine reagent dipstick (USG‐D), urine electrical conductivity using an OAKTON Con 6 conductivity handheld meter (UEC), urine color (UColor) using a custom‐designed 8‐point color chart, and urine creatinine concentration (UCreat) for assessing UC in dairy cattle. Animals 20 periparturient Holstein‐Friesian cows. Methods Urine was obtained by perineal stimulation or urethral catheterization and urine osmolality (UOsm, reference method), USG‐R, USG‐D, UEC, UColor, and UCreat determined. Diagnostic test performance was evaluated using Spearman's rho and logistic regression to determine the area under the receiver operating curve (AUC) and optimal cut point for diagnosing hypohydration (UOsm ≥800 mOsm/kg). P < .05 was considered significant. Results The best performing test for diagnosing hypohydration was USG‐R (AUC = 0.90) at an optimal cut point ≥1.030. The second‐best performing test was UEC (AUC = 0.82) at a cut point of ≥23.7 mS/cm, followed by UCreat (AUC = 0.76) at a cut point of ≥95.3 mg/dL, and UColor (AUC = 0.74) at a cut point of ≥4 on an 8‐point scale. Urine specific gravity measured by dipstick performed poorly (AUC = 0.63). Conclusions and Clinical Importance USG‐R and UEC provide practical and sufficiently accurate methods for measuring UC in dairy cattle. Urine color had moderate clinical utility as a no‐cost cow‐side method for assessing UC, whereas dipstick refractometry is not recommended for assessing UC.
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Affiliation(s)
- Ameer A Megahed
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Champaign, Illinois.,Department of Animal Medicine, Internal Medicine, Faculty of Veterinary Medicine, Benha University, Benha, Egypt
| | - Walter Grünberg
- Clinic for Cattle, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Peter D Constable
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Champaign, Illinois
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Identification of Urine Metabolites as Biomarkers of Early Lyme Disease. Sci Rep 2018; 8:12204. [PMID: 30111850 PMCID: PMC6093930 DOI: 10.1038/s41598-018-29713-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 07/10/2018] [Indexed: 02/06/2023] Open
Abstract
Metabolites detectible in human biofluids are attractive biomarkers for the diagnosis of early Lyme disease (ELD), a vector-borne infectious disease. Urine represents an easily obtained clinical sample that can be applied for diagnostic purposes. However, few studies have explored urine for biomarkers of ELD. In this study, metabolomics approaches were applied to evaluate small molecule metabolites in urine from patients with ELD (n = 14), infectious mononucleosis (n = 14) and healthy controls (n = 14). Metabolic biosignatures for ELD versus healthy controls and ELD versus infectious mononucleosis were generated using untargeted metabolomics. Pathway analyses and metabolite identification revealed the dysregulation of several metabolic processes in ELD as compared to healthy controls or mononucleosis, including metabolism of tryptophan. Linear discriminant analyses demonstrated that individual metabolic biosignatures can correctly discriminate ELD from the other patient groups with accuracies of 71 to 100%. These data provide proof-of-concept for use of urine metabolites as biomarkers for diagnostic classification of ELD.
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Singh GKS, Balzer BWR, Desai R, Jimenez M, Steinbeck KS, Handelsman DJ. Requirement for specific gravity and creatinine adjustments for urinary steroids and luteinizing hormone concentrations in adolescents. Ann Clin Biochem 2015; 52:665-71. [PMID: 25780247 DOI: 10.1177/0004563215580385] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Urinary hormone concentrations are often adjusted to correct for hydration status. We aimed to determine whether first morning void urine hormones in growing adolescents require adjustments and, if so, whether urinary creatinine or specific gravity are better adjustments. DESIGN AND METHODS The study population was adolescents aged 10.1 to 14.3 years initially who provided fasting morning blood samples at 0 and 12 months (n = 343) and first morning urine every three months (n = 644). Unadjusted, creatinine and specific gravity-adjusted hormonal concentrations were compared by Deming regression and Bland-Altman analysis and grouped according to self-rated Tanner stage or chronological age. F-ratios for self-rated Tanner stages and age groups were used to compare unadjusted and adjusted hormonal changes in growing young adolescents. Correlations of paired serum and urinary hormonal concentration of unadjusted and creatinine and specific gravity-adjusted were also compared. RESULTS Fasting first morning void hormone concentrations correlated well and were unbiased between unadjusted or adjusted by either creatinine or specific gravity. Urine creatinine concentration increases with Tanner stages, age and male gender whereas urine specific gravity was not influenced by Tanner stage, age or gender. Adjustment by creatinine or specific gravity of urinary luteinizing hormone, estradiol, testosterone, dihydrotestosterone and dehydroepiandrosterone concentrations did not improve correlation with paired serum concentrations. CONCLUSIONS Urine steroid and luteinizing hormone concentrations in first morning void samples of adolescents are not significantly influenced by hydration status and may not require adjustments; however, if desired, both creatinine and specific gravity adjustments are equally suitable.
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Affiliation(s)
- Gurmeet K S Singh
- Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, Australia Faculty of Pharmacy, Universiti Teknologi MARA, Bandar Puncak Alam, Selangor, Malaysia
| | - Ben W R Balzer
- Academic Department of Adolescent Medicine, Children's Hospital at Westmead, Westmead, Australia Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Reena Desai
- Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, Australia
| | - Mark Jimenez
- Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, Australia
| | - Katharine S Steinbeck
- Academic Department of Adolescent Medicine, Children's Hospital at Westmead, Westmead, Australia Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - David J Handelsman
- Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, Australia
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Smolders R, Koch HM, Moos RK, Cocker J, Jones K, Warren N, Levy L, Bevan R, Hays SM, Aylward LL. Inter- and intra-individual variation in urinary biomarker concentrations over a 6-day sampling period. Part 1: Metals. Toxicol Lett 2014; 231:249-60. [DOI: 10.1016/j.toxlet.2014.08.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 08/11/2014] [Accepted: 08/12/2014] [Indexed: 10/24/2022]
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Xia Y, Wong LY, Bunker BC, Bernert JT. Comparison of creatinine and specific gravity for hydration corrections on measurement of the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) in urine. J Clin Lab Anal 2014; 28:353-63. [PMID: 24648246 DOI: 10.1002/jcla.21693] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 09/12/2013] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) was measured in all participants aged 6 years and older from the Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey 2007-2008. The suitability of using creatinine or specific gravity for urinary NNAL correction in exposure assessment is examined in this study. METHODS Effects of both specific gravity and creatinine correction on urinary NNAL among smokers were investigated with multiple linear regression models using either normalization or the fitting of creatinine and specific gravity in the model as covariates. RESULTS When log-scaled NNAL was normalized by either creatinine or specific gravity, R(2) was slightly higher for creatinine than for specific gravity (R(2) = 0.1694 and 0.1439, for creatinine and specific gravity, respectively). When log-scaled NNAL was normalized by both factors, the R(2) was improved (R(2) = 0.2068). When specific gravity or creatinine was included as a covariate separately in the models, they were highly significant factors (P < 0.001, R(2) = 0.2226 and 0.1681 for creatinine and specific gravity, respectively). However, when both were included in the model as covariates, creatinine remained highly significant (P < 0.001), whereas the significance of specific gravity was eliminated (P = 0.4294). CONCLUSION This study confirms significant relationships between NNAL concentrations and both urine creatinine and specific gravity. We conclude that creatinine is the more influential and preferred variable to account for urine dilution in tobacco-specific nitrosamine exposure assessment.
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Affiliation(s)
- Yang Xia
- Division of Laboratory Science, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Andersen EM, Sobus JR, Strynar MJ, Pleil JD, Nakayama SF. Evaluating an alternative method for rapid urinary creatinine determination. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2014; 77:1114-1123. [PMID: 25072898 DOI: 10.1080/15287394.2014.922391] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Creatinine (CR) is an endogenously produced chemical that is routinely assayed in urine specimens to assess kidney function and sample dilution. The industry-standard method for CR determination, known as the kinetic Jaffé (KJ) method, relies on an exponential rate of a colorimetric change, and can therefore require automated processing equipment for moderate- to high-throughput analysis (hundreds to thousands of samples per day). This study evaluates an alternative colorimetric method, the "plateau Jaffé" (PJ) method, which utilizes the chemistry of the KJ method, a commercially available kit, and a multipoint calibration curve. This method is amenable to moderate-throughput sample analysis and does not require automated processing equipment. Thirty-two spot urine samples from healthy adult volunteers were analyzed for creatinine concentration (CRc) using the KJ and PJ methods. Samples were also analyzed using a liquid chromatography time-of-flight mass spectrometry (LC-TOF/MS) method, which acted as an analytical control. Replicate measurements of spot samples (natural log-transformed values) were used to estimate method precision, and linear regression models were used to evaluate method accuracy (LC-TOF/MS measurements were considered the analytical benchmark). Measurement precision was comparable across all three methods, with coefficent of variation estimates ranging from 3 to 6%. Regression models generally showed good agreement across methods with R(2) estimates ranging from .996 to .998, slope estimates ranging from .944 to .986, and y-intercept estimates ranging from 0.111 to 0.303. Minor bias (between 2 and 16%) was observed across methods at the tails of the measurement distributions. The provided regression equations can be used to adjust for this bias and to improve CR measurement comparisons across studies employing different methods. Considering these results, the PJ method is a suitable alternative to the industry standard KJ method for urinary CRc determination. It can be implemented for moderate-throughput sample analysis using modest and commonly available lab instrumentation and manual sample preparation techniques.
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Affiliation(s)
- Erik M Andersen
- a Human Exposure and Atmospheric Sciences Division , National Exposure Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency , Research Triangle Park , North Carolina , USA
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Laguna TA, Wagner BD, Starcher B, Luckey Tarro HK, Mann SA, Sagel SD, Accurso FJ. Urinary desmosine: a biomarker of structural lung injury during CF pulmonary exacerbation. Pediatr Pulmonol 2012; 47:856-63. [PMID: 22431382 PMCID: PMC3856884 DOI: 10.1002/ppul.22525] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 11/24/2011] [Indexed: 01/05/2023]
Abstract
RATIONALE Cystic fibrosis (CF) lung disease is characterized by structural changes and remodeling in airway architecture and lung parenchyma. Neutrophilic inflammation and infection lead to injury and breakdown of airway matrix constituents, including elastin. The non-invasive measurement of urinary desmosine (UDes), a breakdown product of elastin, may be reflective of ongoing lung injury and may serve as a biomarker of active short-term damage during pulmonary exacerbation. Our objectives were to measure desmosine in the urine of CF patients hospitalized for treatment of a pulmonary exacerbation and to explore the correlation between desmosine concentration and other markers of clinical improvement, including lung function and inflammatory mediators. METHODS Urine and blood samples plus lung function measurements were collected at up to three points during hospitalization for treatment of a CF pulmonary exacerbation. We used a repeated measures model, adjusted for age and time between measurements, to compare log transformed urine desmosine concentrations across multiple time points and to correlate those concentrations with related clinical variables. Change in UDes concentration was investigated using a statistical model that incorporated normalization factors to account for variations in urinary concentration. RESULTS Desmosine was measured by radioimmunoassay (RIA) in 155 spot urine samples from 53 CF patients hospitalized for 63 pulmonary exacerbations (range of results: 0-235 pmol Des/ml). Specific gravity (SG) adjusted UDes concentration decreased significantly during admission for CF pulmonary exacerbation, P < 0.01 (average length of stay = 11 days). No correlation was observed between UDes concentration and lung function or inflammatory markers. CONCLUSIONS UDes decreased significantly following treatment for an acute pulmonary exacerbation and may be a useful biomarker of short-term injury to the CF lung. Further investigation is needed to evaluate the utility of UDes concentration in the long-term progression of CF lung disease.
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Affiliation(s)
- Theresa A Laguna
- Department of Pediatrics, University of Minnesota Medical School and The University of Minnesota Amplatz Children's Hospital, Minneapolis, Minnesota 55455, USA.
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Bader M, Messerer P, Will W. Urinary creatinine concentrations in an industrial workforce and comparison with reference values of the general population. Int Arch Occup Environ Health 2012; 86:673-80. [DOI: 10.1007/s00420-012-0802-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 07/24/2012] [Indexed: 11/29/2022]
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B'Hymer C, Krieg E, Cheever KL, Toennis CA, Clark JC, Kesner JS, Gibson R, Butler MA. Evaluation and comparison of urinary metabolic biomarkers of exposure for the jet fuel JP-8. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2012; 75:661-672. [PMID: 22712851 PMCID: PMC4699168 DOI: 10.1080/15287394.2012.688483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A study of workers exposed to jet fuel propellant 8 (JP-8) was conducted at U.S. Air Force bases and included the evaluation of three biomarkers of exposure: S-benzylmercapturic acid (BMA), S-phenylmercapturic acid (PMA), and (2-methoxyethoxy)acetic acid (MEAA). Postshift urine specimens were collected from various personnel categorized as high (n = 98), moderate (n = 38) and low (n = 61) JP-8 exposure based on work activities. BMA and PMA urinary levels were determined by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS), and MEAA urinary levels were determined by gas chromatography-mass spectrometry (GC-MS). The numbers of samples determined as positive for the presence of the BMA biomarker (above the test method's limit of detection [LOD = 0.5 ng/ml]) were 96 (98.0%), 37 (97.4%), and 58 (95.1%) for the high, moderate, and low (control) exposure workgroup categories, respectively. The numbers of samples determined as positive for the presence of the PMA biomarker (LOD = 0.5 ng/ml) were 33 (33.7%), 9 (23.7%), and 12 (19.7%) for the high, moderate, and low exposure categories. The numbers of samples determined as positive for the presence of the MEAA biomarker (LOD = 0.1 μ g/ml) were 92 (93.4%), 13 (34.2%), and 2 (3.3%) for the high, moderate, and low exposure categories. Statistical analysis of the mean levels of the analytes demonstrated MEAA to be the most accurate or appropriate biomarker for JP-8 exposure using urinary concentrations either adjusted or not adjusted for creatinine; mean levels of BMA and PMA were not statistically significant between workgroup categories after adjusting for creatinine.
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Affiliation(s)
- Clayton B'Hymer
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 4676 Columbia Parkway, Cincinnati, OH 45226, USA.
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Simultaneous determination of serotonin and creatinine in urine by combining two ultrasound-assisted emulsification microextractions with on-column stacking in capillary electrophoresis. J Sep Sci 2011; 35:436-44. [DOI: 10.1002/jssc.201100778] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Revised: 10/27/2011] [Accepted: 11/01/2011] [Indexed: 11/07/2022]
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Konvalinka A, Scholey JW, Diamandis EP. Searching for new biomarkers of renal diseases through proteomics. Clin Chem 2011; 58:353-65. [PMID: 21980170 DOI: 10.1373/clinchem.2011.165969] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Technological advances have resulted in a renaissance of proteomic studies directed at finding markers of disease progression, diagnosis, or responsiveness to therapy. Renal diseases are ideally suited for such research, given that urine is an easily accessible biofluid and its protein content is derived mainly from the kidney. Current renal prognostic markers have limited value, and renal biopsy remains the sole method for establishing a diagnosis. Mass spectrometry instruments, which can detect thousands of proteins at nanomolar (or even femtomolar) concentrations, may be expected to allow the discovery of improved markers of progression, diagnosis, or treatment responsiveness. CONTENT In this review we describe the strengths and limitations of proteomic methods and the drawbacks of existing biomarkers, and provide an overview of opportunities in the field. We also highlight several proteomic studies of biomarkers of renal diseases selected from the plethora of studies performed. SUMMARY It is clear that the field of proteomics has not yet fulfilled its promise. However, ongoing efforts to standardize sample collection and preparation, improve study designs, perform multicenter validations, and create joint industry-regulatory bodies offer promise for the recognition of novel molecules that could change clinical nephrology forever.
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Affiliation(s)
- Ana Konvalinka
- Department of Medicine, Division of Nephrology, University of Toronto, Toronto, Ontario, Canada
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(2-Methoxyethoxy)acetic acid: a urinary biomarker of exposure for jet fuel JP-8. Int Arch Occup Environ Health 2011; 85:413-20. [DOI: 10.1007/s00420-011-0687-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 07/19/2011] [Indexed: 10/17/2022]
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Muscat JE, Liu A, Richie JP. A comparison of creatinine vs. specific gravity to correct for urinary dilution of cotinine. Biomarkers 2011; 16:206-11. [PMID: 21288164 DOI: 10.3109/1354750x.2010.538084] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT The validity of urinary correction standards has not been established for most analytes. METHODS We compared urinary creatinine and specific gravity as dilution correction standards for cotinine in a community-based study of smokers. RESULTS Models of blood cotinine regressed against CR or SG (measured by total soluble solids) significantly improved the fit compared to a model without a dilution measure (P < 0.01). There were no differences in model fit between CR- and SG-corrected values. Both CR and SG were significant predictors of urinary cotinine regressed against cigarettes smoked per day (P < 0.01). CONCLUSION CR and SG are valid and interchangeable correction standards.
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Affiliation(s)
- Joshua E Muscat
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
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Gaines LGT, Fent KW, Flack SL, Thomasen JM, Whittaker SG, Nylander-French LA. Factors affecting variability in the urinary biomarker 1,6-hexamethylene diamine in workers exposed to 1,6-hexamethylene diisocyanate. ACTA ACUST UNITED AC 2010; 13:119-27. [PMID: 20978689 DOI: 10.1039/c0em00122h] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Although urinary 1,6-hexamethylene diamine (HDA) is a useful biomarker of exposure to 1,6-hexamethylene diisocyanate (HDI), a large degree of unexplained intra- and inter-individual variability exists between estimated HDI exposure and urine HDA levels. We investigated the effect of individual and workplace factors on urine HDA levels using quantitative dermal and inhalation exposure data derived from a survey of automotive spray painters exposed to HDI. Painters' dermal and breathing-zone HDI-exposures were monitored over an entire workday for up to three separate workdays, spaced approximately one month apart. One urine sample was collected before the start of work with HDI-containing paints, and multiple samples were collected throughout the workday. Using mixed effects multiple linear regression modeling, coverall use resulted in significantly lower HDA levels (p = 0.12), and weekday contributed to significant variability in HDA levels (p = 0.056). We also investigated differences in urine HDA levels stratified by dichotomous and classification covariates using analysis of variance. Use of coveralls (p = 0.05), respirator type worn (p = 0.06), smoker status (p = 0.12), paint-booth type (p = 0.02), and more than one painter at the shop (p = 0.10) were all found to significantly affect urine HDA levels adjusted for creatinine concentration. Coverall use remained significant (p = 0.10), even after adjusting for respirator type. These results indicate that the variation in urine HDA level is mainly due to workplace factors and that appropriate dermal and inhalation protection is required to prevent HDI exposure.
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Affiliation(s)
- Linda G T Gaines
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina, CB #7431, Rosenau Hall, Chapel Hill, NC 27599-7431, USA
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