title: Associations between Urinary Excretion of Cadmium and Renal Biomarkers in Nonsmoking Females: A Cross-Sectional Study in Rural Areas of South China.
abstract: OBJECTIVE
  The aim of this study was to systematically evaluate the relationship between urinary excretion of cadmium (U-Cd) and biomarkers of renal dysfunction.
  
  
  METHODS
  One hundred eighty five non-smoking female farmers (aged from 44 to 71 years) were recruited from two rural areas with different cadmium levels of exposure in southern China. Morning spot urine samples were collected for detecting U-Cd, urinary creatinine (U-cre), β₂-microglobulin (β₂-MG), α₁-microglobulin (α₁-MG), metallothionein (MT), retinol binding protein (RBP), albumin (AB), N-acetyl-β-D-glucosaminidase (NAG), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGT) and kidney injury molecule-1 (KIM-1). Spearman's rank correlation was carried out to assess pairwise bivariate associations between continuous variables. Three different models of multiple linear regression (the cre-corrected, un-corrected and cre-adjusted model) were used to model the dose-response relationships between U-Cd and nine urine markers.
  
  
  RESULTS
  Spearman's rank correlation showed that NAG, ALP, RBP, β₂-MG and MT were significantly associated with U-Cd for both cre-corrected and observed data. Generally, NAG correlated best with U-Cd among the nine biomarkers studied, followed by ALP and MT. In the un-corrected model and cre-adjusted model, the regression coefficients and R² of nine biomarkers were larger than the corresponding values in the cre-corrected model, indicating that the use of observed data was better for investigating the relationship between biomarkers and U-Cd than cre-corrected data.
  
  
  CONCLUSIONS
  Our results suggest that NAG, MT and ALP in urine were better biomarkers for long-term environmental cadmium exposure assessment among the nine biomarkers studied. Further, data without normalization with creatinine show better relationships between cadmium exposure and renal dysfunction.
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China. jnurae@163.com.|Department of Occupational and Environmental Health, Medical School, Ji'Nan University, Guangzhou 510632, China. jnurae@163.com.
authors.forename: Yun-rui
authors.initials: YR
authors.lastname: Zhang
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China. wangp@gdiph.org.cn.|Guangdong Provincial Institute of Public Health, Guangzhou 511430, China. wangp@gdiph.org.cn.
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China. liangxuxia@126.com.
authors.forename: Xu-xia
authors.initials: XX
authors.lastname: Liang
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, 119077, Singapore. ephtcs@nus.edu.sg.
authors.forename: Chuen Seng
authors.initials: CS
authors.lastname: Tan
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China. tan-sword@163.com.
authors.forename: Jian-bin
authors.initials: JB
authors.lastname: Tan
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China. wjgdcdc@126.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China. huangqiong@cdcp.org.cn.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Huang
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China. huangr@gdiph.org.cn.|Guangdong Provincial Institute of Public Health, Guangzhou 511430, China. huangr@gdiph.org.cn.
authors.forename: Rui
authors.initials: R
authors.lastname: Huang
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China. jnulizhixue@163.com.|Department of Occupational and Environmental Health, Medical School, Ji'Nan University, Guangzhou 510632, China. jnulizhixue@163.com.
authors.forename: Zhi-xue
authors.initials: ZX
authors.lastname: Li
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China. chenwcgz@126.com.
authors.forename: Wen-cai
authors.initials: WC
authors.lastname: Chen
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China. wshixuan@126.com.
authors.forename: Shi-xuan
authors.initials: SX
authors.lastname: Wu
authors.affiliation: National University of Singapore Environmental Research Institute (NERI), 117597 Singapore. choon_nam_ong@nuhs.edu.sg.
authors.forename: Choon Nam
authors.initials: CN
authors.lastname: Ong
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China. yangxingfen@21cn.com.
authors.forename: Xing-fen
authors.initials: XF
authors.lastname: Yang
authors.affiliation: Key Laboratory of Food Safety Risk Assessment of Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing 100022, China. wuyongning@cfsa.net.cn.
authors.forename: Yong-ning
authors.initials: YN
authors.lastname: Wu
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine; D000328:Adult; D000368:Aged; D000419:Albuminuria; D000510:Alpha-Globulins / Q000652:urine; D015415:Biomarkers / Q000652:urine; D002104:Cadmium / Q000652:urine*; D002681:China; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D007668:Kidney / Q000378:metabolism*; D008562:Membrane Glycoproteins / Q000652:urine; D008668:Metallothionein / Q000652:urine; D008875:Middle Aged; D011991:Receptors, Virus; D054840:Retinol-Binding Proteins, Cellular / Q000652:urine; D012424:Rural Population; D001613:beta 2-Microglobulin / Q000652:urine; D005723:gamma-Glutamyltransferase / Q000652:urine
chemical_list: D000510:Alpha-Globulins; D015415:Biomarkers; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D008562:Membrane Glycoproteins; D011991:Receptors, Virus; D054840:Retinol-Binding Proteins, Cellular; C016001:alpha-1-microglobulin; D001613:beta 2-Microglobulin; D002104:Cadmium; D008668:Metallothionein; D003404:Creatinine; D005723:gamma-Glutamyltransferase; D000118:Acetylglucosaminidase
keywords: biomonitoring; cadmium; cross-sectional studies; renal; women