title: Nickel exposure and prevalent albuminuria and β2-microglobulinuria: evidence from a population-based study.
abstract: BACKGROUND
  High exposure to nickel could induce renal dysfunction in rodents and occupational workers. However, little is known about the effects of non-occupational exposure to nickel on renal health in the general population. We aimed to examine the associations of urinary nickel concentrations with albuminuria and β2-microglobulinuria in Chinese adults.
  
  
  METHODS
  2115 non-institutionalised Chinese men and women aged 55-76 years from Beijing and Shanghai were included. Urinary nickel concentrations were assessed by inductively coupled plasma mass spectroscopy. Plasma uric acid, urea nitrogen, C reactive protein and urinary albumin, β2-microglobulin and creatinine were measured. Albuminuria was defined as urinary albumin ≥30 mg/g creatinine, and β2-microglobulinuria was defined as urinary β2-microglobulin ≥200 µg/g creatinine.
  
  
  RESULTS
  Median concentration of urinary nickel was 3.95 μg/g creatinine (IQR: 2.57-6.71 μg/g creatinine), and prevalence of albuminuria, β2-microglobulinuria and both albuminuria and β2-microglobulinuria was 22.1%, 24.5% and 9.7%, respectively. Comparing the highest with the lowest quartile of urinary nickel, the ORs (95% CIs) were 1.99 (1.46 to 2.78) for albuminuria, 1.44 (1.07 to 1.95) for β2-microglobulinuria, and 2.95 (1.74 to 4.97) for both albuminuria and β2-microglobulinuria, after adjustment for demographic characteristics, lifestyle behaviours, body mass index, hypertension and diabetes. The association remained significant when further controlling for inflammatory markers or other heavy metals (all p trend <0.05).
  
  
  CONCLUSIONS
  This study suggested that urinary nickel levels were positively associated with albuminuria and β2-microglobulinuria in Chinese men and women, who had relatively low background nickel exposure. More prospective studies are needed to confirm our findings.
authors.affiliation: From the Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Chinese Academy of Sciences, and University of Chinese Academy of Sciences, Shanghai, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Liu
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Qi
authors.initials: Q
authors.lastname: Sun
authors.affiliation: From the Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Chinese Academy of Sciences, and University of Chinese Academy of Sciences, Shanghai, China.
authors.forename: Mingjiang
authors.initials: M
authors.lastname: Zhu
authors.affiliation: From the Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Chinese Academy of Sciences, and University of Chinese Academy of Sciences, Shanghai, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Sun
authors.affiliation: From the Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Chinese Academy of Sciences, and University of Chinese Academy of Sciences, Shanghai, China.
authors.forename: Zhenzhen
authors.initials: Z
authors.lastname: Wang
authors.affiliation: From the Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Chinese Academy of Sciences, and University of Chinese Academy of Sciences, Shanghai, China.
authors.forename: Huaixing
authors.initials: H
authors.lastname: Li
authors.affiliation: From the Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Chinese Academy of Sciences, and University of Chinese Academy of Sciences, Shanghai, China.
authors.forename: Zi
authors.initials: Z
authors.lastname: Li
authors.affiliation: From the Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Chinese Academy of Sciences, and University of Chinese Academy of Sciences, Shanghai, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: From the Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Chinese Academy of Sciences, and University of Chinese Academy of Sciences, Shanghai, China.
authors.forename: Huiyong
authors.initials: H
authors.lastname: Yin
authors.affiliation: From the Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Chinese Academy of Sciences, and University of Chinese Academy of Sciences, Shanghai, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Lin
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000652:urine*; D015415:Biomarkers / Q000652:urine*; D002681:China / Q000453:epidemiology; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009532:Nickel / Q000652:urine*; D015995:Prevalence
chemical_list: D015415:Biomarkers; D009532:Nickel
keywords: ENVIRONMENTAL HEALTH; EPIDEMIOLOGY; RENAL