Variability of Urinary Cadmium Excretion in Spot Urine Samples, First Morning Voids, and 24 h Urine in a Healthy Non-smoking Population: Implications for Study Design

Overview

Journal J Expo Sci Environ Epidemiol

Specialties Environmental Health
Public Health

Date 2013 Sep 12

PMID 24022669

Citations 26

Authors

Magnus Akerstrom

Lars Barregard

Thomas Lundh

Gerd Sallsten

Affiliations

Soon will be listed here.

Abstract

When selecting the least biased exposure surrogate, for example, the concentration of a biomarker in a urine sample, information on variability must be taken into consideration. We used mixed-effects models to estimate the variability and determinants of urinary cadmium (U-Cd) excretion using spot urine samples collected at six fixed times during 2 days about 1 week apart, from 24 healthy non-smokers. The urine samples were analysed for U-Cd, the concentrations were adjusted for dilution, and the excretion rates were calculated. Between-individual variability dominated the total variability for most measures of U-Cd excretion, especially for 24 h urine and first morning samples. The U-Cd excretion showed a circadian rhythm during the day, and time point of sampling was a significant factor in the mixed-effects models, thus a standardised sampling time, such as first morning urine samples, needs to be applied. Gender, urinary flow rate, age, and urinary protein excretions were also significant determinants for U-Cd excretion. The choice of biomarker for U-Cd excretion was found to be more important in individually-based studies of exposure-response relationships than in studies of comparing Cd levels of groups. When planning a study, this variability of U-Cd in spot samples must be acknowledged.

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