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Int. J. Environ. Res. Public Health 2015, 12(10), 11988-12001;

Associations between Urinary Excretion of Cadmium and Renal Biomarkers in Nonsmoking Females: A Cross-Sectional Study in Rural Areas of South China

Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
Department of Occupational and Environmental Health, Medical School, Ji'Nan University, Guangzhou 510632, China
Guangdong Provincial Institute of Public Health, Guangzhou 511430, China
Saw Swee Hock School of Public Health, National University of Singapore, 119077, Singapore
National University of Singapore Environmental Research Institute (NERI), 117597 Singapore
Key Laboratory of Food Safety Risk Assessment of Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing 100022, China
These authors contributed equally to this work.
Authors to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 19 June 2015 / Revised: 19 August 2015 / Accepted: 1 September 2015 / Published: 24 September 2015
Full-Text   |   PDF [663 KB, uploaded 24 September 2015]


Objectives: 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. View Full-Text
Keywords: cadmium; biomonitoring; renal; women; cross-sectional studies cadmium; biomonitoring; renal; women; cross-sectional studies
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Zhang, Y.-R.; Wang, P.; Liang, X.-X.; Tan, C.S.; Tan, J.-B.; Wang, J.; Huang, Q.; Huang, R.; Li, Z.-X.; Chen, W.-C.; Wu, S.-X.; Ong, C.N.; Yang, X.-F.; Wu, Y.-N. Associations between Urinary Excretion of Cadmium and Renal Biomarkers in Nonsmoking Females: A Cross-Sectional Study in Rural Areas of South China. Int. J. Environ. Res. Public Health 2015, 12, 11988-12001.

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