Department of Clinical Biochemistry, University Hospital Southampton NHS Foundation Trust, Tremona Road, C Level MP 6, South Block, Southampton SO16 6YD, UK.
Ann Clin Biochem. 2012 Jul;49(Pt 4):341-51. doi: 10.1258/acb.2011.011179. Epub 2012 Feb 23.
Introduction of inductively coupled plasma mass spectrometry (ICP-MS) into clinical laboratories has led to an increasing application of analyses to risk assessment for toxicity from environmental exposure to trace elements, and in occupational monitoring. Interpretation of results from random urine samples may be problematic and measurement of excretion over 24 h is sometimes preferable. Recent reference data are sparse.
Twenty-four-hour urine samples from 111 healthy adults from the renal stones clinic in Southampton, UK, were analysed for 31 trace elements using ICP-MS and for zinc using atomic absorption spectroscopy. Non-parametric 0.95 coverage intervals were determined for trace element excretion per 24 h and as a ratio to creatinine, for the full study cohort and separately for men (n=77) and women (n=34).
Beryllium was undetectable in 95% of samples, bismuth in 87% and uranium in 75%. In comparison with published ranges, reference intervals for this cohort were higher for molybdenum, tin and vanadium, and for arsenic due to inclusion of fish arsenicals. Aluminium, chromium, iron, lead and mercury were lower. In our cohort, 24-h excretion of 17 elements was significantly higher in men than in women. However, when expressed as trace element to creatinine ratios, the situation reversed strikingly. Because of their lower creatinine excretion, ratios for 18 elements were significantly higher for women.
New adult reference intervals were obtained for 24-h urine trace element excretion. Trace element:creatinine ratios must be used cautiously, with separate ranges for men and women.
电感耦合等离子体质谱（ICP-MS）在临床实验室中的应用，使得对微量元素环境暴露毒性风险评估以及职业监测中的分析越来越多。随机尿液样本的结果解读可能存在问题，且 24 小时尿液排泄量的测量有时更为可取。目前参考数据较为匮乏。
在英国南安普顿的肾结石诊所，对 111 名健康成年人的 24 小时尿液样本进行了分析，采用 ICP-MS 分析了 31 种微量元素，原子吸收光谱法分析了锌。对整个研究队列和男性（n=77）和女性（n=34）队列分别测定了 24 小时微量元素排泄量和肌酐比值的非参数 0.95 覆盖区间。
95%的样本中未检出铍，87%的样本中未检出铋，75%的样本中未检出铀。与已发表的范围相比，该队列的参考区间较高的元素有钼、锡和钒，以及由于包括鱼类砷化物而增加的砷。铝、铬、铁、铅和汞的水平较低。在我们的队列中，17 种元素的 24 小时排泄量在男性中明显高于女性。然而，当以微量元素与肌酐的比值表示时，情况则截然相反。由于肌酐排泄量较低，女性的 18 种元素比值明显更高。
获得了 24 小时尿液微量元素排泄的新成人参考区间。必须谨慎使用微量元素与肌酐的比值，男女需分别设定范围。
