脂质和肌酐调整以评估环境暴露对健康的影响。
Lipid and Creatinine Adjustment to Evaluate Health Effects of Environmental Exposures.
机构信息
Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Research Triangle Park, Durham, NC, 27709, USA.
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 TW Alexander Dr, Research Triangle Park, Durham, NC, 27709, USA.
出版信息
Curr Environ Health Rep. 2017 Mar;4(1):44-50. doi: 10.1007/s40572-017-0122-7.
PURPOSE OF REVIEW
Urine- and serum-based biomarkers are useful for assessing individuals' exposure to environmental factors. However, variations in urinary creatinine (a measure of dilution) or serum lipid levels, if not adequately corrected for, can directly impact biomarker concentrations and bias exposure-disease association measures.
RECENT FINDINGS
Recent methodological literature has considered the complex relationships between creatinine or serum lipid levels, exposure biomarkers, outcomes, and other potentially relevant factors using directed acyclic graphs and simulation studies. The optimal measures of urinary dilution and serum lipids have also been investigated. Existing evidence supports the use of covariate-adjusted standardization plus creatinine adjustment for urinary biomarkers and standardization plus serum lipid adjustment for lipophilic, serum-based biomarkers. It is unclear which urinary dilution measure is best, but all serum lipid measures performed similarly. Future research should assess methods for pooled biomarkers and for studying diseases and exposures that affect creatinine or serum lipids directly.
目的综述
尿液和血清生物标志物可用于评估个体接触环境因素的情况。然而，如果不对尿液肌酐（一种稀释度的衡量指标）或血清脂质水平进行适当校正，可能会直接影响生物标志物浓度，并对暴露-疾病关联的衡量指标产生偏差。
最近的发现
最近的方法学文献使用有向无环图和模拟研究，考虑了肌酐或血清脂质水平、暴露生物标志物、结果以及其他潜在相关因素之间的复杂关系。还研究了尿液稀释和血清脂质的最佳衡量指标。现有证据支持对尿液生物标志物使用协变量调整加肌酐校正，对亲脂性血清生物标志物使用标准化加血清脂质校正。目前尚不清楚哪种尿液稀释衡量指标最佳，但所有血清脂质衡量指标的表现都相似。未来的研究应评估用于合并生物标志物的方法以及用于研究直接影响肌酐或血清脂质的疾病和暴露的方法。
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