Variation in urinary flow rates according to demographic characteristics and body mass index in NHANES: potential confounding of associations between health outcomes and urinary biomarker concentrations.
Variation in urinary flow rates according to demographic characteristics and body mass index in NHANES: potential confounding of associations between health outcomes and urinary biomarker concentrations.
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DOI：
10.1289/ehp.1408944
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发表时间：
2015-04
影响因子：
10.4
通讯作者：
Blount BC
中科院分区：
文献类型：
--
作者：
Hays SM;Aylward LL;Blount BC
尿液分析物浓度受暴露水平和尿流率（UFR）的影响。UFR与人口统计学特征或体重指数（BMI）的系统性差异可能混淆健康结局与生物标志物浓度之间相关性的评估。我们评估了2009-2012年NHANES（国家健康和营养调查）数据集中不同年龄、性别、种族/民族和BMI类别的UFR（毫升/小时）和体重调整的UFR（UFRBW;毫升/千克/小时）模式。在年龄分层（6-11岁、12-19岁、20-39岁、40-59岁和≥ 60岁）亚组（性别、人种/种族和BMI类别）中比较几何平均（GM）UFR和UFRBW。在样本年龄组中评估了案例研究化学品双酚A和2，5-二氯苯酚的尿液分析物浓度或质量排泄率（纳克/小时和纳克/千克/小时BW）模式。UFR从6岁到60岁增加，然后随着年龄的增加而下降。UFRBW随年龄的增长呈负相关。UFR，而不是UFRBW，在性别上有显著差异（12岁后男性>女性）。在人种/种族类别中观察到这两个指标的差异。在所有年龄组中，UFRBW（而非UFR）与BMI类别和腰围呈负相关。尿渗透压随BMI增加而增加。案例研究表明，不同的风险暴露度量的结果的关系。常规的水合状态调节不能完全解决流速变化的影响。UFR和UFRBW随年龄、性别、人种/种族和BMI类别表现出系统性差异。这些变化可能会混淆基于尿液浓度的潜在风险-健康结果关联的评估。分析物排泄率是此类评估中有价值的暴露指标。Hays SM，Aylward LL，Blount BC. 2015. NHANES中根据人口统计学特征和体重指数的尿流率变化：健康结局和尿生物标志物浓度之间相关性的潜在混杂因素环境健康展望123：293-300; http：dx.doi.org/10.1289/ehp.1408944
Urinary analyte concentrations are affected both by exposure level and by urinary flow rate (UFR). Systematic variations in UFR with demographic characteristics or body mass index (BMI) could confound assessment of associations between health outcomes and biomarker concentrations. We assessed patterns of UFR (milliliters per hour) and body weight–adjusted UFR (UFRBW; milliliters per kilogram per hour) across age, sex, race/ethnicity, and BMI category in the NHANES (National Health and Nutrition Examination Survey) 2009–2012 data sets. Geometric mean (GM) UFR and UFRBW were compared across age-stratified (6–11, 12–19, 20–39, 40–59, and ≥ 60 years) subgroups (sex, race/ethnicity, and BMI category). Patterns of analyte urinary concentration or mass excretion rates (nanograms per hour and nanograms per kilogram per hour BW) were assessed in sample age groups for case study chemicals bisphenol A and 2,5-dichlorophenol. UFR increased from ages 6 to 60 years and then declined with increasing age. UFRBW varied inversely with age. UFR, but not UFRBW, differed significantly by sex (males > females after age 12 years). Differences in both metrics were observed among categories of race/ethnicity. UFRBW, but not UFR, varied inversely with BMI category and waist circumference in all age groups. Urinary osmolality increased with increasing BMI. Case studies demonstrated different exposure–outcome relationships depending on exposure metric. Conventional hydration status adjustments did not fully address the effect of flow rate variations. UFR and UFRBW exhibit systematic variations with age, sex, race/ethnicity, and BMI category. These variations can confound assessments of potential exposure–health outcome associations based on urinary concentration. Analyte excretion rates are valuable exposure metrics in such assessments. Hays SM, Aylward LL, Blount BC. 2015. Variation in urinary flow rates according to demographic characteristics and body mass index in NHANES: potential confounding of associations between health outcomes and urinary biomarker concentrations. Environ Health Perspect 123:293–300; http://dx.doi.org/10.1289/ehp.1408944
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