Lipid and Creatinine Adjustment to Evaluate Health Effects of Environmental Exposures.
Lipid and Creatinine Adjustment to Evaluate Health Effects of Environmental Exposures.
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DOI：
10.1007/s40572-017-0122-7
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发表时间：
2017-03
影响因子：
7.9
通讯作者：
Buckley JP
中科院分区：
文献类型：
--
作者：
O'Brien KM;Upson K;Buckley JP
基于尿液和血清的生物标志物可用于评估个体对环境因素的暴露。然而，尿肌酐（稀释的量度）或血清脂质水平的变化，如果没有充分校正，可以直接影响生物标志物浓度和偏倚确定性-疾病关联量度。最近的方法学文献考虑了肌酐或血脂水平，暴露生物标志物，结果和其他潜在的相关因素之间的复杂关系，使用有向无环图和模拟研究。并对尿稀释和血脂的最佳测定方法进行了探讨。现有证据支持使用协变量调整的标准化加肌酐调整的尿生物标志物和标准化加血清脂质调整的亲脂性，血清为基础的生物标志物。目前尚不清楚哪种尿稀释测量方法最好，但所有血脂测量方法的表现相似。未来的研究应评估汇集生物标志物的方法，并研究直接影响肌酐或血脂的疾病和暴露。
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 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.