An assessment of sensitivity biomarkers for urinary cadmium burden
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RESEARCH ARTICLE
Open Access
An assessment of sensitivity biomarkers for urinary cadmium burden Yuting Li1, Hongmei Wang2*, Jie Yu1, Qiong Yan1, Honggang Hu1, Lishu Zhang1, Tian Tian1, Xianglei Peng1, Shuo Yang1 and Shen Ke1*
Abstract Background: Excess cadmium (Cd) intake poses a general risk to health and to the kidneys in particular. Among indices of renal dysfunction under Cd burden measures are the urinary N-acetyl-β-D-glucosidase (UNAG) and urinary β2-microglobulin (Uβ2-MG) enzymes. However, the end-pointed values and the Cd burden threshold remain controversial because the scopes fluctuate widely. Methods: To ascertain the clinical benchmark dose of urinary Cd (UCd) burden for renal dysfunction, 1595 residents near a Cd site were surveyed. Urine was sampled and assayed. A benchmark dose low (BMDL) was obtained by fitting UCd levels and index levels. Results: We found that over 50% of the subjects were suffering from Cd exposure as their UCd levels far exceeded the national standard threshold of 5.000 μg/g creatinine (cr). Further analysis indicated that Uβ2-MG was more sensitive than UNAG for renal dysfunction. The BMDL for UCd was estimated as 3.486 U/g cr (male, where U is unit of enzyme) and 2.998 U/g cr (female) for UNAG. The BMDL for Uβ2-MG, which is released into urine from glomerulus after Cd exposure, was found to be 2.506 μg/g cr (male, where μg is the unit of microglobulin) and 2.236 μg/g cr (female). Conclusions: Uβ2-MG is recommended as the sensitivity index for renal dysfunction, with 2.2 μg/g cr as the threshold for clinical diagnosis. Our findings suggest that Uβ2-MG is the better biomarker for exposure to Cd. Keywords: Urinary cadmium, Urinary N-acetyl-β-D-glucosidase (UNAG), Urinary β2-microglobulin (Uβ2-MG), Benchmark dose, Renal dysfunction
Background Cadmium (Cd) in the environment enters organisms via the atmosphere, drinking water, and contaminated soil and food [1]. Excess Cd exposure is harmful to health [2, 3]. The well-known case of the Itai-Itai disease in Japan was the most severe stage of long-term Cd exposure [1]. Many organs are damaged by excess Cd burden, * Correspondence: [email protected]; [email protected] 2 State Key Laboratory of Environmental Criteria and Risk Assessment, Department of Environment and Health, Chinese Research Academy of Environmental Sciences, Beijing 100012, PR China 1 Department of Life Science and Bioengineering, School of Science, Beijing Jiaotong University, No.3, Shangyuan Village, Haidian District, Beijing 100044, China
resulting in defective bone formation, including osteoporosis [4, 5], and some cancers [6, 7]. The kidney is an important organ that suffers damage from Cd exposure, as reported by previous studies [8, 9]. This view has been further supported by more recent research, which has also recommended that the kidney is to be considered an early-stage target of Cd [10, 11]. A range of factors (including age, years of exposure, and gender) that affect the relationship between Cd burden and the prevalence of kidney dysfunction have been
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