Performance of Urine, Blood, and Integrated Metal Biomarkers in Relation to Birth Outcomes in a Mixture Setting
Year: 2021
Type: conference-abstract
Abstract: BACKGROUND AND AIM: The ability to evaluate mixture effects of metal mixtures are limited by the uncertainty whether a single biological medium can fully capture exposure for each metal. The aim of this study was to examine the mixture predictive performance of urine and blood metal biomarkers and integrated multi-media biomarkers in association with birth outcomes. METHODS: In our analysis of 847 women from the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) study, we measured 10 essential and non-essential metals in repeated and paired samples of urine and blood during pregnancy. For each metal, we integrated exposure estimates from paired urine and blood biomarkers into multi-media biomarkers (MMBs), using intraclass-correlation coefficient (ICC) and weighted quantile sum (WQS) approaches. Using Ridge regressions, four separate Environmental risk scores (ERSs) for metals in urine, blood, MMBICC, and MMBWQS were computed as a weighted sum of the 10 metal concentrations. We then examined associations between urine, blood, and multi-media biomarker ERSs and birth outcomes using linear and logistic regressions, adjusting for maternal age, maternal education, pre-pregnancy body mass index (BMI), and second-hand smoke exposure. RESULTS:Individuals with high ERS (3rd tertile) showed increased odds of preterm birth compared to individuals with low ERS (1st tertile), with 2.8-fold for urine (specific gravity corrected); 3.2- fold for blood; 3.9-fold for the multi-media biomarkers composed using ICC; and 5.2-fold for multi-media biomarkers composed using WQS. The four ERSs had comparable predictive performances (AUC ranging from 0.64 to 0.68) when urine is examined with specific gravity corrected concentrations; the performances were also significantly better than the performance of urine ERS without accounting for specific gravity. CONCLUSIONS:Within a practical metal panel, measuring metals in either urine or blood may be an equally good approach to evaluate the metals as a mixture, but only when the urine measurements are corrected for urinary dilution. KEYWORDS: Metals, prenatal stress, social support, manganese, Puerto Rico.
Source: ISEE Conference Abstracts
Language: English
Subfield: Health, Toxicology and Mutagenesis
Field: Environmental Science
Domain: Physical Sciences
Open Access status: diamond
OpenAlex ID: W3195829931