DOI QR코드

DOI QR Code

Urinary Creatinine Concentration in the Korean Population in KNHANES IV, 2009

한국인의 요중 크레아티닌 농도에 관한 연구 -국민건강영양조사 4기 자료 이용-

  • Jung, Kyung-Sick (Institute of Environmental and Occupational Medicine, Soonchunhyang University) ;
  • Kim, Nam-Soo (Institute of Environmental and Occupational Medicine, Soonchunhyang University) ;
  • Lee, Byung-Kook (Institute of Environmental and Occupational Medicine, Soonchunhyang University)
  • 정경식 (순천향대학교 환경산업의학연구소) ;
  • 김남수 (순천향대학교 환경산업의학연구소) ;
  • 이병국 (순천향대학교 환경산업의학연구소)
  • Received : 2011.12.07
  • Accepted : 2012.02.23
  • Published : 2012.02.29

Abstract

Objectives: Biomonitoring is used to assess human environmental exposures. Urinary biomonitoring data are typically adjusted to a constant creatinine concentration to correct for variable dilutions among spot samples. Our objective was to investigate urinary creatinine concentrations by region, gender, age and lifestyle. Methods: We studied urinary creatinine concentrations in 6,286 Koreans aged 20 years old and older who participated the fourth Korea National Health and Nutrition Survey (KNHANES IV) in 2009. Urinary creatinine concentration analysis used the Jaffe method. Results: The average urinary creatinine concentration of 6,286 Koreans was 158.99 mg/dl. The urinary creatinine concentration was significantly higher among men (184.97 mg/dl) than women (130.02 mg/dl). In both men and women, urinary creatinine concentrations were significantly different according to age group (p < 0.01). Whereas the urinary creatinine concentration of men significantly differed with smoking in adjusted comparison analysis, that of women significantly differed by education level. Ninety-two percent of urinary creatinine concentration was included within WHO guidelines effective range(30 mg/dl ${\leq}$ urinary creatinine concentration ${\leq}$ 300 mg/dl). In multiple regression analysis, creatinine was influenced by gender, age and body mass index (BMI). Conclusions: The urinary creatinine value obtained from representative samples of adult Koreans aged 20 year and older in KNHANES IV 2009 could be used as a reference value for other nationally studied surveys, such as abandoned metal mine surveys and surveys for industrial complexes.

Keywords

References

  1. Department of Health and Human Services Centers for Disease Control and Prevention. Fourth National Report on Human Exposure to Environmental Chemicals. 2009.
  2. Department of Health and Human Services Centers for Disease Control and Prevention. NHANES (National Health and Nutrition Examination Survey). Available http://www.cdc.gov/nchs/nhanes.htm [accessed 29 July 2011].
  3. Federal Environment Agency (Umwelt Bundes Amt). German Environmental Survey for Children 2003/06 GerES IV Human Biomonitoring. Federal Environment Agency (Umweltbundesamt), Dessau-Rosslau, Robert Koch-Institut (RKI). Berlin; 2008.
  4. Becker K, Conrad A, Kirsch N, Kolossa-Gehring M, Schulz C, Seiwert M, et al. German Environmental Survey (GerES) : Human biomonitoring as a tool to identify exposure pathways. Int J Hyg Environ Health. 2007; 210: 267-269. https://doi.org/10.1016/j.ijheh.2007.01.010
  5. Angerer J, Ewers U, Wilhelm, M. Human biomonitoring: State of the art. Int J Hyg Environ Health. 2007; 210: 201-228. https://doi.org/10.1016/j.ijheh.2007.01.024
  6. National Institute of Environmental Research. Research of toxic substance in biomarkers of residents in Korea. Seoul: Ministry of Environmental; 2007.
  7. National Academy of Environmental Science. Research of toxic substance in biomarkers of residents in Korea. Seoul: Ministry of Environmental; 2008.
  8. Ministry of Environmental Korea. Environmental Health Law; 2010.
  9. World Health Organization. Biological monitoring of chemical exposure in the workplace. GENEVA; 1996.
  10. Kim H, Kim SM, Cho SH Urinary creatinine adjustment for determination of urinary cadmium. J Preventive Med. 1991; 24(3): 459-461.
  11. Barr DB, Wilder LC, Caudill SP, Gonzalez AJ, Needham LL. Pirkle J. Urinary creatinine concentrations in the U.S. population: implications for urinary biologic monitoring measurements. Environ Health Perspect. 2005; 113(2): 192-200. https://doi.org/10.1289/ehp.7337
  12. Hill RH Jr, Ashley DL, Head SL, Needham LL, Pirkle JL. p-Dichlorobenzene exposure among 1,000 adults in the United States. Arch Environ Health. 1995; 50(4): 277-280. https://doi.org/10.1080/00039896.1995.9935954
  13. Shealy DB, Barr JR, Ashley DL, Patterson DG, Jr Camann DE, Bond AE. Correlation of environmental carbaryl measurements with serum and urinary 1-naphthol measurements in a farmer applicator and his family. Environ Health Perspect. 1997; 105(5): 510-513. https://doi.org/10.1289/ehp.97105510
  14. Boeniger MF, Lowry LK, Rosenberg J. Interpretation of urine results used to assess chemical exposure with emphasis on creatinine adjustments: a review. Am Ind Hyg Assoc J. 1993; 54(10): 615- 627. https://doi.org/10.1080/15298669391355134
  15. To-Figueras J, Sala M, Otero R, Barrot C, Santiago- Silva M, Rodamilans M. Metabolism of hexachlorobenzene in humans: association between serum levels and urinary metabolites in a highly exposed population. Environ Health Perspect. 1997; 105(1): 78-83. https://doi.org/10.1289/ehp.9710578
  16. Moriguchi J, Ezaki T, Tsukahara T, Fukui T, Ukai H, Okamoto S, et al. Decreases in urine specific gravity and urinary creatinine in elderly women. Int Arch Occup Environ Health. 2005; 78(6): 438-445. https://doi.org/10.1007/s00420-004-0597-z
  17. Nortier J, Bernard A, Roels H, Deschodt-Lanckman M, Gueuning C, Lauwerys R. Urinary neutral endopeptidase in workers exposed to cadmium: interaction with cigarette smoking. Occup Environ Med. 1997; 54(6): 432-436. https://doi.org/10.1136/oem.54.6.432
  18. Barbanel CS, Winkelman JW, Fischer GA, King AJ. Confirmation of the department of transportation criteria for a substituted urine specimen. Occup Environ Med. 2002; 44(5): 407-416. https://doi.org/10.1097/00043764-200205000-00009
  19. Barr DB, Thomas K, Curwin B, Landsittel D, Raymer J, Lu C, Donnelly KC, Acquavella J. Biomonitoring of exposure in farmworker studies. Environ Health Perspect. 2006; 114(6): 936-942. https://doi.org/10.1289/ehp.8527
  20. Hall MV, Leathard HL, Coley J. Urinary hormone levels during the natural menstrual cycle: the effect of age. J Endocrinol. 2001; 170: 157-164. https://doi.org/10.1677/joe.0.1700157
  21. Davies KM, Heaney RP, Rafferty K. Decline in muscle mass with age in women: a longitudinal study using an indirect measure. Metabolism. 2002; 51: 935-939. https://doi.org/10.1053/meta.2002.33355
  22. Suwazono Y, Akesson A, Alfven T, Jarup L, Vahter M. Creatinine versus specific gravity-adjusted urinary cadmium concentrations. Biomarkers. 2005; 10(2-3): 117-126. https://doi.org/10.1080/13547500500159001
  23. Han SK, Lee KY, Choi HS, Chung HS, Kim YW, Shim YS, et al. The alteration of cell-mediated immunity in geriatric population. Korean J Med. 1994; 46(4): 772-780.
  24. Lee JH, Ahn RM. Relevance of gender, age and the body mass index to changes in urinary creatinine concentration in Korea adults. J Environ Hlth Sci. 2010; 36(3): 215-221.
  25. Spierto FW, Hannon WH, Gunter EW, Smith SJ. Stability of urine creatinine. Clinica Chimica Acta. 1997; 264: 227-232. https://doi.org/10.1016/S0009-8981(97)00080-6
  26. Soliman SA, Abdel-Hay MH, Sulaiman MI, Tayeb OS. Stability of creatinine, urea and uric acid in urine stored under various conditions. Clinica Chimica Acta. 1986; 160: 319-326. https://doi.org/10.1016/0009-8981(86)90200-7
  27. Carrieri M, Trevisan A, Bartolucci GB. Adjustment to concentration-dilution of spot urine sample: correlation between specific gravity and creatinine. Int Arch Occup Environ Health. 2001; 74: 63-67. https://doi.org/10.1007/s004200000190
  28. Ohira SI, Kirk AB, Dasgupta PK. Automated measurement of urinary creatinine by multichannel kinetic spectrophotometry. Analytical Biochemistry. 2009; 384: 238-244. https://doi.org/10.1016/j.ab.2008.10.015
  29. Arndt T. Urine-creatinine concentration as a marker of urine dilution: Reflections using a cohort of 45,000 sample. Forensic Sci Int. 2009; 186: 48-51. https://doi.org/10.1016/j.forsciint.2009.01.010
  30. Park JH. Exposure assessment of biological agents in indoor environmental. Korean J Environ Health Sci. 2009; 35(4): 239-248. https://doi.org/10.5668/JEHS.2009.35.4.239
  31. Mage DT, Allen RH, Gondy G, Smith W, Barr DB, Needham LL. Estimating pesticide dose from urinary pesticide concentration data by creatinine corretion in the Third National Health and Nutrition Examination Survey (NHANES-III). Journal of Exposure Analysis and Environmental Epidemiology. 2004; 14: 457-465. https://doi.org/10.1038/sj.jea.7500343
  32. Derhasching U, Kittler H, Woisetschlager C, Bur A, Herkner H, Hirschl MM. Microalbumin measurement alone or calculation of the albumin/creatinine ratio for the screeing of hypertension patients?. Nephrology Dialysis Transplantation. 2002; 17: 81-85.
  33. Shin MA, Paek DM, Yoon CS. The relationship between the bone mineral density and urinary cadmium concentration of residents in an industrial complex. Environ Res. 2011; 111: 101-109. https://doi.org/10.1016/j.envres.2010.11.010
  34. Swaddiwudhipong W, Mahasakpan P, Limpatanachote P, Krintratun S. Correlations of urinary cadmium with hypertension and diabetes in persons living in cadmium-contaminates villages in northwestern Thailand. Environ Res. 2010; 110: 612-616. https://doi.org/10.1016/j.envres.2010.06.002
  35. Al-Saleh I, Shinwari N, Mashhour A, Mohamed Gel-D, Ghosh MA, Shammasi Z, Al-Nasser A. Cadmium and murcury levels in Saudi women and its possible relationship with hypertension. Biol Trace Elem Res. 2006; 112: 13-29. https://doi.org/10.1385/BTER:112:1:13
  36. Spencer K. Analytical reviews in clinical biochemistry. Ann Clin Biochem. 1986; 23: 1-25. https://doi.org/10.1177/000456328602300101
  37. Moore RR, Jr, Hirata-Dulas CA, Kasiske BL. Use of urine specific gravity to improve screening for albuminuria. Kidney Int. 1997; 52: 240-243. https://doi.org/10.1038/ki.1997.326
  38. Parikh CR, Gyamlani GG, Carvounis CP. Screening for microalbuminuria simplified by urine specific gravity. Am J Nephrol. 2002; 22: 315-319. https://doi.org/10.1159/000065220
  39. National Institute for Occupational Safety and Health. Criteria for a recommended standard-occupational exposure to benzene. DEHW, Cincinnati, Ohio, USA; 1974, p.109-112.
  40. Elkins HB, Pagnotto LD, Smith HL. Concentration adjustment in urinalisys. Am Ind Hyg Assoc J. 1974; 35: 559-565. https://doi.org/10.1080/0002889748507072
  41. Bjornsson TD. Use of serum creatinine concentrations to determine renal function. Clin Pharmacokinet. 1979; 4: 200-222. https://doi.org/10.2165/00003088-197904030-00003
  42. Tuner WJ, Cohn S. Total body potassium and 24- hour creatinine excretion in healthy males. Clin Pharm Ther. 1975; 18: 405-412. https://doi.org/10.1002/cpt1975184405
  43. Freeman NC, Wainman T, Lioy PJ, Stern AH, Shupack SI. The effect of remediation of chromium waste sites on chromium levels in urine of children living in the surrounding neighborhood. J Air Waste Manag Assoc. 1995; 45: 604-614. https://doi.org/10.1080/10473289.1995.10467390
  44. O'Rourke MK, Lizardi PS, Rogan SP, Freeman NC, Aguirre A, Saint CG. Pesticide exposure and creatinine variation among young children. J Expo Anal Environ Epidemiol. 2000; 10: 672-681. https://doi.org/10.1038/sj.jea.7500119
  45. Worsfold M, Davie MW, Haddaway MJ. Agerelated change in body composition, hydroxyproline, and creatinine in normal women. Calcif Tissue Int. 1999; 64: 40-44. https://doi.org/10.1007/s002239900576

Cited by

  1. Effects of Factors Associated with Urine Hippuric Acid Correction Values in Urinary Creatinine by HPLC and Jaffe Method and Specific Gravity HPLC Jaffe Method vol.25, pp.4, 2015, https://doi.org/10.15269/JKSOEH.2015.25.4.493