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Influence of body mass index status on urinary creatinine and specific gravity for epidemiological study of children

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European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

In epidemiological studies, urinary biomonitoring is a valid approach to assess the association between environmental chemical exposure and children’s health. Many clinical biomarkers (e.g., endogenous metabolites) are also based on analysis of urine. Considering the variability in urinary output, urinary concentrations of chemicals are commonly adjusted by creatinine and specific gravity (SG). However, there is a lack of systematic evaluation of their appropriateness for children. Furthermore, urinary SG and creatinine excretion could be influenced by body mass index (BMI), but the effect of BMI status on the two correction factors is unknown. We measured SG and creatinine concentrations of repeated first morning urine samples collected from 243 primary school children (8–11 years) over 5 consecutive weekdays. Urinary SG presented a higher temporal consistency compared with creatinine. Urinary SG was associated with sex (p < 0.001), whereas sex (p =0.034) and BMI (p = 00.008) were associated with urinary creatinine levels. Inter-day collection time was not associated with SG or creatinine after excluding the effect of Monday as a confounder. When stratified by BMI status, none of the factors were associated with creatinine among the overweight and obese children.

Conclusion: Generally, SG is preferable for correcting the variability in urinary output for children although creatinine correction may also perform well in overweight and obese children. SG correction is recommended for epidemiological exposure analysis in children based on urinary levels of exogenous or endogenous metabolites.

What is Known:

• Creatinine and SG are common factors for correcting urinary dilution.

• The data of temporal variability of urinary creatinine or SG is limited.

What is New:

• The inter-day variability of urinary SG and creatinine in children is explored.

• The influence of BMI status on urinary creatinine and SG is analyzed.

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Abbreviations

BMI:

Body mass index

BPA:

Bisphenol A

CI:

Confidence interval

ICC:

Intraclass correlation coefficient

NHANES:

National Health and Nutrition Examination Survey

SG:

Specific gravity

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Acknowledgments

This study was supported by the Natural Science Foundation of China (No.81373089), 985 Innovation Platform Project for Superiority Subject of Ministry of Education of China (No. EZF201001), grants of the National Health Research Program from the State Ministry of Health of China (No.201202012).

Conflict of interest

The authors declare no conflict of interest.

Authors’ contributions

B.W. wrote the manuscript, with contributions from H.X.W. and Y.C.; Y.Z., B.W., H.X.W., and C.X.T. performed the collections of samples and anthropometric data. B.W., H.X.W, and W.Z. conducted the measurements of samples. B.W. and Y.Z. performed the statistical analyses. Y.C., Q.W.J., and Y.Z. jointly supervised this study. All authors contributed to and approved the final manuscript.

Author information

Authors and Affiliations

  1. School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China

    Bin Wang, Hexing Wang, Ying Zhou & Qingwu Jiang

  2. Centers for Disease Control and Prevention of Changning District, Shanghai, China

    Chuanxi Tang

  3. Department of Geriatrics, The Affiliated Taizhou Hospital of Wenzhou Medical University, Linhai City, Zhejiang Province, China

    Wei Zhou

  4. Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada

    Yue Chen

  5. Room 125, Building 8, 130 Dong-An Road, Shanghai, 200032, China

    Ying Zhou

Authors
  1. Bin Wang
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  2. Chuanxi Tang
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  3. Hexing Wang
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  4. Wei Zhou
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  5. Yue Chen
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  6. Ying Zhou
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Corresponding author

Correspondence to Ying Zhou.

Additional information

Communicated by Jaan Toelen

Revisions received: 26 December 2014/11 March 2015

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Wang, B., Tang, C., Wang, H. et al. Influence of body mass index status on urinary creatinine and specific gravity for epidemiological study of children. Eur J Pediatr 174, 1481–1489 (2015). https://doi.org/10.1007/s00431-015-2558-9

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  • DOI: https://doi.org/10.1007/s00431-015-2558-9

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