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Lipid and Creatinine Adjustment to Evaluate Health Effects of Environmental Exposures
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Lipid and Creatinine Adjustment to Evaluate Health Effects of Environmental Exposures
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Journal Article
Lipid and Creatinine Adjustment to Evaluate Health Effects of Environmental Exposures
2017
Overview
Purpose of Review
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 Findings
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.
Summary
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.
Publisher
Springer International Publishing,Springer Nature B.V
