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Background: Advances in technology have led to the identification of a greater number of metabolites related to diet. Although fruit intake biomarkers have been reported in some studies, these findings require further replication, considering the relevance of fruits for diet quality and health.Objectives: The aim of this study was to explore the associations of a set of potential urinary biomarkers of diet, assessed using a targeted metabolomics approach, with self-reported fruit intake data in participants of a computer-assisted 24-h dietary recall (GloboDiet software) validation study.Methods: A total of 93 individuals aged 43-72 y, 54% female, participated in this study. The subjects were a subsample of the Longitudinal Study of Adult Health (ELSA-Brasil). A 24-h dietary recall was obtained with the aid of GloboDiet software matching a 24-h urine sample from each participant. Candidate biomarkers were selected in a literature search and identified in urine by LC coupled to high-resolution MS. Spearman correlation analyses were performed between fruit intake and each biomarker.Results: Spearman correlation analysis showed that total fruits intake was significantly correlated with citric acid (ρ = 0.213, P = 0.041), ferulic acid sulfate I (ρ = 0.240, P = 0.020), hesperetin glucuronide/homoeriodictyol glucuronide (ρ = 0.303, P = 0.003), hydroxyhippuric acid (ρ = 0.239, P = 0.021), homovanillic alcohol sulfate (ρ = 0.339, P = 0.001), methylgallic acid sulfate (ρ = 0.268, P = 0.009), naringenin glucuronide (NG; ρ = 0.278, P = 0.007), proline betaine (PB; ρ = 0.305, P = 0.003), syringic acid sulfate (ρ = 0.210, P = 0.044), and sinapic acid sulfate (ρ = 0.412, P < 0.001). Among them, 3 have been described in literature as promising biomarkers for intake of total fruit, oranges, and citrus fruit: NG, hesperetin glucuronide, and PB.Conclusions: Associations of total fruits intake with urinary measurements indicate the potential usefulness of dietary biomarkers in the Brazilian population as a complement to self-reported dietary assessments. [ABSTRACT FROM AUTHOR]

Background Developing approaches for the objective assessment of sugars intake in population research is crucial for generating reliable disease risk estimates, and evidence-based dietary guidelines. Twenty-four-hour urinary sucrose and fructose (24uSF) was developed as a predictive biomarker of total sugars intake based on 3 UK feeding studies, yet its performance as a biomarker of total sugars among US participants is unknown. Objectives To investigate the performance of 24uSF as a biomarker of sugars intake among US participants, and to characterize its use. Methods Ninety-eight participants, aged 18–70 y, consumed their usual diet under controlled conditions of a feeding study for 15 d, and collected 8 nonconsecutive 24-h urines measured for sucrose and fructose. Results A linear mixed model regressing log 24uSF biomarker on log total sugars intake along with other covariates explained 56% of the biomarker variance. Total sugars intake was the strongest predictor in the model (Marginal R2 = 0.52; P  <0.0001), followed by sex (P  = 0.0002) and log age (P  = 0.002). The equation was then inverted to solve for total sugars intake, thus generating a calibrated biomarker equation. Calibration of the biomarker produced mean biomarker-based log total sugars of 4.79 (SD = 0.59), which was similar to the observed log 15-d mean total sugars intake of 4.69 (0.35). The correlation between calibrated biomarker and usual total sugars intake was 0.59 for the calibrated biomarker based on a single biomarker measurement, and 0.76 based on 4 biomarker repeats spaced far apart. Conclusions In this controlled feeding study, total sugars intake was the main determinant of 24uSF confirming its utility as a biomarker of total sugars in this population. Next steps will include validation of stability assumptions of the biomarker calibration equation proposed here, which will allow its use as an instrument for dietary validation and measurement error correction in diet-disease association studies. [ABSTRACT FROM AUTHOR]

Background: Measurement of multiple food intake exposure biomarkers in urine may offer an objective method for monitoring diet. The potential of spot and cumulative urine samples that have reduced burden on participants as replacements for 24-h urine collections has not been evaluated.Objective: The aim of this study was to determine the utility of spot and cumulative urine samples for classifying the metabolic profiles of people according to dietary intake when compared with 24-h urine collections in a controlled dietary intervention study.Methods: Nineteen healthy individuals (10 male, 9 female, aged 21-65 y, BMI 20-35 kg/m2) each consumed 4 distinctly different diets, each for 1 wk. Spot urine samples were collected ∼2 h post meals on 3 intervention days/wk. Cumulative urine samples were collected daily over 3 separate temporal periods. A 24-h urine collection was created by combining the 3 cumulative urine samples. Urine samples were analyzed with metabolite fingerprinting by both high-resolution flow infusion electrospray mass spectrometry (FIE-HRMS) and proton nuclear magnetic resonance spectroscopy (1H-NMR). Concentrations of dietary intake biomarkers were measured with liquid chromatography triple quadrupole mass spectrometry and by integration of 1H-NMR data.Results: Cross-validation modeling with 1H-NMR and FIE-HRMS data demonstrated the power of spot and cumulative urine samples in predicting dietary patterns in 24-h urine collections. Particularly, there was no significant loss of information when post-dinner (PD) spot or overnight cumulative samples were substituted for 24-h urine collections (classification accuracies of 0.891 and 0.938, respectively). Quantitative analysis of urine samples also demonstrated the relation between PD spot samples and 24-h urines for dietary exposure biomarkers.Conclusions: We conclude that PD spot urine samples are suitable replacements for 24-h urine collections. Alternatively, cumulative samples collected overnight predict similarly to 24-h urine samples and have a lower collection burden for participants. [ABSTRACT FROM AUTHOR]

Background There is growing interest in assessing a population's prevalence of inadequate nutrient intake using biomarkers. However, within-person variation is generally ignored because repeated data collections are considered costly and burdensome. Objectives The study aimed to show the importance of estimating, from repeated 24-h urine collections, a population's habitual salt intake and to explore the potential of using the ratio of within-person variance to total variance from an external source (W:T variance) with single 24-h urine collection. Methods Salt intake was predicted from data for 24-h urinary sodium excretion in adult kidney transplant recipients in 1992–1997 (n  = 432) and 2006–2011 (n  = 1159). The salt intake distribution of single-day measurements was compared with estimates from multiple 24-h urine collections, which were statistically corrected for within-person variance. Habitual salt intake was also estimated using single-day measurements and external variance estimates. From each distribution, the proportion below specified cut-off values was estimated. Results In 2006–2011 the average habitual salt intake was 10.6 g/d (men) and 8.5 g/d (women); in 1992–1997 these values were 8.6 g/d and 7.5 g/d, respectively. The proportion with salt intake <6 g/d was 5% and 13% in 2006–2011 and 22% and 28% in 1992–1997, respectively, for men and women. Correction for within-person variance significantly narrowed the salt intake distribution—the proportion with salt intake <6 g/d was overestimated by 3–13 percentage points using single-day data. Sensitivity analyses showed the importance of a sufficient sample size for estimating variance components. Variation of the W:T variance showed up to 40 percentage points deviation in the proportion with intakes below a specified cut-off value. Conclusions To estimate a population's salt intake distribution, it is important to correct 24-h urinary sodium excretion for within-person variance. Predicting habitual salt intake distribution using single-day measurements with external variances is promising; a sensitivity analysis is recommended to show the effect of different external variances. [ABSTRACT FROM AUTHOR]

To document trends in human exposure to environmental pollutants, the German Environmental Specimen Bank (ESB) has been routinely collecting and archiving 24-h urine samples from young adults at four sampling sites in Germany on an annual basis. For the purpose of normalizing measured analyte concentrations, urinary creatinine (UC), specific gravity (SG), conductivity (CON), and total urine volume (UVtot) of 24-h urine samples have also been recorded. These parameters are however susceptible to variation over time, as well as within/among participants and normalization against them can thus affect the interpretation of data regarding exposure to environmental pollutants. To evaluate the influence of normalization against these parameters, we first sought to determine variations of these parameters with regard to differences between sexes and trends over time. We analysed data from 8619 urine samples collected from 1997 to 2016. We observed an inverse relation between UVtot and UC, SG, and CON. We also found differences between sexes for UC, SG and CON, but not UVtot. UC, SG, and CON showed significant decreasing trends over time in both sexes. In contrast, a significant increase of over 30% in UVtot, independent of participant age and BMI, was revealed. This increase in UVtot and the concomitant sample dilution is likely to have an impact on measured analyte concentrations in 24-h urine samples. Hence, normalization of urinary concentrations is warranted when interpreting time trends of human exposure. Next, urinary calcium (Ca2+) concentrations of ESB participants were used to demonstrate the effects of normalization against each of the four urine parameters. From 1997 to 2016, measured Ca2+ concentrations showed a statistically significant but scientifically implausible decrease. Normalization of Ca2+ concentrations against UVtot (by calculating the total daily excretion), UC, or CON, but not SG, eliminated this decrease. Consistent with previous work, Ca2+ concentrations in urine and total daily Ca2+ excretion were higher for males than females. Normalization against UC, SG, or CON, however, attenuated this difference. Thus, to avoid misinterpretation in trend analysis and sex-specific excretion in 24-h urine samples, the calculation of the total daily excretion is recommended. [ABSTRACT FROM AUTHOR]

Background and Aims: High sodium (Na) and low potassium (K) intake are associated with hypertension and CVD risk. This study explored the associations of health literacy (HL), food literacy (FL), and salt awareness with salt intake, K intake, and Na/K ratio in a workplace intervention trial in Switzerland.Methods and Results: The study acquired baseline data from 141 individuals, mean age 44.6 years. Na and K intake were estimated from a single 24-h urine collection. We applied validated instruments to assess HL and FL, and salt awareness. Multiple linear regression was used to investigate the association of explanatory variables with salt intake, K intake, and Na/K. Mean daily salt intake was 8.9 g, K 3.1 g, and Na/K 1.18. Salt intake was associated with sex (p < 0.001), and K intake with sex (p < 0.001), age (p = 0.02), and waist-to-height ratio (p = 0.03), as was Na/K. HL index and FL score were not significantly associated with salt or K intake but the awareness variable "salt content impacts food/menu choice" was associated with salt intake (p = 0.005).Conclusion: To achieve the established targets for population Na and K intake, health-related knowledge, abilities, and skills related to Na/salt and K intake need to be promoted through combined educational and structural interventions. Clinical Trials Registry number: DRKS00006790 (23/09/2014). [ABSTRACT FROM AUTHOR]

Sodium, potassium, calcium, magnesium, zinc, copper and iron are associated with the sequela of hypertension. The most reliable method for testing those elements is by collecting 24-h urine samples. However, this is cumbersome and collection of spot urine is more convenient in some circumstance. The aim of this study was to compare the concentrations of different elements in 24-h urine and spot urine. Methods Data was collected from a sub-study of China Salt Substitute and Stroke Study. 240 participants were recruited randomly from 12 villages in two counties in Ningxia, China. Both spot and 24-h urine specimens were collected from each patient. Routine urine test was conducted, and concentration of elements was measured using microwave digestion and Inductively Coupled Plasma-Optical Emission Spectrometry. Partial correlation analysis and Spearman correlation analysis were used to investigate the concentration of different elements and the relationship between 24- h urine and spot urine. Results A partial correlation in sodium, potassium, calcium, magnesium and iron was found between paired 24-h urine and spot urine samples except copper and zinc: 0.430, 0.426, 0.550, 0.221 and 0.191 respectively. Conclusions Spot urine can replace 24-h urine for estimating some of the elements in hypertensive patients with normal renal function. [ABSTRACT FROM AUTHOR]

Highlights: [•] Biomarkers of cigarette smoke exposure were measured in spot urine. [•] Samples were collected at different times of the day for 3 days. [•] The spot urine levels were validated against the 24h urine collection. [•] Daily smoke exposure can be best estimated from early morning spot urine. [Copyright &y& Elsevier]

Abstract: Background: Evaluate the level of interference of biochemists dosages in the 24-hour urine using or not the 6mol/l HCl acid in different concentrations and conditions and its implications in the most demanded analytes in clinical laboratory. Methods: Twenty-two volunteers collected three 24-hour urine in 3 conditions: with 5ml/l and 20ml/l of 6mol/l HCl in the container, and without acid preservative. The samples collected without preservative were separated in aliquots and added 5ml/l of 6mol/l HCl after 24h. Analytes, uric acid creatinine, urea, chlorides, glucose, magnesium, sodium, potassium, microalbumin, proteins, amylase, aldosterone, calcium, cortisol, phosphorus, citric acid, oxalate, and metanephrines, were determined. Results: Uric acid, glucose, microalbumin, protein, amylase and aldosterone showed that %CV ranging from 16 to 57% in the presence of acid preservative. Analytes that need acid preservative cortisol, citric acid and oxalate showed %CV ranging from 6 to 27% with r=0.66, r=0.77, r=0.70 respectively provided 5ml/l after delivery and r=0.31, r=0.70 and r=0.48 without preservative acid when compared with the gold standard (with 20ml/l of 6mol/l HCl). Conclusions: Glucose, microalbumin, protein, amylase and aldosterone urinary did not show good performance in the presence of acid preservative. Analytes that need acid preservative showed variation acceptable in condition 5ml/l of 6mol/l HCl added after 24h. [Copyright &y& Elsevier]

Abstract: Renal excretion mechanisms are xenobiotic-specific; therefore, accurate exposure assessment requires an understanding of relationships of xenobiotic biomarker concentration and excretion rate to urine flow, specific gravity and creatinine concentration. Twenty-four-hour urine collection for xenobiotic exposure assessment is considered the “gold standard” procedure. Random spot-urine collection is convenient and minimizes subject compliance concerns but requires that normalization techniques be employed to account for diuresis and diurnal variation in xenobiotic biomarker excretion. This paper examines and makes recommendations concerning normalization techniques and conditions under which spot-urine results most accurately reflect 24-h urine results. Specific gravity, creatinine, and xenobiotic biomarkers were determined in smokers’ spot and 24-h urines. Normalization techniques were applied, variance-component analyses were performed to estimate variability, spot urines were pooled mathematically to simulate 24-h urines and analyses of variance were performed to evaluate spot urines’ ability to reflect 24-h urine concentrations. For each xenobiotic biomarker concentration, log-linear relationships were observed with urine flow, specific gravity, and creatinine. For most xenobiotic biomarker excretion rates, log-linear relationships were observed with urine flow; creatinine, however, was unaffected by urine flow. The conventional creatinine ratio-normalization technique demonstrated greater variability (within-day, between-day and between-subject) than other normalization techniques. Comparisons of simulated 24-h urines to spot urines suggest that spot-urine collection be performed only between 2 p.m. and 2 a.m. and that the modified specific-gravity-adjusted-creatinine ratio-normalization technique and the creatinine-regression normalization technique yield the best agreement between spot- and simulated 24-h urine results. [Copyright &y& Elsevier]

Summary Introduction Specific factors associated with the risk of developing pediatric urinary stone disease remain unclear, especially those that may be associated with recurrent stone disease. Objective We compared the results of 24-h urine collections in children with a solitary stone episode to those with multiple stone episodes to determine if there is a difference that may be associated with multiple stone formation in children. Study design A multi-institutional retrospective analysis was completed to assess 24-h urinary metabolic profiles in children with urolithiasis aged 2–18 years old. Differences in mean urine collections between the two groups were assessed using chi-square tests to test the associations among gender, stone type, and multiple stone status, as well as multivariate analyses using general linear models. Results We analyzed 142 solitary stone patients and 136 multiple stone patients from four centers were included. Multiple stone patients were older than solitary stone patients (mean 13.4 ± 3.6 years vs. 12 ± 3.9 years, p = 0.002). Females were more likely to have multiple stones (58% vs. 39%, p = 0.002). BMI was not associated with multiple stones ( p = 0.8467). Multiple stone formers had lower urine volumes, although this did not reach statistical significance when compared with solitary stone formation (20.4 mL/kg/day ± 11.5 vs. 22.9 ± 13.0, p = 0.0880). Higher values for super-saturation of calcium oxalate were associated with multiple stone disease in univariate ( p = 0.0485) and multivariate analysis ( p = 0.0469) (Figure). Centers located in the Southeast of the United States saw a higher proportion of children with multiple stones (Tennessee 62.7%, Virginia 44.4%, Oregon 31.6%, Michigan 27.3%, p < 0.0001). Discussion In a large multi-institutional retrospective analysis we found that multiple stone disease was associated with higher super-saturations of calcium oxalate. Many urinary parameters changed with patient age, highlighting that the values should be interpreted with respect to patient age. The inability to comment on follow-up because of the nature of our dataset is a limitation of this study. Conclusion Multiple stone disease in children is associated with higher super-saturation calcium oxalate, while lower urinary volume may also be associated with multiple stones; however, further study is required. Early metabolic evaluation may help risk stratify children likely to form multiple stones. Figure Super-saturation of calcium oxalate and multiple stone status. [ABSTRACT FROM AUTHOR]

Summary Objective In recent years, there has been increased incidence of urolithiasis in children. Changing nutritional patterns and sedentary lifestyles predispose to urolithiasis, as well as to the global rise in obesity. It has been established that the prevalence of high body mass index (BMI) is increasing in the pediatric population. The aim of the present study was to incorporate 24-h urine metabolic analysis results with BMI values to evaluate the tendency towards stone formation in children. Methods Eighty-four children were recruited to the study, stratified into three BMI categories as low, normal, or upper. All patients were evaluated with 24-h urine analysis results. Patients with a secondary cause of stone formation such as hyperparathyroidism, cystinuria, primary hyperoxaluria, inflammatory bowel disease, cystic fibrosis, history of prematurity and/or use of drug, recurrent urinary tract infection, and urinary tract anomaly were excluded. Additionally, it was ensured that none of the patients were taking specific medication or diet that could alter their acid-base metabolism and calcium, oxalate, and uric acid levels. Results Mean BMI of patients was 21.6 ± 2.9 kg/m 2 . LBMI was found in 52 (61.9%), N-BMI in 20 (23.8%), and U-BMI in 12 (14.3%) of the patients. No significant differences were present between the three groups for stone sizes and numbers. The patients' characteristics and 24-h urine parameters for BMI groups are presented in the Table. Discussion In the literature, several studies have focused on the relationship between obesity and pediatric urinary stone disease. However, only a few evaluated the urinary metabolic analysis in pediatric patients. We have encountered different results from mainly adult studies and some pediatric studies. Our study shows that U-BMI children are not under greater risk for urolithiasis than the other groups. An important portion of our study group was in the L-BMI group; nevertheless we cannot conclude that having a low BMI predisposes to urolithiasis based on the urinary metabolic evaluation as well as the stone sizes and numbers. The N-BMI group has increased risk factors for urolithiasis rather than the other groups, according to results of 24-h urine analysis. Conclusion The results of our study indicate that BMI itself could not be considered as a separate and definite risk factor for urolithiasis development in children. Although the mechanisms and causative factors for urinary stone formation are better defined in adults, further studies investigating these parameters in children are warranted. Table Patients' characteristics and 24-h urine parameters for BMI groups. L-BMI mean ± SD N-BMI mean ± SD U-BMI mean ± SD p Sex Male 28 8 6 0.575 Female 24 12 6 Age (years) 6.9 ± 4.0 9.2 ± 4.5 9.4 ± 5.5 0.071 BMI (kg/m 2 ) 15.5 ± 1.6 20.8 ± 1.5 30.1 ± 2.9 <0.001 Stone number 1.6 ± 1.0 2.0 ± 1.5 1.7 ± 0.8 0.709 Stone size (mm) 13.7 ± 10.2 13.8 ± 10.5 13.0 ± 9.6 0.951 Ca (mg/kg/24 h) 3.7 ± 3.0 4.2 ± 3.9 1.3 ± 0.9 0.021 Citrate (mg/1.73 m 2 /24 h) 362 ± 442 461 ± 391 622 ± 450 0.057 Uric acid (mg/kg/24 h) 4.6 ± 4.0 3.2 ± 2.7 1.8 ± 1.4 0.017 a Oxalate (mg/1.73 m 2 /24 h) 7.4 ± 10.6 12.0 ± 12.4 9.9 ± 6.2 0.003 Magnesium (mg/kg/24 h) 4.0 ± 3.3 3.3 ± 2.1 3.2 ± 2.2 0.609 Sodium (mmol/24 h) 91.3 ± 46.9 108.2 ± 76.1 88.3 ± 45.9 0.897 a Difference between L-BMI and U-BMI groups. [ABSTRACT FROM AUTHOR]