Serum Trace Elements and Concurrent Renal, Hepatic, and Electrolyte Biomarkers: A Secondary Cross-Sectional Analysis of SPES
- 1Department of Public Health, University of Naples “Federico II”, Via Sergio Pansini 5, 80131 Naples, Italy
- 2Institute of Clinical Physiology (IFC), National Research Council (CNR), Via G. Moruzzi 1, 56124 Pisa, Italy
- 3Department of Human Sciences and Quality of Life Promotion, San Raffaele University, 00166 Rome, Italy
Abstract
The relationships between circulating trace elements and routinely measured renal, hepatic, and electrolyte biomarkers remain incompletely characterized. We conducted a secondary cross-sectional analysis of 19 serum elements and concurrent biochemistry in 4137 adults from the Exposure Study on Susceptible People (SPES), Campania, Italy. Creatinine, alanine aminotransferase (ALT), gamma-glutamyl transferase, and potassium were primary outcomes; additional renal, hepatic, mineral, and protein-related measurements were secondary or exploratory. Associations were estimated with covariate adjustment, multiple imputation, and within-family false-discovery-rate control. Per doubling of concentration, lithium was associated with 0.54% higher creatinine (95% confidence interval, 0.22–0.86%). Antimony associations with ALT and potassium were sensitive to the handling of below-quantification concentrations and were not established among directly quantified measurements. Secondary and exploratory findings included higher bilirubin with iron and lower bilirubin with copper; higher ferritin with iron and lower ferritin with cobalt; higher uric acid with strontium, selenium, lithium, and arsenic; and higher albumin, total protein, and total calcium with selenium. Additional albumin adjustment approximately halved the selenium coefficients for total calcium and total protein. The primary associations were small, and their biological and clinical relevance remains uncertain. These cross-sectional findings identify hypotheses concerning renal handling, iron status, and overlapping protein-associated biochemistry.
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BibTeX
@article{cerino2026serum,
title = {{Serum Trace Elements and Concurrent Renal, Hepatic, and Electrolyte Biomarkers: A Secondary Cross-Sectional Analysis of SPES}},
author = {Pellegrino Cerino and Fabrizio Minichilli and Elvira De Rosa and Maria Triassi and Paolo Montuori and Carlo Buonerba},
journal = {International Journal of Molecular Sciences},
year = {2026},
month = oct,
doi = {10.3390/ijms27209313},
url = {https://www.mdpi.com/1422-0067/27/20/9313},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Serum Trace Elements and Concurrent Renal, Hepatic, and Electrolyte Biomarkers: A Secondary Cross-Sectional Analysis of SPES
AU - Pellegrino Cerino
AU - Fabrizio Minichilli
AU - Elvira De Rosa
AU - Maria Triassi
AU - Paolo Montuori
AU - Carlo Buonerba
PY - 2026
DA - 2026/10/01
JO - International Journal of Molecular Sciences
DO - 10.3390/ijms27209313
UR - https://www.mdpi.com/1422-0067/27/20/9313
AB - The relationships between circulating trace elements and routinely measured renal, hepatic, and electrolyte biomarkers remain incompletely characterized. We conducted a secondary cross-sectional analysis of 19 serum elements and concurrent biochemistry in 4137 adults from the Exposure Study on Susceptible People (SPES), Campania, Italy. Creatinine, alanine aminotransferase (ALT), gamma-glutamyl transferase, and potassium were primary outcomes; additional renal, hepatic, mineral, and protein-related measurements were secondary or exploratory. Associations were estimated with covariate adjustment, multiple imputation, and within-family false-discovery-rate control. Per doubling of concentration, lithium was associated with 0.54% higher creatinine (95% confidence interval, 0.22–0.86%). Antimony associations with ALT and potassium were sensitive to the handling of below-quantification concentrations and were not established among directly quantified measurements. Secondary and exploratory findings included higher bilirubin with iron and lower bilirubin with copper; higher ferritin with iron and lower ferritin with cobalt; higher uric acid with strontium, selenium, lithium, and arsenic; and higher albumin, total protein, and total calcium with selenium. Additional albumin adjustment approximately halved the selenium coefficients for total calcium and total protein. The primary associations were small, and their biological and clinical relevance remains uncertain. These cross-sectional findings identify hypotheses concerning renal handling, iron status, and overlapping protein-associated biochemistry.
SN - 1422-0067
ER -