Determination of multiple mycotoxins in paired plasma and urine samples to assess human exposure in Nanjing, China

This study was conducted to investigate mycotoxin exposure in 260 rural residents (age 18–66 years) in Nanjing, China. Paired plasma and first morning urine samples were analyzed for 26 mycotoxin biomarkers, including 12 parent mycotoxins and 14 mycotoxin metabolites, by an ultra-high-performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) method. Mycotoxins and their metabolites were detected in 95/260 (36.5%) plasma samples and 144/260 (55.4%) urine samples. The most prevalent mycotoxin in plasma was ochratoxin A (OTA), with the incidence of 27.7% (range 0.312–9.18 μg/L), while aflatoxin B₁-lysine (AFB₁-lysine) (incidence 19.6%, range 10.5–74.5 pg/mg albumin), fumonisin B₁ (FB₁) (incidence 2.7%, range 0.305–0.993 μg/L), deoxynivalenol (DON) (incidence 2.3%, range 1.39–5.53 μg/L), zearalenone (ZEN) (incidence 6.5%, range 0.063–0.418 μg/L) and zearalanone (ZAN) (incidence 1.2%, range 0.164–0.346 μg/L) were also detected in plasma samples. Deoxynivalenol-15-glucuronide (DON-15-GlcA) was the most frequently detected urinary mycotoxin, with the incidence of 43.8% (range 0.828–37.7 μg/L). DON (incidence 10.0%, range 1.39–14.7 μg/L), DON-3-glucuronide (DON-3-GlcA) (incidence 15.8%, range 0.583–5.84 μg/L), aflatoxin M₁ (AFM₁) (incidence 10.4%, range 0.125–0.464 μg/L), ZAN (incidence 7.7%, range 0.106–1.82 μg/L), ZEN (incidence 6.9%, range 0.056–0.311 μg/L), FB₁ (incidence 3.1%, range 0.230–1.33 μg/L), T-2 toxin (incidence 2.3%, range 0.248–3.61 μg/L) and OTA (incidence 1.2%, range 0.153–0.557 μg/L) were also found in urine samples. Based on the plasma or urinary levels, the daily intakes of AFB₁, FB₁, ZEN, DON and OTA were estimated. The results showed that the investigated rural dwellers were exposed to multiple mycotoxins, especially to carcinogenic mycotoxin AFB₁ with a mean daily intake of 0.41 μg/kg·bw/day, thereby underlining a potential public health concern. To the best of our knowledge, this is the first study to evaluate human exposure to mycotoxins with direct measurements of multiple mycotoxins in paired plasma and urine samples for over 200 subjects of a single population.