Vitamin D: Methods of 25 hydroxyvitamin D analysis, targeting at risk populations and selecting thresholds of treatment

被引:18
作者
Glendenning, Paul [1 ,2 ,3 ]
Inderjeeth, Charles A. [2 ]
机构
[1] Royal Perth Hosp, Dept Core Clin Pathol & Biochem, Perth, WA, Australia
[2] Univ Western Australia, Sch Med & Pharmacol, Nedlands, WA 6009, Australia
[3] Univ Western Australia, Sch Pathol & Lab Med, Nedlands, WA 6009, Australia
关键词
Vitamin D; Methods of 25OHD analysis; 25OHD target of treatment; SERUM 25-HYDROXYVITAMIN D; TANDEM MASS-SPECTROMETRY; BONE-MINERAL DENSITY; D DEFICIENCY; PARATHYROID-HORMONE; D SUPPLEMENTATION; DECISION LIMITS; D INSUFFICIENCY; BINDING ASSAY; FRACTURE RISK;
D O I
10.1016/j.clinbiochem.2012.04.002
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Interest in vitamin D has intensified with the association of vitamin D deficiency (VDD) with many diseases. This review will outline the limitations of current 25 hydroxyvitamin D (25OHD) methods, the target treatment threshold, and review the classical (endocrine/bone) and non-classical (paracrine/non-bone) actions of vitamin D. Recent standardisation by the National Institutes of Standards and Technology and use of LC tandem mass methodology has reduced inter-method bias but insensitivity and imprecision of automated methods have challenged assay performance. Many diseases are associated with VDD but randomised clinical trial data demonstrating the benefit of un-activated sterol supplementation only exists for the prevention of falls and fractures. Consequently, 25OHD measurement should be restricted to high falls or fracture risk patients. Controversy regarding the 25OHD target of therapy requires consensus. Until resolved, widespread adoption of screening programmes and measurement of 25OHD in patients at risk of non-musculoskeletal disease is premature, costly and not supported by evidence. (C) 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:901 / 906
页数:6
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