Hashemipour Sima, Larijani Bagher, Adibi Hossein, Sedaghat Mojtaba, Pajouhi Mohammad, Bastan-Hagh Mohammad Hasan, Soltani Akbar, Javadi Ebrahim, Shafaei Ali Reza, Baradar-Jalili Reza, Hossein-Nezhad Arash
Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.
J Bone Miner Metab. 2006;24(3):213-8. doi: 10.1007/s00774-005-0674-8.
Vitamin D (Vit D) is an essential element for the regulation of serum calcium, phosphate, and alkaline phosphatase (Alk Ph). Because the Vit D serum level is not usually measured directly, Vit D deficiency is diagnosed indirectly by changes in serum calcium, phosphate, and Alk Ph leves. The current study assessed the status of these biochemical parameters in subjects with different degrees of Vit D deficiency. We selected 1,210 subjects, between 20 and 69 years old, randomly from the Tehran population. Subjects with diseases or medications that modified bone metabolism were excluded from the study. Serum 25(OH) D, calcium, phosphate, Alk Ph, and parathyroid hormone (PTH) levels were measured and the status of these biochemical parameters was compared in subjects with different degrees of Vit D deficiency. Vit D deficiency was diagnosed in 79.6% of the subjects. Different degrees of Vit D deficiency were classified as follows: group 1, severe; group 2, moderate; and group 3, mild. Serum PTH levels in the Vit D-deficient groups were significantly higher than that in group 4 (normal Vit D). Serum calcium and phosphate levels in groups 1 and 2 were significantly lower than those in groups 3 and 4. No significant difference was seen in serum Alk Ph in the groups with different degrees of Vit D deficiency. The sensivity for at least one biochemical variable (calcium, phosphorus, or Alk Ph) for the detection of severe, moderate, and mild Vit D deficiency was 24.2%, 13.8%, and 6%, respectively. When the serum 25(OH) D level was reduced to less than 25 nmol/l (groups 1 and 2), the effects of Vit D deficiency on calcium and phosphate levels were obvious. Therefore, the usual biochemical parameters (calcium, phosphate, Alk Ph) alone do not have sufficient sensitivity to detect mild deficiency of Vit D.
维生素D（Vit D）是调节血清钙、磷和碱性磷酸酶（Alk Ph）的必需元素。由于通常不直接测量血清Vit D水平，因此通过血清钙、磷和Alk Ph水平的变化间接诊断Vit D缺乏症。本研究评估了不同程度Vit D缺乏症患者这些生化参数的状况。我们从德黑兰人群中随机选取了1210名年龄在20至69岁之间的受试者。患有改变骨代谢的疾病或正在服用此类药物的受试者被排除在研究之外。测量了血清25(OH)D、钙、磷、Alk Ph和甲状旁腺激素（PTH）水平，并比较了不同程度Vit D缺乏症患者这些生化参数的状况。79.6%的受试者被诊断为Vit D缺乏症。不同程度的Vit D缺乏症分类如下：第1组，重度；第2组，中度；第3组，轻度。Vit D缺乏组的血清PTH水平显著高于第4组（Vit D正常）。第1组和第2组的血清钙和磷水平显著低于第3组和第4组。不同程度Vit D缺乏症组的血清Alk Ph未见显著差异。检测重度、中度和轻度Vit D缺乏症时，至少一种生化变量（钙、磷或Alk Ph）的敏感性分别为24.2%、13.8%和6%。当血清25(OH)D水平降至低于25 nmol/l时（第1组和第2组），Vit D缺乏对钙和磷水平的影响明显。因此，仅常用的生化参数（钙、磷、Alk Ph）对检测轻度Vit D缺乏症的敏感性不足。
