Osteoporosis Clinical Center and Research Program, University of Wisconsin-Madison, Madison, WI 53705, USA.
J Clin Densitom. 2009 Oct-Dec;12(4):417-27. doi: 10.1016/j.jocd.2009.06.001. Epub 2009 Sep 5.
As clinicians are more widely appreciating the endemic nature of low vitamin D status, measurement of serum 25-hydroxyvitamin D (25(OH)D), the accepted measure of vitamin D status, has increased. Challenges to 25(OH)D measurement include the presence of 2 forms of vitamin D-ergocalciferol and cholecalciferol (vitamin D(2) and vitamin D(3), respectively)- and the hydrophobic nature of vitamin D. The current state of 25(OH)D measurement is reviewed; modest differences between methodologies persist and confound the application of a single cut point (e.g., 30 ng/mL/75 nmol/L) for the diagnosis of low vitamin D status. The absence of standard calibrators contributes to between-laboratory differences in 25(OH)D measurement. Until there is improved assay standardization and subsequent evidence-based consensus, it seems premature to recommend widespread screening 25(OH)D measurement. Selectively obtaining 25(OH)D measurement in individuals at clinical risk for vitamin D deficiency and/or those most likely to promptly experience benefits from supplementation seems appropriate.
随着临床医生越来越意识到维生素 D 缺乏症的普遍存在，血清 25-羟维生素 D（25(OH)D）的检测——维生素 D 状况的公认衡量标准——也有所增加。25(OH)D 检测面临的挑战包括维生素 D 有两种形式——麦角钙化醇和胆钙化醇（分别为维生素 D(2)和维生素 D(3)），以及维生素 D 的疏水性。本文回顾了 25(OH)D 检测的现状；不同方法之间仍存在一些差异，这使得使用单一切点（例如 30ng/mL/75nmol/L）来诊断维生素 D 缺乏症变得复杂。缺乏标准校准品导致了实验室间 25(OH)D 检测的差异。在检测方法得到改进并达成基于证据的共识之前，建议广泛筛查 25(OH)D 似乎还为时过早。在有维生素 D 缺乏风险的个体和/或最有可能从补充中迅速获益的个体中选择性地进行 25(OH)D 检测似乎更为合适。
