临床实验室中 25-羟维生素 D 的测定:现行程序、性能特征和局限性。

Measurement of 25-hydroxyvitamin D in the clinical laboratory: current procedures, performance characteristics and limitations.

机构信息

Department of Clinical Biochemistry, Macewen Building, Royal Infirmary, Glasgow G4 0SF, UK.

出版信息

Steroids. 2010 Jul;75(7):477-88. doi: 10.1016/j.steroids.2010.02.012. Epub 2010 Feb 24.

Abstract

In this review we describe procedures, performance characteristics and limitations of methods available for the measurement of 25-hydroxyvitamin (25OHD) since the year 2000. The two main types of methods are competitive immunoassay and those based on chromatographic separation followed by non-immunological direct detection (HPLC, LC-MS/MS). Lack of a reference standard for 25OHD has, until recently, been a major issue resulting in poor between-method comparability. Fortunately this should soon improve due to the recent introduction of a standard reference material in human serum (SRM 972) from the National Institute of Standards and Technology (NIST). For immunoassay, specificity can be an issue especially in relation to the proportion of 25OHD2 that is quantified whereas HPLC and LC-MS/MS methods are able to measure the two major vitamin D metabolites 25OHD2 and 25OHD3 independently. HPLC and LC-MS/MS require more expensive equipment and expert staff but this can be offset against lower reagent costs. Increasingly procedures are being developed to semi-automate or automate HPLC and LC-MS/MS but run times remain considerably longer than for immunoassays especially if performed on automated platforms. For most HPLC and LC-MS/MS methods extraction and procedural losses are corrected for by the inclusion of an internal standard which, in part, may account for higher results compared to immunoassay. In general precision of immunoassay, HPLC and LC-MS/MS are comparable and all have the required sensitivity to identify severe vitamin D deficiency. Looking to the future it is hoped that the imminent introduction of a standard reference method (or methods) for 25OHD will further accelerate improvements in between method comparability.

摘要

在本次综述中,我们描述了自 2000 年以来可用于 25-羟维生素(25OHD)测量的方法的程序、性能特征和局限性。两种主要类型的方法是竞争性免疫测定和基于色谱分离后非免疫直接检测的方法(HPLC、LC-MS/MS)。直到最近,缺乏 25OHD 的参考标准一直是导致方法间可比性差的主要问题。幸运的是,由于国家标准与技术研究院(NIST)最近推出了人血清(SRM 972)标准参考物质,这种情况应该很快会得到改善。对于免疫测定,特异性可能是一个问题,特别是与定量的 25OHD2 比例有关,而 HPLC 和 LC-MS/MS 方法能够独立测量两种主要的维生素 D 代谢物 25OHD2 和 25OHD3。HPLC 和 LC-MS/MS 需要更昂贵的设备和专业人员,但这可以抵消试剂成本较低的问题。越来越多的程序正在被开发以半自动或自动化 HPLC 和 LC-MS/MS,但运行时间仍然比免疫测定长得多,特别是如果在自动化平台上进行。对于大多数 HPLC 和 LC-MS/MS 方法,通过包含内标物来校正提取和程序损失,这在一定程度上可能导致与免疫测定相比结果更高。一般来说,免疫测定、HPLC 和 LC-MS/MS 的精密度相当,并且都具有识别严重维生素 D 缺乏的所需灵敏度。展望未来,希望即将推出的 25OHD 标准参考方法(或方法)将进一步加速方法间可比性的提高。

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