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在健康成年人中,血清 PTH 评估的维生素 D 生物学活性在很大程度上独立于 DBP 浓度。

In healthy adults, biological activity of vitamin D, as assessed by serum PTH, is largely independent of DBP concentrations.

机构信息

Department of Human Genetics and Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.

出版信息

J Bone Miner Res. 2014 Feb;29(2):494-9. doi: 10.1002/jbmr.2042.

Abstract

Vitamin D insufficiency, as measured by 25-hydroxyvitamin D (25[OH]D) levels, has been associated with important health outcomes. The majority of vitamin D in circulation is bound to vitamin D-binding protein (DBP) and albumin, and recent genetic studies have demonstrated that serum DBP is a major determinant of 25(OH)D concentrations in adults. The impact of circulating DBP levels on vitamin D's biologic action, is unclear, but is of particular relevance to vitamin D epidemiology, because a lack of control for DBP levels could strongly influence the association of vitamin D with disease. Serum parathyroid hormone (PTH) levels can act as a biological readout of 25(OH)D activity. We therefore assessed the relationship between serum total and free 25(OH)D and PTH with and without adjusting for DBP, in 2073 subjects of European descent. Total 25(OH)D levels correlated positively (r = 0.19, p = 1.8 × 10(-17)) with DBP, whereas the free 25(OH)D correlated negatively (r = -0.14, p = 5.0 × 10(-12)). Total and free 25(OH)D levels correlated negatively with PTH (r = -0.29, p = 1.3 × 10(-39); r = -0.26, p = 1.9 × 10(-33), respectively). Including age, body mass index (BMI), sex, estimated glomerular filtration rate, calcium, and season of blood draw as covariates, total 25(OH)D levels were significantly associated with log-transformed PTH (lnPTH) levels (linear term: β = -0.010, p < 0.0001, squared term: β = 0.00004, p < 0.0001) and this association was not changed by adjusting for DBP. These findings provide evidence that in a largely vitamin D-sufficient cohort, the biological effect of vitamin D on PTH levels is mainly independent of DBP concentration. Accordingly, this study may provide useful information for studies investigating the relationship between vitamin D, DBP, and disease.

摘要

维生素 D 不足(通过 25-羟维生素 D(25[OH]D)水平衡量)与重要的健康结果有关。循环中的大多数维生素 D 与维生素 D 结合蛋白(DBP)和白蛋白结合,最近的遗传研究表明,血清 DBP 是成人 25(OH)D 浓度的主要决定因素。循环 DBP 水平对维生素 D 生物学作用的影响尚不清楚,但与维生素 D 流行病学密切相关,因为缺乏对 DBP 水平的控制可能会强烈影响维生素 D 与疾病的关联。血清甲状旁腺激素(PTH)水平可以作为 25(OH)D 活性的生物学指标。因此,我们在 2073 名欧洲血统的受试者中评估了总 25(OH)D 和游离 25(OH)D 与 PTH 之间的关系,同时调整了 DBP 因素。总 25(OH)D 水平与 DBP 呈正相关(r=0.19,p=1.8×10(-17)),而游离 25(OH)D 呈负相关(r=-0.14,p=5.0×10(-12))。总 25(OH)D 和游离 25(OH)D 水平与 PTH 呈负相关(r=-0.29,p=1.3×10(-39);r=-0.26,p=1.9×10(-33))。将年龄、体重指数(BMI)、性别、估计肾小球滤过率、钙和采血季节作为协变量纳入后,总 25(OH)D 水平与对数变换的 PTH(lnPTH)水平显著相关(线性项:β=-0.010,p<0.0001,平方项:β=0.00004,p<0.0001),并且这种关联在调整 DBP 后并未改变。这些发现提供了证据表明,在一个主要维生素 D 充足的队列中,维生素 D 对 PTH 水平的生物学作用主要独立于 DBP 浓度。因此,本研究可为研究维生素 D、DBP 和疾病之间关系的研究提供有用信息。

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