Su Zengliu, Narla Satya Nandana, Zhu Yusheng
Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA.
Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA.
Clin Chim Acta. 2014 Jun 10;433:200-5. doi: 10.1016/j.cca.2014.03.022. Epub 2014 Mar 27.
25-Hydroxyvitamin D (25-OHD) is one of the most popular tests requested by clinicians nowadays because in addition to bone diseases, many non-skeletal disorders have been suggested to be linked to vitamin D deficiency or insufficiency. Methodologies used in clinical laboratories include competitive vitamin D protein binding assays (CPBA), immunoassays, high performance liquid chromatography (HPLC), and liquid chromatography-tandem mass spectrometry (LC-MS/MS). In this review article, we introduce the basic metabolism and physiology of vitamin D, key issues in the methods for 25-OHD measurement currently used in most clinical laboratories, and clinical applications of 25-OHD testing. We conclude that although the methodologies for 25-OHD testing have improved significantly, considerable bias between different methods and laboratories still exists. Therefore, standardization of the method is critical. The optimal 25-OHD levels should be determined based on the standardized method. Also, more studies are needed to further determine the relationship between vitamin D deficiency or insufficiency and non-skeletal diseases as well as daily vitamin D dose requirement for reducing the risk of non-skeletal diseases.
25-羟维生素D（25-OHD）是目前临床医生最常要求进行的检测项目之一，因为除了骨骼疾病外，许多非骨骼疾病也被认为与维生素D缺乏或不足有关。临床实验室使用的方法包括竞争性维生素D蛋白结合测定法（CPBA）、免疫测定法、高效液相色谱法（HPLC）和液相色谱-串联质谱法（LC-MS/MS）。在这篇综述文章中，我们介绍了维生素D的基本代谢和生理学、大多数临床实验室目前用于测量25-OHD的方法中的关键问题以及25-OHD检测的临床应用。我们得出结论，尽管25-OHD检测方法有了显著改进，但不同方法和实验室之间仍存在相当大的偏差。因此，方法的标准化至关重要。应基于标准化方法确定最佳的25-OHD水平。此外，还需要更多研究来进一步确定维生素D缺乏或不足与非骨骼疾病之间的关系以及降低非骨骼疾病风险所需的每日维生素D剂量。
