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尿毒症患儿血清24,25(OH)₂D浓度:肾功能的一种反映

Serum concentrations of 24,25(OH)2D in uremic children: a reflection of renal function.

作者信息

Weisman Y, Lum G M, Reiter E O, Gilboa N, Knox G F, Root A W

出版信息

J Pediatr. 1979 Feb;94(2):190-3. doi: 10.1016/s0022-3476(79)80820-3.

Abstract

The mean serum concentration of 24,25(OH)2D determined by competitive protein-binding radioassay was significantly lower in ten uremic children maintained on hemodialysis (0.82 +/- 0.43[SD] ng/ml) than in ten patients with impaired renal function not requiring hemodialysis (1.30 +/- 0.54 ng/ml, P less than 0.05), or in 12 normal children (2.98 +/- 1.57 ng/ml, P less than 0.01). The serum levels of 250HD were similar in all groups. There were significant (P less than 0.01) positive correlations between the serum concentration of 24,25(OH)2D or the ratio 24,25(OH)2D/25OHD and the creatinine clearance. The serum concentration of 24,25(OH)2D was significantly decreased also in six anephric adults relative to normal adult values. The data indicate that production of 24,25(OH)2D is impaired in subjects with compromised renal function. Inasmuch as the major active metabolite of Vitamin D, i.e., 1,25(OH)2D, is requried for renal synthesis of 24,25(OH)2D measurement of the latter metabolite may provide a convenient method for assessment of renal vitamin D metabolism. The role of this metabolite in the pathogenesis of renal osteodystrophy remains speculative.

摘要

通过竞争性蛋白结合放射分析法测定,10名维持血液透析的尿毒症儿童的血清24,25(OH)2D平均浓度(0.82±0.43[标准差]ng/ml)显著低于10名不需要血液透析的肾功能受损患者(1.30±0.54 ng/ml,P<0.05),也低于12名正常儿童(2.98±1.57 ng/ml,P<0.01)。所有组的血清250HD水平相似。血清24,25(OH)2D浓度或24,25(OH)2D/25OHD比值与肌酐清除率之间存在显著(P<0.01)正相关。相对于正常成人值,6名无肾成人的血清24,25(OH)2D浓度也显著降低。数据表明,肾功能受损的受试者中24,25(OH)2D的产生受损。由于维生素D的主要活性代谢物即1,25(OH)2D是肾脏合成24,25(OH)2D所必需的,因此测量后一种代谢物可能为评估肾脏维生素D代谢提供一种简便方法。这种代谢物在肾性骨营养不良发病机制中的作用仍属推测。

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