Vitamin D and Cardiovascular Disease: Can Novel Measures of Vitamin D Status Improve Risk Prediction and Address the Vitamin D Racial Paradox?
Vitamin D and Cardiovascular Disease: Can Novel Measures of Vitamin D Status Improve Risk Prediction and Address the Vitamin D Racial Paradox?
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DOI：
10.1007/s12170-017-0528-7
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发表时间：
2017-01-01
影响因子：
1.9
通讯作者：
Michos, Erin D.
中科院分区：
文献类型：
--
作者：
Kim, Samuel M.;Lutsey, Pamela L.;Michos, Erin D.
审查的目的-这篇评论文章的主要重点是提供一个国家的最先进的更新一些新兴措施的维生素D状态，并讨论如何评估这些关键的维生素D代谢物可能会提高cardiovascular disease（CVD）outcomes.Recent Findings的风险维生素D缺乏症是一个非常普遍的条件，相对容易治疗补充和/或适度的阳光照射。大量的实验和流行病学证据表明，维生素D缺乏是心血管疾病的危险因素。迄今为止，大多数流行病学研究都集中在总25-羟基维生素D [25（OH）D]浓度上，这是维生素D储存的既定标志。然而，有新的证据表明，其他新的维生素D代谢标志物可能更好地表征“真正的”维生素D状态。一些关键的新指标包括生物可利用的25（OH）D、游离25（OH）D、1，25-二羟基维生素D、24，25-二羟基维生素D3 [24，25（OH）（2）D3]和24，25（OH）（2）D3与25（OH）D的比率[维生素D代谢比率]。利用这些生物标志物可以提高维生素D和心血管疾病风险之间的关联的理解，并可能提供解释的观察，即25（OH）D是一个更强的心血管疾病的危险因素，在白人比Blacks.Summary维生素D状态的新措施可能会改变临床实践，就如何筛选患者目前的维生素D状态，并定义为维生素D缺乏或不。然而，测量这些维生素D状态的替代标志物中的任何一个是否可以提供关于CVD风险的进一步见解，而不是传统测量的25（OH）D浓度，目前尚不确定。这是一个迫切需要进一步研究的领域。
Purpose of Review The major focus of this review article is to provide a state-of-the-art update on some emerging measures of vitamin D status and discuss how assessment of these key vitamin D metabolites might improve prognostication of risk for cardiovascular disease (CVD) outcomes.Recent Findings Vitamin D deficiency is a highly prevalent condition and relatively easy to treat with supplementation and/or modest sunlight exposure. A substantial body of experimental and epidemiological evidence suggests that vitamin D deficiency is a risk factor for CVD. Most epidemiologic studies to date have focused on total 25-hydroxyvitamin D [25(OH)D] concentrations, which is the established marker of vitamin D stores. However, there is emerging evidence that other novel markers of vitamin D metabolism may better characterize "true" vitamin D status. Some key novel measures include bioavailable 25(OH) D, free 25(OH) D, 1,25-dihydroxyvitamin D, 24,25-dihydroxyvitamin D3 [ 24,25(OH)(2)D3], and ratio of 24,25(OH)(2)D3 to 25(OH) D [ the vitamin D metabolic ratio]. Utilization of these biomarkers may enhance understanding of the association between vitamin D and CVD risk and may provide explanation for the observation that 25(OH)D is a stronger CVD risk factor in Whites than Blacks.Summary Novel measures of vitamin D status could potentially change clinical practice regarding how patients are currently screened for vitamin D status and defined as vitamin D deficient or not. However, whether measuring any of these alternate markers of vitamin D status can provide further insight regarding CVD risk beyond the traditionally measured 25(OH)D concentrations is uncertain at this time. This is an area where further research is strongly needed.