Measured free 25-hydroxyvitamin D in healthy children and relationship to total 25-hydroxyvitamin D, calculated free 25-hydroxyvitamin D and vitamin D binding protein.
Measured free 25-hydroxyvitamin D in healthy children and relationship to total 25-hydroxyvitamin D, calculated free 25-hydroxyvitamin D and vitamin D binding protein.
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DOI：
10.1016/j.clinbiochem.2018.08.007
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发表时间：
2018-08
影响因子：
2.8
通讯作者：
M. López-Molina;Cecilia Santillán;M. Murillo;Aina Valls;L. Bosch;J. Bel;M. Granada
中科院分区：
文献类型：
--
作者：
M. López-Molina;Cecilia Santillán;M. Murillo;Aina Valls;L. Bosch;J. Bel;M. Granada
研究背景儿童维生素D缺乏症仍然是一个全球性的健康问题.测定游离25-羟基维生素D浓度比测定总25-羟基维生素D（25（OH）D）水平能更好地评价维生素D状况。（m-f25（OH）D）和计算的游离25（OH）D（c-f25（OH）D），总计25（OH）D，完整甲状旁腺激素（iPTH）和其他磷酸钙代谢标志物。建立血清m-f25（OH）D浓度对应于总共25（OH）D > 50 nmol/L被认为是儿童维生素D充足状态。设计前瞻性队列研究。2017年1月和2月在地中海人群中。患者健康儿童。通过ELISA测量sm-f25（OH）D和维生素D结合蛋白（VDBP）。游离25（OH）D与总25（OH）D（r：0.804，p <0.001）、血清钙（r：0.26，p：0.035）和c-f25（OH）D（r：0.553，p：0.016）直接相关;与iPTH（r：-0.374，p：0.002）、碱性磷酸酶（r：-0.28，p：0.026）和年龄（r：-0.289，p：0.018）负相关。总25（OH）D与m-f25（OH）D相同的参数相关，但血清钙除外。多元回归分析表明，m-f25（OH）D的变异与钙离子浓度无关，而与总25（OH）D和VDBP相关（β：0.156，p：0.026）和总25（OH）D（β：0.043，p <0.001），区分总25（OH）D不足和充足的最佳m-f25（OH）D临界值为>9.8 pmol/L（曲线下面积（AUC）：0.897（95%可信区间（CI）：（0.798-0.958）;p< .001;灵敏度：72.7%（95%CI：49.8-89.3）;特异性：95.5%（95%可信区间：结论直接测定的游离维生素D与磷酸钙代谢指标的相关性好于总25（OH）D和c-f25（OH）D。D在健康儿童群体中。
Backgroundvitamin D deficiency in children is still a global health problem. Measuring free 25-hydroxyvitamin D concentrations could provide a better estimate of the vitamin D status than total 25-hydroxyvitamin D (25(OH)D) levels.ObjectiveTo assess the relationship between measured free vitamin D (m-f25(OH)D) and calculated free 25(OH)D (c-f25(OH)D), total 25(OH)D, intact parathyroid hormone (iPTH) and other markers of phosphocalcic metabolism.To establish serum m-f25(OH)D concentrations corresponding to a total 25(OH)D > 50 nmol/L which is accepted as vitamin D-sufficiency status in children.DesignProspective cohort study.SettingJanuary and February 2017 in a Mediterranean population.Patientshealthy children.Measurementsm-f25(OH)D and vitamin D binding protein (VDBP) by ELISA. Free 25(OH)D was calculated using the formula described by Bikle.Resultsm-f25(OH)D directly correlated with total 25(OH)D (r:0.804,p< .001), serum calcium (r:0.26,p:0.035), and c-f25(OH)D (r:0.553,p:0.016); and inversely with iPTH (r:-0.374, p:0.002), alkaline phosphatase (r:-0.28, p:0.026), and age (r:-0.289, p:0.018). Total 25(OH)D correlated with the same parameters as m-f25(OH)D except for serum calcium. However, c-f25(OH)D correlated only with total 25(OH)D and VDBP, both included in the calculation formula.Multiple regression analysis showed that m-f25(OH)D variations were independently explained by calcium (β:0.156, p:0.026) and total 25(OH)D (β:0.043,p< .001).The optimal m-f25(OH)D cut-off for discriminating between insufficient and sufficient total 25(OH)D was >9.8 pmol/L (Area Under Curve (AUC): 0.897 (95% confidence interval (CI): (0.798–0.958);p< .001; sensitivity:72.7% (95%CI: 49.8–89.3); specificity: 95.5% (95%CI: 84.5–99.4)).ConclusionsDirectly measured free vitamin D correlated better with markers of phosphocalcic metabolism than total 25(OH)D and c-f25(OH)D in a population of healthy children.