Joris R Delanghe, Marijn M Speeckaert, Thomas Maenhout
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引用次数: 0
Abstract
Background: Assessing vitamin D status, typically evaluated using serum or plasma 25-hydroxy vitamin D [25(OH)D] concentration, is complex because of various influencing factors.
Methods: Seasonality significantly affects intra-individual variability in 25(OH)D levels. This variation can be addressed by employing cosinor functions that are tailored to the geographical location of the patient to correct for seasonal effects. In addition to seasonality, genetic factors, such as DBP polymorphism and body composition, particularly adiposity, play crucial roles. Dialysis patients with DBP 2-2 phenotype exhibit higher vitamin D requirements. Genotyping/phenotyping of DBP allows for better tailored vitamin D supplementation. The lipid-soluble nature of vitamin D also interacts with plasma components such as serum triglycerides, which can influence vitamin D measurements. Adiposity, which is negatively correlated with vitamin D concentration, necessitates body mass-based mathematical adjustments for accurate vitamin D assessment in subjects with extreme BMI values.
Conclusions: Accordingly, vitamin D replacement therapy must be personalized, taking into account factors such as body size and seasonal variations, to effectively reach the target serum 25(OH)D concentrations.
背景:评估维生素 D 状态通常使用血清或血浆 25- 羟基维生素 D [25(OH)D] 浓度:评估维生素 D 状态通常使用血清或血浆中 25- 羟基维生素 D [25(OH)D] 的浓度,由于影响因素多种多样,因此评估工作十分复杂:方法:季节性会对 25(OH)D 水平的个体内变异性产生重大影响。这种变异可通过采用适合患者地理位置的 cosinor 函数来校正季节性影响。除季节性外,遗传因素(如 DBP 多态性和身体组成,尤其是脂肪含量)也起着至关重要的作用。具有 DBP 2-2 表型的透析患者对维生素 D 的需求更高。通过对 DBP 进行基因分型/表型分析,可以更有针对性地补充维生素 D。维生素 D 的脂溶性也会与血清甘油三酯等血浆成分相互作用,从而影响维生素 D 的测量。肥胖与维生素 D 浓度呈负相关,因此有必要对体重进行数学调整,以便对体重指数值极高的受试者进行准确的维生素 D 评估:因此,维生素 D 替代疗法必须考虑到体型和季节变化等因素,进行个性化治疗,才能有效达到目标血清 25(OH)D 浓度。
期刊介绍:
Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.