Vitamin D assay and supplementation: still debatable issues.

IF 2.2 Q2 MEDICINE, GENERAL & INTERNAL

Diagnosis Pub Date : 2024-09-20 eCollection Date: 2025-02-01 DOI:10.1515/dx-2024-0147

Mario Plebani, Martina Zaninotto, Sandro Giannini, Stefania Sella, Maria Fusaro, Giovanni Tripepi, Maurizio Gallieni, Markus Herrmann, Mario Cozzolino

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引用次数: 0

Abstract

Over the last decades, in addition to the improvement of pathophysiological knowledge regarding the role and mechanisms of action of vitamin D, there has been a progressive advancement in analytical technologies for its measurement, as well as in methodological standardization. A significant number of scientific works, meta-analyses, and guidelines have been published on the importance of vitamin D and the need for supplementation in deficient individuals. However, it appears necessary to clarify the fundamental elements related to the measurement of vitamin D (both at the strictly analytical and post-analytical levels) and the scientific evidence related to the efficacy/safety of supplementation. In particular, there is a need to discuss current recommended levels for deficiency, insufficiency and possible toxicity in the light of evidence from standardization projects. Additionally, given the important interrelations between vitamin D, parathyroid hormone (PTH), and fibroblast growth factor-23 (FGF23), the analytical issues and clinical utility of these biomarkers will be discussed.

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维生素 D 检测和补充：仍有争议的问题。

在过去的几十年里，除了有关维生素 D 作用和作用机制的病理生理学知识得到了提高之外，维生素 D 的测量分析技术和方法标准化也在不断进步。大量科学著作、荟萃分析和指南都已发表，论述了维生素 D 的重要性以及缺乏维生素 D 的人补充维生素 D 的必要性。然而，似乎有必要澄清与维生素 D 测量有关的基本要素（包括严格的分析和分析后水平）以及与补充维生素 D 的有效性/安全性有关的科学证据。特别是，有必要根据标准化项目的证据，讨论目前针对缺乏、不足和可能的毒性的建议水平。此外，鉴于维生素 D、甲状旁腺激素 (PTH) 和成纤维细胞生长因子-23 (FGF23) 之间的重要相互关系，还将讨论这些生物标记物的分析问题和临床效用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnosis MEDICINE, GENERAL & INTERNAL-

CiteScore

7.20

自引率

5.70%

发文量

期刊介绍： Diagnosis focuses on how diagnosis can be advanced, how it is taught, and how and why it can fail, leading to diagnostic errors. The journal welcomes both fundamental and applied works, improvement initiatives, opinions, and debates to encourage new thinking on improving this critical aspect of healthcare quality.　 Topics: -Factors that promote diagnostic quality and safety -Clinical reasoning -Diagnostic errors in medicine -The factors that contribute to diagnostic error: human factors, cognitive issues, and system-related breakdowns -Improving the value of diagnosis – eliminating waste and unnecessary testing -How culture and removing blame promote awareness of diagnostic errors -Training and education related to clinical reasoning and diagnostic skills -Advances in laboratory testing and imaging that improve diagnostic capability -Local, national and international initiatives to reduce diagnostic error