诊断维生素D缺乏症的替代标志物

R. Boutros, Rania Abd El-Baky, Laila Ali Hendawy, D. Marawan
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引用次数: 1

摘要

背景/目的维生素D缺乏症正在成为一个全球性问题。维生素缺乏症-D是通过测量血液中的25-羟基维生素D来诊断的。在埃及,这种药的价格为500埃及镑,而一安瓿含有20万单位维生素D的价格为5埃及镑。因此,我们需要能够负担得起的维生素D缺乏症标志物。材料与方法在春夏两季对90例20 ~ 60岁的健康患者进行横断面研究。参与者进行了病史记录、临床检查,并测量了血红蛋白、肌酐、钙(总钙和离子钙)、磷、镁、甲状旁腺激素(PTH)和25-羟基维生素D。结果在测试的样本中,维生素D缺乏症(30 ng/ml)的患病率仅为1.11%。PTH与维生素D水平呈显著负相关(r= - 0.2),而血清钙(总钙和电离钙)和磷水平呈显著正相关。通过受试者工作特征曲线预测PTH的准确率为70%,总Ca的准确率为38%,电离Ca的准确率为43%,磷的准确率为60.7%。结论甲状旁腺素、钙、磷可作为维生素D缺乏的标志物;这些检查的费用不到200镑,从而使这种广泛流行的疾病的诊断费用节省了60%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Surrogate markers for diagnosis of vitamin D deficiency
Background/objectives Vitamin D deficiency is becoming a pandemic problem. Hypovitaminosis-D is diagnosed by measuring 25-hydroxyvitamin D in blood. In Egypt this costs 500 EGP, whereas one ampoule containing 200 000 units of vitamin D costs 5 EGP. Therefore, we need markers for vitamin D deficiency that are affordable. Materials and methods We conducted a cross-sectional study on 90 healthy patients aged 20–60 years during spring and summer. Participants underwent history taking, clinical examination, and measurements of hemoglobin, creatinine, calcium (Ca) (total and ionized), phosphorus, magnesium, parathyroid hormone (PTH), and 25-hydroxyvitamin D. Results The prevalence of vitamin D deficiency (<20 ng/ml) was 73.33%, that of insufficiency (21–30 ng/ml) was 25.56%, and that of vitamin D sufficiency (>30 ng/ml) was only 1.11% in the samples tested. PTH had a significant inverse correlation with vitamin D level (r=−0.2), whereas serum Ca (total and ionized) and phosphorus had a positive correlation. By receiver operating characteristic curve the predictive accuracy of PTH was 70%, whereas that of total Ca was 38%, ionized Ca was 43%, and phosphorous was 60.7%. Conclusion Measurements of PTH, Ca, and phosphorus can be used as markers for vitamin D deficiency; these tests cost less than 200 EGP, resulting in 60% savings in the cost of diagnosis of this widely prevalent condition.
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