Determination of Free 25(OH)D Concentrations and Their Relationships to Total 25(OH)D in Multiple Clinical Populations

Autor: Davide Verotta, Roger Bouillon, K. E. Naylor, Daniel D. Bikle, Eric S. Orwoll, Kerry S Jones, Simon Bowles, Inez Schoenmakers, Janice B. Schwartz, Richard Eastell, Carrie M. Nielson, Michael F. Holick, Vivian Berg, Rolf Jorde, Jennifer Walsh, Amy L Evans, Martin Kaufmann, Jennifer C. Lai, Glenville Jones, J. Christopher Gallagher
Rok vydání: 2018
Předmět:
0301 basic medicine
Liver Cirrhosis
Male
Vitamin D-binding protein
Endocrinology
Diabetes and Metabolism
Clinical Biochemistry
Biochemistry
chemistry.chemical_compound
0302 clinical medicine
Endocrinology
Pregnancy
Reference Values
Outpatients
Vitamin D
African Continental Ancestry Group
Vitamin D-Binding Protein
Health condition
Middle Aged
Female
Analysis of variance
Adult
medicine.medical_specialty
Post hoc
Clinical Sciences
Black People
030209 endocrinology & metabolism
Prediabetic State
Paediatrics and Reproductive Medicine
03 medical and health sciences
Endocrinology & Metabolism
Clinical Research
Internal medicine
medicine
Vitamin D and neurology
Humans
Clinical Research Articles
Aged
Creatinine
business.industry
Biochemistry (medical)
Albumin
Nursing Homes
030104 developmental biology
Cross-Sectional Studies
chemistry
Haplotypes
business
Nursing homes
Digestive Diseases
Zdroj: The Journal of clinical endocrinology and metabolism, vol 103, iss 9
Schwartz, JB; Gallagher, JC; Jorde, R; Berg, V; Walsh, J; Eastell, R; et al.(2018). Determination of Free 25(OH)D Concentrations and Their Relationships to Total 25(OH)D in Multiple Clinical Populations. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 103(9), 3278-3288. doi: 10.1210/jc.2018-00295. UCSF: Retrieved from: http://www.escholarship.org/uc/item/44w5n8qk
ISSN: 1945-7197
DOI: 10.1210/jc.2018-00295.
Popis: ContextThe optimal measure of vitamin D status is unknown.ObjectiveTo directly measure circulating free 25-hydroxyvitamin D[25(OH)D] concentrations and relationships to total 25(OH)D in a clinically diverse sample of humans.DesignCross-sectional analysis.SettingSeven academic sites.PatientsA total of 1661 adults: healthy (n = 279), prediabetic (n = 479), outpatients (n = 714), cirrhotic (n = 90), pregnant (n = 20), nursing home resident (n = 79).InterventionsMerge research data on circulating free 25(OH)D (directly-measured immunoassay), total 25(OH)D (liquid chromatography/tandem mass spectrometry), D-binding protein [DBP; by radial (polyclonal) immunodiffusion assay], albumin, creatinine, intact parathyroid hormone, and DBP haplotype.Main outcome measuresDistribution of free 25(OH)D (ANOVA with Bonferroni correction for post hoc comparisons) and relationships between free and total 25(OH)D (mixed-effects modeling incorporating clinical condition, DBP haplotype with sex, race, estimated glomerular filtration rate (eGFR), body mass index (BMI), and other covariates).ResultsFree 25(OH)D was 4.7 ± 1.8 pg/mL (mean ± SD) in healthy persons and 4.3 ± 1.9 pg/mL in outpatients, with levels of 0.5 to 8.1 pg/mL and 0.9 to 8.1 pg/mL encompassing 95% of healthy persons and outpatients, respectively. Free 25(OH)D was higher in patients with cirrhosis (7.1 ± 3.0 pg/mL; P < 0.0033) and nursing home residents (7.9 ± 2.1 pg/mL; P < 0.0033) than in other groups and differed between whites and blacks (P < 0.0033) and between DBP haplotypes (P < 0.0001). Mixed-effects modeling of relationships between free and total 25(OH)D identified clinical conditions (patients with cirrhosis > nursing home residents > patients with prediabetes > outpatients > pregnant women) and BMI (lesser effect) as covariates affecting relationships but not eGFR, sex, race, or DBP haplotype.ConclusionsTotal 25(OH)D, health condition, race, and DBP haplotype affected free 25(OH)D, but only health conditions and BMI affected relationships between total and free 25(OH)D. Clinical importance of free 25(OH)D needs to be established in studies assessing outcomes.
Databáze: OpenAIRE
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