维生素D及其受体在强直性脊柱炎患者中的表达及其临床意义

目的：研究As患者PBMC维生素D受体（VDR）mRNA的表达及血清25-羟维生素D,和1,25-二羟维生素D3的水平,探讨其与AS疾病活动性（BASDAI、CRP、ESR）的相关性。方法：选取26例AS患者（As组）和年龄、性别与之相匹配的13名健康志愿者（健康对照组）。采用SYBRGreenI实时荧光定量PCR检测两组受检者PBMC的VDRmRNA表达水平,应用ELISA法检测两组受检者血清25-羟维生素D3和1,25-二羟维生素D3水平,分析VDRmRNA表达水平、血清25-羟维生素D3和1,25-二羟维生素D3水平与临床相关指标（BASDAI、CRP、ESR）的关系。结果：As患者PBMC的VDRmRNA表达水平明显高于健康对照组（P〈0．01）,VDRmRNA表达水平与临床相关指标（BASDAI、CRP、ESR）无关（P〉0．05）。AS患者血清25．羟维生素D3、1,25-二羟维生素D3水平分别为（5．3±2．6）μg／L、（12．8±6．0）ng／L,明显低于健康对照组（14．7±3．5）μg/L、（32．6±18．5）ng／L（P均〈0．01）。AS患者血清1,25-二羟维生素D3的水平与BASDAI（r=-0．481,P〈0．05）、ESR（r=-0．535,P〈0．01）、CRP（r=-0．674,P〈0．01）均呈负相关。血清25-羟维生素D,水平与BASDAI、CRP、ESR无关（P〉0．05）。结论：As患者VDRmRNA表达水平升高,但与As的疾病活动无关。As患者血清1,25-二羟维生素D3水平下降,与疾病活动呈负相关,可作为AS疾病活动的指标之一。AS患者PBMC的VDR活化可能与1,25-二羟维生素D,的作用无关。     

Association between serum vitamin D levels and venous thromboembolism (VTE): A systematic review and meta-analysis of observational studies

ObjectiveAlthough many studies have attempted to unravel the relationship between vitamin D deficiency and the incidence of VTE, the results remained inconsistent. To address this discrepancy, we performed a systematic review and meta-analysis to precisely disentangle the relationship between serum vitamin D levels and VTE risk.MethodsThe Web of Science, Scopus, PubMed/Medline, Embase, and Google Scholar databases were searched for all available observational studies that reported the risk of venous thromboembolism (VTE) based on serum vitamin D levels categories. The search was performed up to March 2020.ResultsSeven studies were included. The overall analysis showed a significantly increased risk of VTE in subjects with low levels of serum vitamin D compared with those with normal vitamin D levels (RR = 1.34; 95% CI: 1.07–1.69; P = 0.011). In a sensitivity analysis, we did not observe a significant effect of any individual study on the combined effect sizes. Nevertheless, significant heterogeneity was present among the studies (Cochrane Q test, p = 0.018, I² = 61%). In the stratified analysis, low vitamin D levels were positively associated with an increased risk of VTE in prospective population-based studies (RR = 1.31; 95% CI: 1.06–1.61; P = 0.010) and in subjects below 60 years old (RR = 1.28; 95% CI: 1.07–1.54; P = 0.060).Conclusionour systematic review and meta-analysis showed that a low serum vitamin D level was indeed associated with an increased risk of VTE.     

Transport of vitamin D sterols in human plasma: effect of excess vitamin D, 25 hydroxyvitamin D and 1,25 dihydroxyvitamin D

Abstract. Vitamin D and its more active metabolites, 25 hydroxyvitamin D (25-OH-D) and 1,25-dihydroxy-vitamin D (1,25-(OH)₂-D), are transported in human plasma on a specific binding protein (DBP), which has been shown to have an α-globulin electrophoretic mobility. Since the concentration of DBP in normal human plasma is approximately 5 μmol/l, whereas that of all the vitamin D metabolites is less than 0·2 μmol/l, DBP is less than 3% saturated under physiological conditions. We have studied the transport of the above-mentioned metabolites in human plasma in vitro at normal and saturating concentrations. Human plasma was incubated with increasing amounts of vitamin D metabolites together with their radiolabelled tracers. Ultracentrifugation was used to isolate plasma lipoproteins (density, d < 1·21 g/ml) and agarose gel electrophoresis of lipoprotein-free plasma (d > 1·21 g/ml) to separate DBP (α globulin) from albumin. The recovery of the tracer in plasma proteins was always more than 80%. At physiological concentrations [³H]25-OH-D bound almost exclusively to DBP (98%), [³H]vitamin D or [¹⁴C]vitamin D bound both to DBP and to lipoproteins (40%), and [³H]1,25-(OH)₂-D bound to DBP (62%), to lipoproteins (15%) and also to albumin (23%). When the concentration of vitamin D metabolites was increased, DBP became saturated. The binding capacity of DBP was similar for all three sterols, about 5 μmol/l plasma, or one mole of sterol per mole of protein, but the saturating concentration was different for the three sterols (vitamin D > 1,25-(OH)₂-D > 25-OH-D). 25-OH-D had the greatest affinity for DBP, and it completely displaced both vitamin D and 1,25(OH)₂-D from DBP at higher concentrations. All sterols bound to both plasma lipoproteins and albumin: vitamin D preferentially to lipoproteins and both 25-OH-D and 1,25-(OH)₂-D to albumin. A similar binding pattern for vitamin D in plasma was observed previously by us in a child with vitamin D toxicity. The increased binding of vitamin D to lipoproteins and especially to albumin may help explain the pathogenesis of toxicity in hypervitaminosis D, where the plasma levels of the more active metabolites are insufficient to account for the clinical signs.     

补充维生素D对冠心病患者冠状动脉病变程度的影响

目的:探讨维生素D干预对冠心病患者冠状动脉Gensini评分的影响及其相关性。方法:采用前瞻性研究方法,选择109例行冠脉CT的冠心病患者为研究对象。将患者分为对照组和干预组,均给予冠心病二级预防药物治疗,干预组加用维D钙片口服及维生素D2肌肉注射治疗。观察两组患者治疗前后各临床指标及冠状动脉Gensini评分的变化,分析各临床指标、维生素D与冠状动脉Gensini评分的相关性。结果:干预组患者治疗后三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、血磷、红细胞沉降率(ESR)、超敏C反应蛋白(hs-CRP)水平和冠状动脉Gensini评分均低于治疗前(P<0.05),高密度脂蛋白胆固醇(HDL-C)、血钙、25羟维生素D[25(OH)D]均高于治疗前(P<0.05)。干预组治疗前后TC、LDL-C、钙、25(OH)D、ESR、hs-CRP及冠状动脉Gensini评分的差值大于对照组(P<0.05)。Pearson相关分析显示,补充维生素D与否、年龄、LDL-C、HDL-C、TC、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、hs-CRP、维生素D水平与冠状动脉Gensini评分明显相关,相关系数分别为-0.519、0.357、0.725、-0.632、0.419、0.290、0.327、0.599、-0.478;多因素线性回归分析显示,LDL-C、hs-CRP升高是冠状动脉病变的危险因素(Gensini评分增加),补充维生素D及HDL-C、维生素D水平升高是冠状动脉病变的保护性因素(Gensini评分减小)。结论:血清维生素D水平与冠状动脉严重程度负相关,提高25(OH)D水平可降低冠心病患者冠状动脉病变严重程度。     

A Scoping Review of Vitamin D for Nonskeletal Health: A Framework for Evidence-based Clinical Practice

BackgroundLow serum 25-hydroxy-vitamin D [25(OH)D] levels are prevalent worldwide. Although the benefits of vitamin D supplementation have focused on skeletal disorders (eg, rickets, osteomalacia, osteoporosis), emerging evidence for nonskeletal health merits further discussion.PurposeThe purpose of this review was to critically examine the vitamin D supplementation literature pertaining to nonskeletal health to help guide clinicians.MethodsA scoping review that included observational studies and randomized clinical trials (RCTs) was performed. Evidence from meta-analyses and individual RCTs are discussed, and controversies and future directions are considered.Findings25(OH)D deficiency is a ubiquitous condition associated with multiple nonskeletal diseases, including cardiometabolic (heart disease, diabetes, and kidney disease), immune (HIV/AIDS and cancer), lung (from traditional chronic disorders to coronavirus disease 2019), and gut diseases. Vitamin D deficiency also affects health across the life span (children, pregnant, and elderly), mental illness, and reproduction in both men and women. In contrast, vitamin D supplementation does not necessarily improve major medical outcomes, even when low 25(OH)D levels are treated. Screening for 25(OH)D status remains an important practice, primarily for high-risk patients (eg, elderly, women with osteoporosis, people with low exposure to sunlight). It is reasonable to supplement with vitamin D to treat 25(OH)D deficiency, such that if beneficial nonskeletal health occurs, this may be considered as a coadjutant instead of the central tenet of the disease. Furthermore, optimizing dosing regimens is an important clinical consideration.ImplicationsAlthough 25(OH)D deficiency is prevalent in nonskeletal diseases, there is no uniform evidence that vitamin D supplementation improves major medical outcomes, even when low 25(OH)D levels are corrected. Findings from RCTs warrant caution due to possible selection bias. Overall, vitamin D supplementation must be guided by circulating levels as a reasonable medical practice to correct 25(OH)D deficiency.     

The effect of vitamin D supplementation on insulin-like growth factor-1: A systematic review and meta-analysis of randomized controlled trials

PurposeThere is equivocality regarding the interaction between vitamin D and insulin-like growth factor-1 (IGF-1). Thus, the aim of this study was to elucidate the effect of vitamin D supplementation on serum levels of IGF-1 by conducting a systematic review and meta-analysis of randomized controlled trials (RCTs).MethodsPubMed, Scopus, and ISI Web of Science databases were searched up to May 2019 for RCTs that evaluated the effect of vitamin D supplementation on IGF-1 levels. Mean and standard deviation changes of IGF-1 in each treatment group were considered for analysis and pooled using random-effect model. Risk of bias for included studies was assessed by the Cochrane scale and the NutriGrade approach was applied to evaluate the quality of evidence.ResultsSix trials (n = 773 participants) were included in the meta-analysis. Compared with control group, vitamin D supplementation yielded no significant effect on serum level of IGF-1 (weighted mean difference [WMD] =4.66 ng/ml, 95 % CIs: -6.72 to 16.03, P = 0.42, I² = 74.8, P_{-heterogeneity} = 0.001). Additionally, no meaningful changes were observed in subgroup analyses.ConclusionThe evidence from the limited number of published trials does not convincingly show that vitamin D supplementation elicits any clinically relevant effects on IGF-1 levels. More high-quality studies are needed to reach a consensual conclusion in this area.     

Vitamin D status,gender and cardiovascular diseases: a systematic review of prospective epidemiological studies

Introduction: Vitamin D deficiency is highly suggested as an emerging risk factor in primary and secondary cardiovascular disease (CVD) prevention. However, there remains controversy regarding the need for vitamin D supplementation in high CVD risk individuals to prevent cardiac episodes and to achieve a better prognosis. Another literature gap is the potential existence of sex-specific associations of this factor with major CVD events or surrogate markers. The interaction of vitamin D and its metabolites with gene-mediated paths as well as lifestyle parameters sets the hypothesis for different effect of this factor on vascular health between men and women.

Areas covered: The aim of the systematic review was to summarize the hitherto data on the association of vitamin D with CVD prevention or progression, separately for men and women. Studies were eligible if they were published research epidemiological studies evaluating the gender-specific effect of vitamin D metabolic serum concentrations on CVD onset, progression or mortality.

Expert opinion: An unequivocal association between vitamin D deficiency and CVD has been demonstrated by large-scale epidemiological studies yet with inconclusive remarks from the standpoint of sex-specific highlights. Epidemiological and experimental studies designed to draw conclusions specified in men and women are demanded.     

Serum 25-Hydroxyvitamin D Level Could Predict the Risk for Peritoneal Dialysis-Associated Peritonitis

♦ Background:

As an immune system regulator, vitamin D is commonly deficient among patients on peritoneal dialysis (PD), which may contribute to their impaired immune function and increased risk for PD-related peritonitis. In this study, we aimed to investigate whether vitamin D deficiency could predict the risk of peritonitis in a prospective cohort of patients on PD.

♦ Methods:

We collected 346 prevalent and incident PD patients from 2 hospitals. Baseline demographic data and clinical characteristics were recorded. Serum 25-hydroxyvitamin D (25[OH]D) was measured at baseline and prior to peritonitis. The mean doses of oral active vitamin D used during the study period were also recorded. The outcome was the occurrence of peritonitis.

♦ Results:

The mean age of patients and duration of PD were 58.95 ± 13.67 years and 28.45 (15.04 – 53.37) months, respectively. Baseline 25(OH)D level was 16.15 (12.13 – 21.16) nmol/L, which was closely associated with diabetic status, longer PD duration, malnutrition, and inflammation. Baseline serum 25(OH)D predicted the occurrence of peritonitis independently of active vitamin D supplementation with a hazard ratio (HR) of 0.94 (95% confidence interval [CI] 0.90 – 0.98) after adjusting for recognized confounders (age, gender, dialysis duration, diabetes, albumin, residual renal function, and history of peritonitis). Compared to the low tertile, middle and high 25(OH)D level tertiles were associated with a decreased risk for peritonitis with HRs of 0.54 (95% CI 0.31 – 0.94) and 0.39 (95% CI 0.20 – 0.75), respectively.

♦ Conclusions:

Vitamin D deficiency evaluated by serum 25(OH)D rather than active vitamin D supplementation is closely associated with a higher risk of peritonitis.     

Comparative analysis of the association between various serum vitamin D biomarkers and sarcopenia

BackgroundVitamin D status is associated with muscle strength and maintenance of muscle fibers. However, which serum vitamin D biomarker better reflects sarcopenia remains unclear. The aim of this study was to investigate associations between various serum vitamin D biomarkers (total 25‐hydroxy vitamin D [25(OH)D], bioavailable 25(OH)D, 24,25‐dihydroxyvitamin D [24,25(OH)₂D], and vitamin D metabolite ratio [VMR]) and sarcopenia.MethodsThe data for 83 hip fracture patients were finally included in the analysis. Sarcopenia was defined according to the Asia Working Group for Sarcopenia (AWGS) criteria. Measurements of 24,25(OH)₂D and 25(OH)D were made using solid‐phase extraction (SPE) and subsequent liquid chromatography‐tandem mass spectrometry (LC‐MS/MS). Vitamin D binding protein (VDBP) concentration was measured using an enzyme‐linked immunosorbent assay. The VMR was calculated by dividing serum 24,25(OH)₂D by serum 25(OH)D and then multiplying by 100. Based on total 25(OH)D, VDBP, and albumin concentrations, bioavailable 25(OH)D concentrations were calculated using the equations from the other previous studies.ResultsBioavailable 25(OH)D levels were significantly (p = 0.030) decreased in the sarcopenia group compared with the non‐sarcopenia group. Results of ROC analysis for the diagnosis of sarcopenia using serum level of bioavailable of 25(OH)D revealed that the cutoff point for bioavailable 25(OH)D was 1.70 ng/ml (AUC = 0.649, p < 0.001). In the group with a bioavailable 25(OH)D less than 1.70 ng/ml, the incidence of sarcopenia increased by 3.3 times (odds ratio: 3.33, p = 0.013).ConclusionWe demonstrated that bioavailable 25(OH)D was associated with sarcopenia among the various serum vitamin D biomarkers. Bioavailable vitamin D might be helpful for assessing the risk of sarcopenia.     

妊娠期肝内胆汁淤积症血清25-(OH)D3水平与总胆汁酸、甘胆酸水平及母婴结局的相关性分析

目的 探讨妊娠期肝内胆汁淤积症(ICP)血清25-(OH)D3水平与总胆汁酸、甘胆酸水平及母婴结局的相关性.方法 回顾性选取2018年12月至2020年4月间在监利市人民医院确诊的孕晚期ICP孕妇90例作为ICP组,选择同期进行产检的孕晚期正常孕妇100例作为正常对照组.检测2组患者的血清25-(OH)D3水平,根据I...     

Serum vitamin D levels correlate to coronary artery disease severity: a retrospective chart analysis

Background: The pro-atherosclerotic nature of vitamin D deficiency has been shown to increase cardiovascular events. We further emphasized and evaluated the severity of coronary artery disease (CAD) with varying levels of vitamin D in relation to age, gender, ethnicity and baseline confounders.

Methods: A retrospective, single-center study of 9,399 patients admitted between 2005 and 2014 for chest pain who underwent coronary angiography. Patients without a vitamin D level, measured as 25-dihydroxyvitamin D (25[OH]D) were excluded from our study. 25(OH)D deficiency and insufficiency were defined by having serum concentration levels of less than 20 ng/ml and 20 to 29.9 ng/ml, respectively, while normal levels were defined as greater than or equal to 30 ng/ml. We assessed levels of 25(OH)D and extent of coronary disease with coronary angiography as obstructive CAD (left main stenosis of ≥50% or any stenosis of ≥70%), non-obstructive CAD (≥1 stenosis ≥20% but no stenosis ≥70%) and normal coronaries (no stenosis >20%).

Results: Among 9,399 patients, 1,311 qualified, of which 308 patients (23%) had normal 25(OH)D levels, 552 patients (42%) had 25(OH)D deficiency and 451 patients (35%) had 25(OH)D insufficiency. In an analysis of the extent of coronary disease, we identified 20% of patients having normal coronaries, 55% having obstructive CAD and 25% having non-obstructive CAD. Baseline clinical risk factors and co-morbidities did not differ between the groups.

Patients with normal 25(OH)D levels were found to have normal coronaries compared to patients with 25(OH)D deficiency or insufficiency (OR: 7, 95% CI: 5.2 – 9.5, p < 0.0001). Comparing patients with normal 25(OH)D levels, patients with 25(OH)D deficiency or insufficiency (<29 ng/ml), 62% were found to have obstructive CAD (n = 624, OR: 2.9, 95% CI: 2.3-3.7, p < 0.0001) and 25% had non-obstructive CAD (n = 249, OR: 1.5, 95% CI: 1.1-2, p = 0.02).

Conclusion: Normal coronaries and CAD were shown to correlate with normal and low levels of 25(OH)D, respectively. There is an inverse relationship between the percentage of coronary artery occlusion and serum 25(OH)D concentrations. Vitamin D may provide benefits in risk stratification of patients with CAD and serve as a possible risk factor.     

Analytical and clinical validation of the 25 OH vitamin D assay for the LIAISON automated analyzer

OBJECTIVE: Methods to assess serum 25 OH vitamin D have improved in accuracy, precision, and ease of use. We describe the analytical and clinical validation of an automated, antibody- and microparticle-based, chemiluminescent immunoassay method for the determination of 25 OH vitamin D. DESIGN AND METHODS: The LIAISON 25 OH Vitamin D assay is a rapid automated method with first results available in 40 min, and a subsequent throughput of 180 samples per hour. Assay performance characteristics of precision and recovery were determined according to the National Committee for Clinical Laboratory Standards (NCCLS) protocols. Analytical and functional sensitivity were determined according to standard protocols. Samples for method comparison studies were obtained from routine clinical samples submitted for 25 OH Vitamin D determination or from apparently healthy normal volunteers. RESULTS: The detection limit for this assay was <2.0 nmol/L across three lots of materials. Functional sensitivity (inter-assay imprecision <20%) was 17.5 nmol/L. Total imprecision (CV) was <15% at 42.5-137.5 nmol/L. Mean (SD) recovery was 101% (13%). The assay was linear on dilution. Comparison with radioimmunoassay (RIA) yielded acceptable correlation (r = 0.88) and clinical equivalence in the range from 37.5 to 150 nmol/L. CONCLUSIONS: The LIAISON 25 OH Vitamin D assay is a rapid, accurate, and precise tool for the measurement of 25 OH vitamin D.     

2型糖尿病患者血25-羟维生素D水平的改变及其对血糖与骨量的影响

目的：研究2型糖尿病患者血25-羟维生素D[25（OH）D]水平的改变对血糖与骨量的影响。方法本研究收集621例复旦大学附属中山医院内分泌科2009年10月至2011年3月住院2型糖尿病患者的临床资料,将测得的血25（OH）D进行季节校正后纳入分析。以血25（OH）D等于50 nmol/L为界将患者分为25（OH）D缺乏组[25（OH）D＜50 nmol/L]及25（OH）D非缺乏组[25（OH）D≥50 nmol/L]两组,观察两组之间糖代谢指标[包括空腹血糖（FBS）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbA1c）、糖化白蛋白、空腹胰岛素（FINS）]及骨代谢指标[包括甲状旁腺激素（PTH）、碱性磷酸酶（ALP）、骨密度]的差异。结果（1）2型糖尿病患者25（OH）D的平均水平低于50 nmol/L,而且女性较男性更低（P＜0.001）;（2）维生素D缺乏组血空腹胰岛素水平高于维生素D非缺乏组（P＜0.05）,胰岛素抵抗指数（HOMA-IR）也高于维生素D非缺乏组（P＜0.001）。FPG、HbA1c及胰岛素分泌指数（HOMA-B）两组间无明显统计学差异;（3）维生素D缺乏组PTH高于维生素D非缺乏组（P＜0.05）;维生素D缺乏组腰椎、股骨颈和全髋骨密度均低于维生素D非缺乏组（P＜0.05）;钙磷乘积及ALP两组间无统计学意义差异。结论2型糖尿病患者普遍存在维生素D缺乏,在2型糖尿病人群中,胰岛素抵抗、骨量流失可能与血25（OH）D水平降低有关。     

Role of vitamin D in arterial hypertension

Vitamin D deficiency is highly prevalent and may contribute to arterial hypertension. The antihypertensive effects of vitamin D include suppression of renin and parathyroid hormone levels and renoprotective, anti-inflammatory and vasculoprotective properties. Low 25-hydroxyvitamin D levels, which are used to classify the vitamin D status, are an independent risk factor for incident arterial hypertension. Meta-analyses of randomized controlled trials showed that vitamin D supplementation reduces systolic blood pressure by 2–6 mmHg. However, further studies are needed before drawing a final conclusion on the effect of vitamin D therapy on blood pressure and cardiovascular risk. In our current clinical practice we should take into account the high prevalence of vitamin D deficiency, the easy, cheap and safe way by which it can be supplemented and the promising clinical data suggesting that vitamin D might be useful for the treatment of arterial hypertension as well as other chronic diseases. Therefore, we recommend that testing for and treating vitamin D deficiency in patients with arterial hypertension should be seriously considered.     

Gender difference in the relationship between anemia and vitamin D in Korean adults: the fifth Korea National Health and Nutrition Examination Survey

This study was conducted to assess the relationship between vitamin D deficiency and anemia, by gender, in Korean adults. The data of 16,060 adults were analyzed (men, 6,840; premenopausal women, 4,916; postmenopausal women, 4,340) from the fifth Korean National Health and Nutrition Examination Survey (KNHANES V) (2010–2012). There were several key findings. First, after adjusting for related variables, the odds ratio (OR) of anemia [hemoglobin (Hb) <13 g/dl in men or Hb <12 g/dl in women] using the vitamin D normal group {25-hydroxyvitamin [25(OH)D] ≥15.0 ng/ml} as reference, was significant for the vitamin D deficient group [25(OH)D <15.0 ng/ml] in the overall population [OR, 1.310; 95% confidence interval (CI), 1.168–1.470]. Second, the OR of anemia, using the vitamin D normal group as reference, was significant for the vitamin D deficient group in premenopausal women (OR, 1.293; 95% CI, 1.105–1.513). However, vitamin D deficiency in the vitamin D normal group in men (OR, 1.093; 95% CI, 0.806–1.484) and postmenopausal women (OR, 1.130; 95% CI, 0.906–1.409) was not significant. In conclusion, Vitamin D deficiency is positively associated with anemia in premenopausal women, but not in men and postmenopausal women.     

An evaluation of automated methods for measurement of serum 25-hydroxyvitamin D

Objectives

To compare two new automated assays with the well-established reference method, DiaSorin radioimmunoassay (RIA), for quantitation of serum total 25-hydroxyvitamin D [25(OH)D].

Methods

25(OH)D from human sera (n = 158) was measured using DiaSorin RIA and two automated platforms, DiaSorin “LIAISON 25 OH Vitamin D TOTAL”, and Roche Modular “Vitamin D3 (25-OH)”. Methods were compared by regression and Bland-Altman analyses.

Results

DiaSorin LIAISON demonstrated a stronger correlation (r = 0.918) and better agreement (bias = − 0.88 nmol/L) with DiaSorin RIA than the Roche Modular assay (r = 0.871, bias = − 2.55 nmol/L). Precision ranges (CV%) for the RIA, LIAISON, and Roche Modular assays, respectively, were: within run (6.8-12.9%, 2.8-8.1%, and 1.9-5.5%), and total precision (7.4-14.5%, 7.3-17.5%, and 7.6-14.5%).

Conclusion

DiaSorin LIAISON displayed the best correlation and agreement with DiaSorin RIA. The DiaSorin LIAISON 25 OH Vitamin D TOTAL assay is an accurate and precise automated tool for serum total 25(OH)D determination.     

维生素D对脂多糖致急性肺损伤大鼠肺组织血管紧张素转化酶2和维生素D受体表达水平的影响

目的 观察维生素D(vitamin D,Vit D)对脂多糖(lipopolysaccharide,LPS)致Wistar大鼠急性肺损伤(acute lung injury,ALI)肺组织中血管紧张素转化酶2(angiotensinconverting enzyme 2,ACE2)和维生素D受体(vitamin D receptor,VDR)表达水平的影响.方法 采用尾静脉注射LPS方法制备大鼠ALI模型;将30只健康雄性Wistar大鼠随机(随机数字法)分为6组:正常对照组(NC组)、LPS组:尾静脉注射LPS 5mg/kg、Vit D组:给予Vit D活性形式(骨化三醇)25 μg/kg连续灌胃3d和(LPS+ Vit D) 1-3组:分别于骨化三醇1μg/kg、5μg/kg、25 μg/kg灌胃3d后尾静脉注射LPS 5mg/kg,所有大鼠于注射LPS的24 h后进行后续实验.分别观察大鼠一般情况,肺组织病理及肺干/湿重比变化、肺组织中VDR、ACE2蛋白及基因水平的表达.结果 LPS组大鼠病态表现(呼吸浅快、精神萎靡、口鼻可见血性分泌物)明显,(LPS+ VitD) 1-3组病态表现和肺组织病理损伤均较LPS组明显减轻.LPS组VDR和ACE2蛋白及基因水平的表达均较NC组和Vit D组显著降低(P＜0.05),(LPS+ VitD) 1-3组各组VDR和ACE2蛋白及基因水平的表达均较LPS组有所升高(P＜0.05),但仍显著低于Vit D组(P＜0.05),其中(LPS+ Vit D) 1-3组各组VDR蛋白及基因水平的表达差异无统计学意义(P＞0.05),ACE2的表达差异有统计学意义(P＜0.05).结论 Vit D能使LPS致ALI大鼠肺组织中ACE2和VDR蛋白及基因表达水平增加,故此推测ACE2和VDR表达增加可能对ALI的发生、发展起保护作用.     

25-羟维生素D3与2型糖尿病血糖控制相关性研究

目的检测2型糖尿病患者血清25-羟维生素D3表达水平,探讨其在2型糖尿病病情评估与血糖控制中的价值。方法收集我院内分泌科诊断的2型糖尿病患者60例,以体检中心60例健康体检者作为对照,电化学发光法检测血清25-羟维生素D3,高效液相色谱法检测糖化血红蛋白,并对其与2型糖尿病患者糖化血红蛋白作相关性分析。结果 2型糖尿病患者血清25-羟维生素D3含量为17.02±0.51ng/ml低于健康体对照组的23.48±0.63ng/ml,差异有统计学意义(P0.05);血清25-羟维生素D3与2型糖尿病患者糖化血红蛋白负相关(r=-0.541,P=0.000),与全部研究对象糖化血红蛋白呈负相关(r=-0.663,P=0.000)。结论 2型糖尿病患者血清25-羟维生素D3含量低于健康体对照组,血清25(OH)D3水平与糖化血红蛋白呈负相关,即2型糖尿病患者的维生素D3水平与血糖控制有关,这对指导2型糖尿病的治疗可能有重要意义。