D Vitamin Düzeyi ve Analiz Yöntemleri
Özet
D vitamini, kalsiyum ve fosfor metabolizmasının düzenlenmesinde kritik bir rol oynayarak vücutta sentezlenen veya diyetle alınan lipofilik bir yapıya sahiptir. Karaciğer ve böbreklerdeki hidroksilasyon süreçleriyle aktif formlarına dönüşen bu vitaminin eksikliği dünya genelinde önemli bir halk sağlığı sorunu teşkil etmektedir. D vitamini durumunun en güvenilir göstergesi olan 25(OH)D ile daha spesifik tanılarda kullanılan 1,25(OH)2D metabolitleri; immünoassay, HPLC ve altın standart kabul edilen LC-MS/MS gibi çeşitli laboratuvar yöntemleriyle analiz edilmektedir.
Vitamin D plays a critical role in regulating calcium and phosphorus metabolism and is a lipophilic structure synthesized in the body or obtained through diet. The deficiency of this vitamin, which transforms into active forms through hydroxylation processes in the liver and kidneys, is a significant global public health issue. Metabolites such as 25(OH)D, the most reliable indicator of vitamin D status, and 1,25(OH)2D, used in more specific diagnoses, are analyzed using various laboratory methods including immunoassays, HPLC, and the gold-standard LC-MS/MS.
Referanslar
Serteser M, Coskun A, Inal T, Unsal I. Challenges in vitamin D analysis / Izazovi u analizi vitamina D. Journal of Medical Biochemistry. 2012;31(4):326-332. DOI: 10.2478/v10011-012-0016-z
Salwen MJ. Vitamins and trace elements. In: McPherson RA, Pincus MR (eds.) Henry’s clinical diagnosis and management by laboratory methods. 22nd ed. Philadelphia: Saunders Elsevier; 2011. p. 417-428.
Gil Á, Plaza-Diaz J, Mesa MD. Vitamin D: Classic and novel actions. Annals of Nutrition and Metabolism. 2018;72(2):87-95. DOI: 10.1159/000486536
Fraser WD. Bone and mineral metabolism. In: Rifai N, Harvath AR, Wittwer CT (eds.) Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6nd ed. USA: Elsevier; 2018. p. 1422-1491.
Adams JS, Hewison M. Update in vitamin D. The Journal of Clinical Endocrinology & Metabolism. 2010;95(2):471-478. DOI:10.1210/jc.2009-1773
Altieri B, Cavalier E, Bhattoa HP, Pérez-López FR, López-Baena MT, Pérez-Roncero GR, et al. Vitamin D testing: advantages and limits of the current assays. European Journal of Clinical Nutrition. 2020;74(2):231-47. DOI: 10.1038/s41430-019-0553-3
Hollis BW. Measuring 25-hydroxyvitamin D in a clinical environment: challenges and needs. The American journal of clinical nutrition. 2008;88(2):507-510. DOI: 10.1093/ajcn/88.2.507S
Thacher TD, Clarke BL. Vitamin D insufficiency. Mayo Foundation for Medical Education and Research. 2011;86(1):50-60 DOI: 10.4065/mcp.2010.0567.
Holick MF. Vitamin D deficiency. The New England Journal of Medicine. 2007;357(3):266-81. DOI: 10.1056/NEJMra070553
Christakos S, Ajibade DV, Dhawan P, Fechner AJ, Mady LJ. Vitamin D: Metabolism. Endocrinology and metabolism clinics of North America. 2010;39(2):243-53. DOI: 10.1016/j.ecl.2010.02.002.
Murray RK, Bender DA, Botham KM et al. Harper’in Biyokimyası. (Gül Güner AKDOĞAN, Biltan ERSÖZ, Nevbahar TURGAN, Çev. Eds.). İstanbul: Nobel Tıp Kitabevleri; 2015.
Harvey RA, Ferrier DR. Lippincott görsel anlatımlı çalışma kitapları: Biyokimya. (Engin ULUKAYA Çev. Ed.). İstanbul: Nobel Tıp Kitabevleri; 2015.
Shenkin A, Roberts NB. Vitamin and trace elements. In: Burtis CA, Ashwood ER, Bruns DE (eds.) Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 5nd ed. USA: Elsevier; 2012. p. 895-983.
Pilz S, Zittermann A, Trummer C, Theiler-Schwetz V, Lerchbaum E, Keppel MH, et al. Vitamin D testing and treatment: a narrative review of current evidence. Endocrine Connections. 2019;8(2):27-43. DOI: 10.1530/EC-18-0432
The Medical Biochemistry Page. Vitamins: Water and fat soluble. (20.04.2022 tarihinde https://themedicalbiochemistrypage.org/adresinden ulaşılmıştır).
Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M. Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122(2):398-417. DOI: 10.1542/peds.2007-1894.
T.C. Sağlık Bakanlığı, Türkiye Halk Sağlığı Kurumu. Türkiye Beslenme Rehberi (TÜBER) 2015. Ankara: T.C. Sağlık Bakanlığı Yayın No: 1031; 2016.
Horst RL, Hollis BW. Vitamin D assays and their clinical utility. In: Holick MF (eds). Vitamin D. Nutrition and Health. Totowa, NJ: Humana Press; 1999. p. 239-271. DOI:10.1007/978-1-4757-2861-3_15
Hollis BW. Assessment of Circulating 25(OH)D and 1, 25(OH)2D: Emergence as clinically important diagnostic tools. Nutrition reviews. 2008;65:87-90. DOI: 10.1111/j.1753-4887.2007.tb00348.x
Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. The American Journal of Clinical Nutrition. 2008;87(4):1080-1086. DOI: 10.1093/ajcn/87.4.1080S
Spiro A, Buttriss JL. Vitamin D: An overview of vitamin D status and intake in Europe. Nutrition bulletin. 2014;39(4):322-350. DOI: 10.1111/nbu.12108.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of clinical endocrinology and metabolism. 2011;96(7):1911-1930.
Aspray TJ, Bowring C, Fraser W, Gittoes N, Javaid MK, Macdonald H, et al. National Osteoporosis Society vitamin D guideline summary. Age and ageing. 2014;43(5):592-5. DOI: 10.1093/ageing/afu093.
Kennel KA, Drake MT, Hurley DL. Vitamin D deficiency in adults: when to test and how to treat. Mayo Clinic proceedings. 2010;85(8):752-757. DOI: 10.4065/mcp.2010.0138.
T.C. Sağlık Bakanlığı, Sağlık Hizmetleri Genel Müdürlüğü, Tetkik ve Teşhis Hizmetleri Daire Başkanlığı. Bu test nerede yapılıyor. (08.04.2022 tarihinde https://ckysweb.saglik.gov.tr/labtestlerapp/testlabara.aspx adresinden ulaşılmıştır).
Kamu Hastaneleri Genel Müdürlüğü, Verimlilik ve Kalite Uygulama Daire Başkanlığı. Verimlilik yerinde değerlendirme rehberi. Sağlık Bakanlığı; 2019. (08.04.2022 tarihinde https://khgmverimlilikkalitedb.saglik.gov.tr/TR,48025/verimlilik-yerinde-degerlendirme-rehberi.html adresinden ulaşılmıştır).
Zerwekh JE. The measurement of vitamin D: analytical aspects. Annals of clinical biochemistry. 2004;41(4):272-281. DOI: 10.1258/0004563041201464.
Su Z, Narla SN, Zhu Y. 25-Hydroxyvitamin D: analysis and clinical application. Clinica chimica acta. 2014;433:200-205. DOI: 10.1016/j.cca.2014.03.022.
Garg U. 25-Hydroxyvitamin D Testing: Immunoassays Versus Tandem Mass Spectrometry. Clinics in laboratory medicine. 2018;38(3):439-453. DOI: 10.1016/j.cll.2018.05.007.
Mineva EM, Schleicher RL, Chaudhary-Webb M, Maw KL, Botelho JC, Vesper HW, et al. A Candidate reference measurement procedure for quantifying serum concentrations of 25-Hydroxyvitamin D3 and 25-Hydroxyvitamin D2 using isotope-dilution liquid chromatography-tandem mass spectrometry. Analytical and Bioanalytical Chemistry. 2015;407(19):5615-5624. DOI: 10.1007/s00216-015-8733-z
Tai SSC, Bedner M, Phinney KW. Development of a candidate reference measurement procedure for the determination of 25-Hydroxyvitamin D3 and 25-Hydroxyvitamin D2 in human serum using isotope-dilution liquid chromatography−tandem mass spectrometry. Analytical Chemistry. 2010;82(5):1942-1948. DOI: 10.1021/ac9026862.
Hollis BW, Horst RL. The assessment of circulating 25(OH)D and 1,25(OH)2D: where we are and where we are going. The Journal of steroid biochemistry and molecular biology. 2007;103(3-5):473-476. DOI: 10.1016/j.jsbmb.2006.11.004.
