羟基维生素D比对报告

不同标本测定儿童25-羟基维生素D的比对分析及偏移评估周后钢;毛安华;谭浩【摘要】目的分析儿童末梢血与静脉血血浆25-羟基维生素D[25(OH)D]水平的差异及可比性,为2种标本25(OH)D检测结果的互认提供依据.方法采用酶联免疫吸附试验分别检测85例儿童末梢血和静脉血血浆25(OH)D水平,采用直线回归分析计算2种标本检测结果的相关系数、直线回归方程以及在医学决定水平处的偏移.结果末梢血25(OH)D水平明显低于静脉血(P<0.01).相关性分析显示,静脉血25(OH)D/末梢血25(OH)D比值与静脉血血细胞比容(HCT)末梢血HCT比值呈明显正相关(r=0.634,P<0.01).末梢血和静脉血25(OH)D水平显著相关(r=0.995),各医学决定水平处的偏移均在试剂盒给定的误差范围内.结论末梢血血浆25(OH)D 水平低于静脉血,但结果具有较好的可比性,临床上可以采集末梢血检测25(OH)D.%Objective To analyze the differences and comparability of 25-hydroxyvitamin D [25 (OH) D] determination results in peripheral blood and venous blood,and to provide a reference for the homogeneity of25(OH)D results determined by the 2 specimen types. Methods The levels of 25 (OH) D of peripheral blood and venous blood were determined by enzyme-linked immunosorbent assay. Linear regression analysis was used to analyze the correlation and bias of 25(OH)D determination results in the 2 specimen types. Results The levels of 25(OH)D of peripheral blood were lower than those of venous blood (P<0.01). The ratio of peripheral blood 25(OH)D/ venous blood 25(OH)D was positively correlated with the ratio of peripheral blood hematocrit(HCT)/ venous blood HCT(r=0.634,P<0.01). There was a correlation for the levels of 25(OH)D between peripheralblood and venous blood(r=0.995). The bias of 25 (OH)D levels between the 2 specimen types was in allowed error provided by kits. Conclusions The levels of 25(OH)D of peripheral blood are lower than those of venous blood,and their results are comparable. Peripheral blood can be used to determine 25(OH)D levels.【期刊名称】《检验医学》【年(卷),期】2017(032)011【总页数】3页(P1036-1038)【关键词】25-羟基维生素D;偏移;末梢血;静脉血【作者】周后钢;毛安华;谭浩【作者单位】湖南省妇幼保健院检验科,湖南长沙 410008;湖南省妇幼保健院检验科,湖南长沙 410008;湖南省妇幼保健院检验科,湖南长沙 410008【正文语种】中文【中图分类】R446.1维生素D是人体必需的一种脂溶性维生素，在调节机体钙、磷代谢，细胞增殖与分化以及免疫功能方面发挥着重要作用。

25-羟基维生素D测定意义在于了解人体内维生素D的储存水平，维生素D缺乏与许多疾病有关，如小儿比较常见的维生素D缺乏性佝偻病、骨软化症，老年人尤其是绝经后妇女，与骨外伤病人容易多发的成人骨质疏松症以及肾性骨病等。

25羟维生素D测定可用于上述疾病的诊断、鉴别与治疗效果的监测，25羟维生素D测定还可用于与维生素D缺乏相关的病症，如癌症、心血管系统疾病、自身免疫性疾病、糖尿病，以及抑郁症的监测，还可用于维生素D过量或者维生素D中毒的诊断。

具体来说，对儿童来说，维生素D是生长发育必不可少的物质，若是缺乏此物质，便会影响骨骼的生长发育，进而导致X型腿、O型腿、方颅等骨骼畸形，所以对儿童进行25-羟维生素D的检测，可用来预防维生素D缺乏，进而防止发生骨骼畸形；对妊娠期妇女来说，由于激素和代谢水平都较之前有所变化，可能会导致维生素D缺乏。

对妊娠期妇女进行25-羟维生素D的检测，可以减小宫内胎儿患先天性佝偻病的几率，并在医生指导下应用相应措施，防止流产等不良后果的发生；对老年人来说，维生素D也是需要定时补充的物质，因为它与骨骼的密度、肌肉强度有关。

若是维生素D缺乏，可能会使老年人行走能力下降，容易发生骨折，所以对老年人进行25-羟维生素D 的检测，可以降低老年人发生骨折的风险。

25-羟基维生素D的临床检测SDD 张文娟一、什么是25-羟基维生素D检测维生素D(vitamin D)是一类脂溶性维生素，属固醇类衍生物，是包括人类在内的高等动物生命必需的重要营养素。

维生素D主要的生理功能是调节体内钙、磷代谢并维持血浆钙、磷水平稳定，参与个体牙齿和骨骼的正常生长发育。

维生素D主要包括五种化合物，分别为维生素D1、D2、D3、D4和D5，家族成员中最重要的是D2和D3，通常所说的维生素D即指这两种形式。

维生素D2（麦角钙化醇) 主要来源于蘑菇, 牛油果等植物性食物；维生素D3 (胆钙化醇) 一方面由皮肤中的7-脱氢胆固醇通过阳光中的紫外线照射裂解转化而来，一方面来源于人摄取的动物性食物，如海鱼, 蛋黄和黄油等[1, 2, 3, 4, 5]。

这两种形式的维生素D并没有生物活性，须与血液中的维生素D结合蛋白（VDBP）结合后，在肝脏中分别代谢成没有活性的体内储备形式的25-羟基维生素D2（骨化二醇）和25-羟基维生素D3(骨化三醇)[1, 4]。

非活性的维生素D在肾脏转换为具有生物活性的代谢物1,25-双羟基维生素D，行使激素功能（D-荷尔蒙）[1, 4]。

D-荷尔蒙调节肠道的钙吸收, 骨骼的矿物质化, 成骨细胞的分化和骨质合成，此外该激素还会影响神经肌肉的功能。

作为维生素D在体内的主要储存形式，血清中的25-羟基维生素D浓度可以作为人体维生素D含量的最佳指标。

25-羟基维生素D是维生素D营养状态的评价指标，美国医学科学院推荐25-OHD的血浓度大于20ng/mL有利于骨骼健康，而许多文献将维生素D缺乏定义为血清25-OHD水平低于20ng/mL，不足为21-29ng/mL，充足为30ng/mL以上，而大于150ng/mL可能会导致中毒。

但是维生素D中毒极为罕见，而维生素D缺乏却十分常见，这与年龄、人种、肤色、生活习惯等等有关。

据统计，全球有超过10亿人缺乏维生素D[1, 6, 7]。

25-羟基维生素d 标准英文回答：25-hydroxyvitamin D, also known as calcidiol, is a form of vitamin D that is used to measure the body's vitamin D status. It is produced in the liver from vitamin D obtained through sunlight exposure or dietary sources. The measurement of 25-hydroxyvitamin D levels is important in assessing an individual's vitamin D status and determining if they are at risk for deficiency or toxicity.The standard requirement for 25-hydroxyvitamin D levels varies depending on the organization or expert providing the guidelines. In general, a level of 20 ng/mL (50 nmol/L) or higher is considered sufficient for most individuals. However, some experts recommend maintaining levels above 30 ng/mL (75 nmol/L) for optimal health.Maintaining adequate levels of 25-hydroxyvitamin D is important for overall health. Vitamin D plays a crucialrole in calcium and phosphate metabolism, which isessential for maintaining strong bones and teeth. It also helps regulate the immune system, supports muscle function, and promotes overall well-being.To meet the standard requirement for 25-hydroxyvitamin D, individuals can obtain vitamin D through sunlight exposure, dietary sources, or supplements. Sunlight is the most efficient way for the body to produce vitamin D, as the skin converts cholesterol into vitamin D when exposed to UVB rays. However, the amount of sunlight needed to produce adequate levels of vitamin D can vary depending on factors such as skin color, geographic location, time of year, and time spent outdoors.Dietary sources of vitamin D include fatty fish (such as salmon and mackerel), fortified dairy products, egg yolks, and certain mushrooms. However, it can be challenging to obtain sufficient vitamin D through diet alone, especially for individuals with limited sun exposure or dietary restrictions.Supplements can be used to ensure adequate vitamin D intake. Vitamin D supplements are available in two forms: vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D3 is the preferred form, as it is more easily absorbed and utilized by the body.In conclusion, the standard requirement for 25-hydroxyvitamin D levels is generally considered to be 20ng/mL or higher. However, maintaining levels above 30 ng/mL is recommended for optimal health. Adequate vitamin D intake can be achieved through sunlight exposure, dietary sources, or supplements. It is important to consult with a healthcare professional to determine the appropriate vitamin D intake based on individual needs and circumstances.中文回答：25-羟基维生素D，也被称为钙二醇，是一种用于衡量人体维生素D水平的形式。