Article (Scientific journals)
Assessment of vitamin D status - a changing landscape.
Herrmann, Markus; Farrell, Christopher-John L.; Pusceddu, Irene et al.
2017In Clinical Chemistry and Laboratory Medicine
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Abstract :
[en] In recent years it has been shown that vitamin D deficiency is associated with an increased incidence as well as the progression of a broad range of diseases including osteoporosis, rickets, cardiovascular disease, autoimmune disease, multiple sclerosis and cancer. Consequently, requests for the assessment of vitamin D status have increased dramatically. Despite significant progress in the analysis of vitamin D metabolites and an expansion of our pathophysiological knowledge of vitamin D, the assessment of vitamin D status remains a challenging and partially unresolved issue. Current guidelines from scientific bodies recommend the measurement of 25-hydroxy vitamin D (25-OHD) in blood as the preferred test. However, growing evidence indicates significant limitations of this test, including analytical aspects and interpretation of results. In addition, the relationships between 25-OHD and various clinical indices, such as bone mineral density and fracture risk, are rather weak and not consistent across races. Recent studies have systematically investigated new markers of vitamin D status including the vitamin D metabolite ratio (VMR) (ratio between 25-OHD and 24,25-dihydroxy vitamin D), bioavailable 25-OHD [25-OHD not bound to vitamin D binding protein (DBP)], and free 25-OHD [circulating 25-OHD bound to neither DBP nor albumin (ALB)]. These parameters may potentially change how we will assess vitamin D status in the future. Although these new biomarkers have expanded our knowledge about vitamin D metabolism, a range of unresolved issues regarding their measurement and the interpretation of results prevent their use in daily practice. It can be expected that some of these issues will be overcome in the near future so that they may be considered for routine use (at least in specialized centers). In addition, genetic studies have revealed several polymorphisms in key proteins of vitamin D metabolism that affect the circulating concentrations of vitamin D metabolites. The affected proteins include DBP, 7-dehydrocholesterol synthase and the vitamin D receptor (VDR). Here we aim to review existing knowledge regarding the biochemistry, physiology and measurement of vitamin D. We will also provide an overview of current and emerging biomarkers for the assessment of vitamin D status, with particular attention methodological aspects and their usefulness in clinical practice.
Disciplines :
Laboratory medicine & medical technology
Author, co-author :
Herrmann, Markus
Farrell, Christopher-John L.
Pusceddu, Irene
Fabregat Cabello, Neus ;  Université de Liège > Département de pharmacie > Chimie médicale
Cavalier, Etienne  ;  Université de Liège > Département de pharmacie > Chimie médicale
Language :
English
Title :
Assessment of vitamin D status - a changing landscape.
Publication date :
January 2017
Journal title :
Clinical Chemistry and Laboratory Medicine
ISSN :
1434-6621
eISSN :
1437-4331
Publisher :
Walter de Gruyter, Berlin, Germany
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 15 September 2016

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