medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2020-5-40-45medalphabet-1466Research ArticleСтатьиКлиническое значение и особенности лабораторного определения витамина DClinical significance and features of laboratory determination of vitamin DДрыгинаЛ. Б.DryginaL. B.

д. б. н., проф., в. н. с. НИО организации научной деятельности

г. Санкт-Петербург

Saint Petersburg

ФГБУ «Всероссийский центр экстренной и радиационной медицины имени А. М. Никифорова» МЧС РоссииРоссияAll-Russian Centre for Emergency and Radiation Medicine n. a. A. M. NikiforovRussian Federation20201506202005Современная лаборатория4045Copyright © Дрыгина Л.Б., 20202020Дрыгина Л.Б.Drygina L.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/1466

Классическая функция витамина D заключается в регуляции обмена кальция. Однако в настоящее время получены убедительные данные о взаимосвязи дефицита витамина D с развитием целого ряда заболеваний. В статье дается анализ результатов исследований последних лет, в которых представлены эффекты витамина D в отношении иммунной, сердечно-сосудистой систем и болезней печени. Рассматриваются механизмы поступления витамина D в организм, представлены новые данные о регуляции уровня активной формы витамина D фосфотонинами (FGF23, MEPE, sFRP-4) и белком Klotho. Представлена характеристика методов определения витамина D в сыворотке крови. Отдельно рассматриваются биологические факторы, которые влияют на результаты количественного определения витамина D разными методами.

The classic function of vitamin D is to regulate calcium metabolism. Currently, however, convincing data have been obtained on the relationship of vitamin D deficiency with the development of a number of diseases. The article analyzes the results of recent studies that present the effects of vitamin D on the immune system, cardiovascular system and liver diseases. Discusses the mechanisms of admission of vitamin D in the body, presents new data on the regulation of levels of active form of vitamin D phosphatonins (FGF23, MEPE, sFRP-4) and protein Klotho. The characteristic of methods of determination of vitamin D in blood serum is presented. Biological factors that influence the results of quantitative determination of vitamin D with different methods are considered separately.

витамин Dдефицит витамина Dметоды количественного определенияvitamin Dvitamin D deficiencymethods of quantitative determinationReferencesДефицит витамина D у взрослых: диагностика, лечение, применение. Клинические рекомендации. – М., 2015. – 75 с.Дефицит витамина D у взрослых: диагностика, лечение, применение. Клинические рекомендации. – М., 2015. – 75 с.Жиляев Е. В. Клиническое значение нарушения кальциевого обмена /Е.В. Жиляев, А. В. Глазунов, П. А. Глазунов // Клин. медицина. – 2011. – № 4. – С. 13–17.Жиляев Е. В. Клиническое значение нарушения кальциевого обмена /Е.В. Жиляев, А. В. Глазунов, П. А. Глазунов // Клин. медицина. – 2011. – № 4. – С. 13–17.Снопов С. А. Механизмы действия витамина D на иммунную систему / Медицинская иммунология. – 2014. – Т. 16, № 6. – С. 499–530.Снопов С. А. Механизмы действия витамина D на иммунную систему / Медицинская иммунология. – 2014. – Т. 16, № 6. – С. 499–530.Abdel-Wareth L. Total vitamin D assay comparison of the Roche Diagnostics “Vitamin D total” electrochemiluminescence protein binding assay with the Chromsystems HPLC method in a population with both D 2 and D 3 forms of vitamin D / L. Abdel-Wareth, A. Haq, A. Turner, S. Khan, A. Salem, F. Mustafa, N. Hussein, F. Pallinalakam, L. Grundy, G. Patras, J. Rajah // Nutrients – 2013. – Vol. 22, T. 5. – N 3. – P. 971–980; DOI: 10.3390/nu5030971.Abdel-Wareth L. Total vitamin D assay comparison of the Roche Diagnostics “Vitamin D total” electrochemiluminescence protein binding assay with the Chromsystems HPLC method in a population with both D 2 and D 3 forms of vitamin D / L. Abdel-Wareth, A. Haq, A. Turner, S. Khan, A. Salem, F. Mustafa, N. Hussein, F. Pallinalakam, L. Grundy, G. Patras, J. Rajah // Nutrients – 2013. – Vol. 22, T. 5. – N 3. – P. 971–980; DOI: 10.3390/nu5030971.Atef S. H. Vitamin D assays in clinical laboratory: Past, present and future challenges / S. H. Atef // www.ncbi.nlm.nih.gov/pubmed/28242262–2018/ – T. 175. P. 136–137; DOI: 10.1016/j.jsbmb.2017.02.011.Atef S. H. Vitamin D assays in clinical laboratory: Past, present and future challenges / S. H. Atef // www.ncbi.nlm.nih.gov/pubmed/28242262–2018/ – T. 175. P. 136–137; DOI: 10.1016/j.jsbmb.2017.02.011.Bizzaro G. Vitamin D and autoimmune Diseases: is vitamin D receptor (VDR) polymorphism the culprit? / G. Bizzaro, A. Antico, A. Fortunato, N. Bizzaro // Isr. Med. Assoc. J. – 2017. – Vol. 19, N 7. – P. 438–443.Bizzaro G. Vitamin D and autoimmune Diseases: is vitamin D receptor (VDR) polymorphism the culprit? / G. Bizzaro, A. Antico, A. Fortunato, N. Bizzaro // Isr. Med. Assoc. J. – 2017. – Vol. 19, N 7. – P. 438–443.Bouillon R. Is Vitamin D 2 Really Bioequivalent to Vitamin D 3?/ R. Bouillon, L. Verlinden, A. Verstuyf // Endocrinology – 2016. – Vol. 157, N 9. – P. 3384– 3387; DOI: 10.1210/en.2016–1528.Bouillon R. Is Vitamin D 2 Really Bioequivalent to Vitamin D 3?/ R. Bouillon, L. Verlinden, A. Verstuyf // Endocrinology – 2016. – Vol. 157, N 9. – P. 3384– 3387; DOI: 10.1210/en.2016–1528.Brown R. B. Vitamin D, cancer, and Dysregulated phosphate metabolism / R. B. Brown // Endocrine – 2019. Jun 23. DOI: 10.1007/s12020–019–01985-y. [Epub ahead of print]Brown R. B. Vitamin D, cancer, and Dysregulated phosphate metabolism / R. B. Brown // Endocrine – 2019. Jun 23. DOI: 10.1007/s12020–019–01985-y. [Epub ahead of print]Buleu F. N. Correlations between vascular stiffness indicators, OPG, and 25-OH Vitamin D 3 status in heart failure patients / F. N. Buleu, C. T. Luca, A. Tudor, M. Badalica-Petrescu, A. Caraba, A. Pah, D. Georgescu, R. Christodorescu, S. Dragan// Medicina (Kaunas). – 2019. – Vol. 25, T. 55. – N 6. – E 309; DOI: 10.3390/medicina55060309.Buleu F. N. Correlations between vascular stiffness indicators, OPG, and 25-OH Vitamin D 3 status in heart failure patients / F. N. Buleu, C. T. Luca, A. Tudor, M. Badalica-Petrescu, A. Caraba, A. Pah, D. Georgescu, R. Christodorescu, S. Dragan// Medicina (Kaunas). – 2019. – Vol. 25, T. 55. – N 6. – E 309; DOI: 10.3390/medicina55060309.Denimal D. Evaluation of the new restandardized 25-hydroxyvitamin D assay on the iSYS platform / D. Denimal, S. Roux, L. Duvillard // Clin Biochem – 2018. – T. 52. – P. 156–160; DOI: 10.1016/j.clinbiochem.2017.11.011.Denimal D. Evaluation of the new restandardized 25-hydroxyvitamin D assay on the iSYS platform / D. Denimal, S. Roux, L. Duvillard // Clin Biochem – 2018. – T. 52. – P. 156–160; DOI: 10.1016/j.clinbiochem.2017.11.011.Durazo-Arvizu R. A. The Vitamin D Standardization Program (VDSP) Manual for Retrospective Laboratory Standardization of Serum 25-Hydroxyvitamin D Data / R. A. Durazo-Arvizu, L. Tian, S.P.J. Brooks, K. Sarafin, K. D. Cashman, M. Kiely, J. Merkel, G. L. Myers, P. M. Coates, C. T. Sempos // J AOAC – 2017. – Vol.1, T.100. – N 5. – P. 1234–1243; DOI: 10.5740/jaoacint.17–0196.Durazo-Arvizu R. A. The Vitamin D Standardization Program (VDSP) Manual for Retrospective Laboratory Standardization of Serum 25-Hydroxyvitamin D Data / R. A. Durazo-Arvizu, L. Tian, S.P.J. Brooks, K. Sarafin, K. D. Cashman, M. Kiely, J. Merkel, G. L. Myers, P. M. Coates, C. T. Sempos // J AOAC – 2017. – Vol.1, T.100. – N 5. – P. 1234–1243; DOI: 10.5740/jaoacint.17–0196.Hillman L. S. Percent true calcium absorption, mineral metabolism, and bone mass in children with arthritis effect of supplementation with vitamin D 3 and calcium / L. S. Hillman et al. // Arthritis Rheum. – 2008. – Vol. 58. – P. 3255–3263.Hillman L. S. Percent true calcium absorption, mineral metabolism, and bone mass in children with arthritis effect of supplementation with vitamin D 3 and calcium / L. S. Hillman et al. // Arthritis Rheum. – 2008. – Vol. 58. – P. 3255–3263.Huang M. Mechanism of error caused by isotope-labeled internal standard: accurate method for simultaneous measurement of vitamin D and pre-vitamin D by liquid chromatography/tandem mass spectrometry / M. Huang, A. B. Cadwallader, R. Heltsley // Rapid Commun Mass Spectrom – 2014. – Vol. 15, T. 8. – N 19. – P. 2101–2110; DOI: 10.1002/rcm.6987.Huang M. Mechanism of error caused by isotope-labeled internal standard: accurate method for simultaneous measurement of vitamin D and pre-vitamin D by liquid chromatography/tandem mass spectrometry / M. Huang, A. B. Cadwallader, R. Heltsley // Rapid Commun Mass Spectrom – 2014. – Vol. 15, T. 8. – N 19. – P. 2101–2110; DOI: 10.1002/rcm.6987.Klapkova E. A comparison of four methods (Immunochemistry and HPLC) for Determination of 25-(OH)-Vitamin D in postmenopausal women. / E. Klapkova, J. Cepova, M. Pechova, K. Dunovska, K. Kotaska, R. Prusa // Clin Lab – 2017. – Vol. 1, Т. 63. – N 2. – P. 385–388; DOI: 10.7754/Clin.Lab.2016.160509.Klapkova E. A comparison of four methods (Immunochemistry and HPLC) for Determination of 25-(OH)-Vitamin D in postmenopausal women. / E. Klapkova, J. Cepova, M. Pechova, K. Dunovska, K. Kotaska, R. Prusa // Clin Lab – 2017. – Vol. 1, Т. 63. – N 2. – P. 385–388; DOI: 10.7754/Clin.Lab.2016.160509.Kudlacek S. Assessment of vitamin D and calcium status in healthy adult Austrian / S. Kudlacek, et al. // Eur. J. Clin. Invest. – 2003. – Vol. 33. – P. 323–331.Kudlacek S. Assessment of vitamin D and calcium status in healthy adult Austrian / S. Kudlacek, et al. // Eur. J. Clin. Invest. – 2003. – Vol. 33. – P. 323–331.Kulie T., Groff A., Redmer J. Vitamin D // Am. J. Physiol. Renal. Physiol. – 2005. – Vol. 289. – F8–28;Kulie T., Groff A., Redmer J. Vitamin D // Am. J. Physiol. Renal. Physiol. – 2005. – Vol. 289. – F8–28;Marino R. Extra-Skeletal Effects of Vitamin D / R. Marino, M. Misra // Nutrients – 2019. – Vol. 27, T. 11. – N 7. – E 1460; DOI: 10.3390/nu11071460.Marino R. Extra-Skeletal Effects of Vitamin D / R. Marino, M. Misra // Nutrients – 2019. – Vol. 27, T. 11. – N 7. – E 1460; DOI: 10.3390/nu11071460.Markiewicz A. Vitamin D receptors (VDR), hydroxylases CYP27B 1 and CYP24A1 and retinoid-related orphan receptors (ROR) level in human uveal tract and ocular melanoma with Different melanization levels. / A. Markiewicz, A. A. Brożyna, E. Podgórska, M. Elas, K. Urbańska, A. M. Jetten, A. T. Slominski, W. Jóźwicki, J. Orłowska-Heitzman, G. Dyduch, B. Romanowska-Dixon // Sci Rep. – 2019. – Vol., T.9. – N 1. – P. 9142; DOI: 10.1038/s41598–019–45161–8.Markiewicz A. Vitamin D receptors (VDR), hydroxylases CYP27B 1 and CYP24A1 and retinoid-related orphan receptors (ROR) level in human uveal tract and ocular melanoma with Different melanization levels. / A. Markiewicz, A. A. Brożyna, E. Podgórska, M. Elas, K. Urbańska, A. M. Jetten, A. T. Slominski, W. Jóźwicki, J. Orłowska-Heitzman, G. Dyduch, B. Romanowska-Dixon // Sci Rep. – 2019. – Vol., T.9. – N 1. – P. 9142; DOI: 10.1038/s41598–019–45161–8.Nabeshima Y. Discovery of a-Klotho unveiled new insights into calcium and phosphate homeostasis / Y. Nabeshima // Proc. Jpn. Acad., Ser. B. – 2009. – Vol. 85., N 3. – P. 125–141.Nabeshima Y. Discovery of a-Klotho unveiled new insights into calcium and phosphate homeostasis / Y. Nabeshima // Proc. Jpn. Acad., Ser. B. – 2009. – Vol. 85., N 3. – P. 125–141.Norman A. W. Minireview: vitamin D receptor: new assignments for an already busy receptor / A.W. Norman // Endocrilogy. – 2006. – Vol. 414, N 12. – P. 5542–5548.Norman A. W. Minireview: vitamin D receptor: new assignments for an already busy receptor / A.W. Norman // Endocrilogy. – 2006. – Vol. 414, N 12. – P. 5542–5548.Panda S. Status of vitamin D and the associated host factors in pulmonary tuberculosis patients and their household contacts: a cross sectional study / S. Panda, A. Tiwari, K. Luthra, S. K. Sharma, A. Singh // J Steroid Biochem Mol Biol. – 2019. – Vol. 27. – P. 105419; DOI: 10.1016/j.jsbmb.2019.105419.Panda S. Status of vitamin D and the associated host factors in pulmonary tuberculosis patients and their household contacts: a cross sectional study / S. Panda, A. Tiwari, K. Luthra, S. K. Sharma, A. Singh // J Steroid Biochem Mol Biol. – 2019. – Vol. 27. – P. 105419; DOI: 10.1016/j.jsbmb.2019.105419.Pham T. M. The Effect of Serum 25-Hydroxyvitamin D on Elevated Homocysteine Concentrations in Participants of a Preventive Health Program / T. M. Pham, J. P. Ekwaru, S. S. Mastroeni, M. F. Mastroeni, S. A. Loehr, P. J. Veugelers // PLoS One. – 2016. – Vol. 22. – T. 11, N 8. – e0161368; DOI: 10.1371/journal.pone.0161368. eCollection 2016.Pham T. M. The Effect of Serum 25-Hydroxyvitamin D on Elevated Homocysteine Concentrations in Participants of a Preventive Health Program / T. M. Pham, J. P. Ekwaru, S. S. Mastroeni, M. F. Mastroeni, S. A. Loehr, P. J. Veugelers // PLoS One. – 2016. – Vol. 22. – T. 11, N 8. – e0161368; DOI: 10.1371/journal.pone.0161368. eCollection 2016.Sangouni A. A. A narrative review on effects of vitamin D on main risk factors and severity of non-alcoholic fatty liver Disease / A. A. Sangouni, S. Ghavamzadeh, A. Jamalzehi // Diabetes Metab Syndr – 2019. – Vol. 13, T. 3. – P. 2260–2265; DOI: 10.1016/j.dsx.2019.05.013.Sangouni A. A. A narrative review on effects of vitamin D on main risk factors and severity of non-alcoholic fatty liver Disease / A. A. Sangouni, S. Ghavamzadeh, A. Jamalzehi // Diabetes Metab Syndr – 2019. – Vol. 13, T. 3. – P. 2260–2265; DOI: 10.1016/j.dsx.2019.05.013.Sempos C. T. Developing vitamin D Dietary guidelines and the lack of 25-hydroxyvitamin D assay standardization: The ever-present past / C. T. Sempos, R. A. Durazo-Arvizu, N. Binkley, J. Jones, J. M. Merkel, G. D. Carter // J Steroid Biochem Mol Biol. – 2016. – Vol. 164. P. 115–119; DOI: 10.1016/j.jsbmb.2015.08.027.Sempos C. T. Developing vitamin D Dietary guidelines and the lack of 25-hydroxyvitamin D assay standardization: The ever-present past / C. T. Sempos, R. A. Durazo-Arvizu, N. Binkley, J. Jones, J. M. Merkel, G. D. Carter // J Steroid Biochem Mol Biol. – 2016. – Vol. 164. P. 115–119; DOI: 10.1016/j.jsbmb.2015.08.027.T. Kulie Vitamin D / Kulie T., Groff A., Redmer J. // Am. J. Physiol. Renal. Physiol. – 2005. – Vol. 289. – F8–28;T. Kulie Vitamin D / Kulie T., Groff A., Redmer J. // Am. J. Physiol. Renal. Physiol. – 2005. – Vol. 289. – F8–28;Torres P. U., Klotho gene, phosphocalcic metabolism, and survival in Dialysis. / P. U. Torres // J. Ren. Nutr. – 2009. – Vol. 19. – P. 50–56.Torres P. U., Klotho gene, phosphocalcic metabolism, and survival in Dialysis. / P. U. Torres // J. Ren. Nutr. – 2009. – Vol. 19. – P. 50–56.Turner C. Effect of a 300 000 IU loading Dose of ergocalciferol (Vitamin D 2) on circulating 1,25(OH)2-vitamin D and fibroblast growth factor-23 (FGF-23) in vitamin D insufficiency/ C. Turner, N. Dalton, R. Inaoui, I. Fogelman, W. D. Fraser, G. Hampson // J Clin Endocrinol Metab – 2013. – Vol. 98, T. 2. – P. 550–556; DOI: 10.1210/jc.2012–2790. Epub 2013 Jan 2.Turner C. Effect of a 300 000 IU loading Dose of ergocalciferol (Vitamin D 2) on circulating 1,25(OH)2-vitamin D and fibroblast growth factor-23 (FGF-23) in vitamin D insufficiency/ C. Turner, N. Dalton, R. Inaoui, I. Fogelman, W. D. Fraser, G. Hampson // J Clin Endocrinol Metab – 2013. – Vol. 98, T. 2. – P. 550–556; DOI: 10.1210/jc.2012–2790. Epub 2013 Jan 2.Wei H. Associations of the risk of lung cancer with serum 25-hydroxyvitamin D level and Dietary vitamin D intake: A Dose-response PRISMA meta-analysis /H. Wei, H. Jing, Q., G. Wei, Z. Heng // Medicine (Baltimore). – 2018. –Vol. 97, N 37. – P. 12282; DOI: 10.1097/MD.0000000000012282.Wei H. Associations of the risk of lung cancer with serum 25-hydroxyvitamin D level and Dietary vitamin D intake: A Dose-response PRISMA meta-analysis /H. Wei, H. Jing, Q., G. Wei, Z. Heng // Medicine (Baltimore). – 2018. –Vol. 97, N 37. – P. 12282; DOI: 10.1097/MD.0000000000012282.Zhu K. Serum 25-hydroxyvitamin D as a predictor of mortality and cardiovascular events: A 20-year study of a community-based cohort / K. Zhu, M. Knuiman, Divitini M., Hung J., Lim E. M., Cooke B. R., Walsh J. P. // Clin Endocrinol (Oxf). – 2018. – Vol. 88, N 1. – P. 154–163.; DOI: 10.1111/cen.13485.Zhu K. Serum 25-hydroxyvitamin D as a predictor of mortality and cardiovascular events: A 20-year study of a community-based cohort / K. Zhu, M. Knuiman, Divitini M., Hung J., Lim E. M., Cooke B. R., Walsh J. P. // Clin Endocrinol (Oxf). – 2018. – Vol. 88, N 1. – P. 154–163.; DOI: 10.1111/cen.13485.Zittermann A. Vitamin D status, supplementation and cardiovascular Disease / A. Zittermann // Anticancer Res. – 2018. – Vol. 38, N 2. – P. 1179–1186.Zittermann A. Vitamin D status, supplementation and cardiovascular Disease / A. Zittermann // Anticancer Res. – 2018. – Vol. 38, N 2. – P. 1179–1186.

The authors declare that there are no conflicts of interest present.