C3-差向异构体测定对评估未成年人体内维生素D贮存的重要性  

Importance of C3 epimer determination for evaluating vitamin D storage in minors

作　　者：何益洋 李园梦 徐鹏[1] 冯倩 蒋文强[1] 俸家富[1] HE Yiyang;LI Yuanmeng;XU Peng;FENG Qian;JIANG Wenqiang;FENG Jiafu(Department of Clinical Laboratory,Mianyang Central Hospital,Mianyang,Sichuan 621000,China;Department of Clinical Laboratory,Nanchong Central Hospital,Nanchong,Sichuan 637000,China;College of Medical Technology,Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610075,China)

机构地区：[1]四川省绵阳市中心医院检验科,四川绵阳621000 [2]四川省南充市中心医院检验科,四川南充637000 [3]成都中医药大学医学技术学院,四川成都610075

出　　处：《国际检验医学杂志》2021年第20期2443-2448,共6页International Journal of Laboratory Medicine

基　　金：四川省科技支持计划基金项目(2015SZ0117)。

摘　　要：目的探讨不同状态下未成年人血清维生素D(VitD),包括VitD_(2)、VitD_(3)和C3-差向异构体(C3-epi)水平对评估体内VitD贮存的影响。方法纳入研究的1671例未成年人分为健康组1204例和疾病组467例(矮小症134例、呼吸道感染215例、营养不良57例和抽动障碍61例);用超高效液相色谱-串联质谱法(UHPLC-MS/MS)检测血清VitD_(2)及VitD_(3)水平,并计算活性VitD_(3)(AVitD_(3))和25羟维生素D[25(OH)D]。另外抽检87例(健康组24例和疾病组63例)的受试者C3-epi浓度。结果疾病组的VitD_(2)、VitD_(3)、25(OH)D和AVitD_(3)水平均低于健康组,差异有统计学意义(P<0.05)。以25(OH)D水平作为判断依据,健康组VitD贮存充足占65.4%,疾病组占52.7%。将VitD_(2)活性折算为AVitD_(3)后,健康组VitD贮存充足占53.2%,疾病组占40.9%。疾病组C3-epi水平高于健康组差异有统计学意义(P<0.05)。结论只检测25(OH)D水平或只检测VitD_(2)和VitD_(3)水平均会高估受试者体内VitD贮存。VitD_(2)、VitD_(3)和C3-epi均检测对准确评价VitD贮存极为重要,尤其是1岁以下婴儿和某些疾病患儿。Objective To investigate the effects of serum vitamin D(VitD)components,including VitD_(2),VitD_(3) and C3 epimer(C3-epi)levels on the evaluation of VitD storage in minors under different health conditions.Methods A total of 1671 minors were divided into healthy group(1204 cases)and disease group(467 cases),the disease group included 134 cases of short stature,215 cases of respiratory infections,57 cases of malnutrition and 61 cases of tic disorders.The levels of VitD_(2) and VitD_(3) were measured by UHPLC-MS/MS in all subjects,and the active VitD_(3)(AVitD_(3))and 25 hydroxyvitamin D[25(OH)D]were calculated.In addition,the C3-epi level of 87 subjects(24 cases in healthy group and 63 cases in disease group)were measured by random sampling.Results VitD_(2),VitD_(3),25(OH)D and AVitD_(3) levels in disease group were significantly lower than those in healthy group,and the differences were statistically significant(P<0.05).According to the level of 25(OH)D,65.4%of the patients in the healthy group had sufficiency VitD and 52.7%in disease group.When the VitD_(2) activity was converted into AVitD_(3),53.2%of the patients in the healthy group had sufficiency VitD,and 40.9%in the disease group.The C3-epi level in the disease group was significantly higher than that in the healthy group,and the difference was statistically significant(P<0.05).Conclusion Measure the 25(OH)D level only,or both VitD_(2) and VitD_(3) levels may overestimate the VitD status in subjects.Detection of VitD_(2),VitD_(3) and C3-epi levels are very important for accurate evaluation of VitD storage in subjects,especially infants under 1 year old and children with certain diseases.

关 键 词：C3-差向异构体 维生素D 液相色谱-串联质谱法 未成年人 

分 类 号：R446.1[医药卫生—诊断学]