维生素D对人体健康产生广泛作用，维生素D缺乏症（ Vitamin D deficiency）可能会导致骨质疏松症进展、跌倒和骨折；同时，在西方国家出现了不一致维生素D标准和实践方案。鉴于此，中国老年学会骨质疏松委员会相关专业人员，制定了《维...维生素D对人体健康产生广泛作用，维生素D缺乏症（ Vitamin D deficiency）可能会导致骨质疏松症进展、跌倒和骨折；同时，在西方国家出现了不一致维生素D标准和实践方案。鉴于此，中国老年学会骨质疏松委员会相关专业人员，制定了《维生素D与成年人骨骼健康应用指南》。该《指南》分为《简化版》和《标准版》，主要证据来源于2013年英国骨质疏松学会指南、2011年美国健康研究院报告，以及国内文献。该指南适用于成年人骨骼疾病，或有骨病风险患者的维生素D缺乏症管理。需说明，该指南不针对儿童期、妊娠期、以及患有严重或终末期慢性肾脏病（4～5期）的人群。该指南《标准版》在本刊已发表《简化版》的基础上进一步详述，相关内容包括中国成年人群维生素D阈值设定、维生素D状况评价、25OHD测量值解释、维生素D缺乏症治疗和监测的详细计划、预防战略等。展开更多
AIM:To evaluate diagnostic value ofα-fetoprotein (AFP)-L3 and prothrombin induced by vitamin K absence-Ⅱ(PIVKA-Ⅱ)in hepatocellular carcinoma(HCC). METHODS:One hundred and sixty-eight patients during routine HCC sur...AIM:To evaluate diagnostic value ofα-fetoprotein (AFP)-L3 and prothrombin induced by vitamin K absence-Ⅱ(PIVKA-Ⅱ)in hepatocellular carcinoma(HCC). METHODS:One hundred and sixty-eight patients during routine HCC surveillance were included in this study.Of the 168 patients,90(53.6%)had HCC including newly developed HCC(n=82)or recurrent HCC after treatment(n=8).Sera were obtained during their first evaluation for HCC development and at the time of HCC diagnosis before commencing HCC treatment.HCC was diagnosed by histological examination,appropriate imaging characteristics-computed tomography or magnetic resonance imaging.Control sera were collected from 78 patients with benign liver disease(BLD),which were obtained during routine surveillance with a suspicion of HCC.AFP,AFP-L3 and PIVKA-Ⅱwere measured in the same serum by microchip capillary electrophoresis and liquid-phase binding assay on a micro-total analysis system Wako i30 auto analyzer.The performance characteristics of three tests and combined tests for the diagnosis of HCC were obtained using receiver operating characteristic curves in all populations and subgroups with AFP<20 ng/mL. RESULTS:Of 90 HCC patients,38(42.2%)patients had AFP<20 ng/mL,20(22.2%)patients had AFP 20-200 ng/mL and 32(35.6%)patients had AFP>200 ng/mL.Of the 78 BLD patients,74(94.9%)patients had AFP<20 ng/mL.After adjustment for age and HBV infection status,AFP-L3 levels were higher in HCC than in BLD among patients with low AFP levels(<20 ng/mL)(P<0.001).In a total of 168 patients,areas under the curve(AUC)for HCC were 0.879,0.887,0.801 and 0.939 for AFP,AFP-L3,PIVKA-Ⅱand the combined markers,respectively.The combined AUC for three markers showed higher value than the AUCs of individual marker(P<0.05).AFP-L3 had higher AUC value than PIVKA-Ⅱfor HCC detection in entire patients(P =0.043).With combination of AFP-L3(cut-off>5%) and PIVKA-Ⅱ(cut-off>40 AU/L),the sensitivity were 94.4%and specificity were 75.6%in all patients.In 112 patients with low AFP levels(<20 ng/mL),AUCs展开更多
维生素D是人体生命中不可缺少的营养素,由于免疫细胞同样表达1α-羟化酶和维生素D受体(vitamin D receptor,VDR),所以维生素D是一种重要的免疫调节剂,它可以调节固有免疫和适应性免疫。维生素D通过与维生素D受体结合,激活和调节多种细...维生素D是人体生命中不可缺少的营养素,由于免疫细胞同样表达1α-羟化酶和维生素D受体(vitamin D receptor,VDR),所以维生素D是一种重要的免疫调节剂,它可以调节固有免疫和适应性免疫。维生素D通过与维生素D受体结合,激活和调节多种细胞通路来发挥其生物学效应。尤其是免疫细胞(抗原递呈细胞、B细胞、T细胞)能够表达1α-羟化酶从而合成维生素D的活性代谢物,更进一步证明了维生素D的免疫调节特性。维生素D缺乏会导致诸如自身免疫性疾病等异常反应。一些观察研究表明补充维生素D有利于降低疾病的严重程度。但是,用于预防或治疗自身免疫性疾病所需补充的血浆25-羟维生素D浓度标准仍有争议。本文将对维生素D免疫调节研究进展以及维生素D在自身免疫性内分泌疾病(自身免疫性甲状腺疾病、1型糖尿病、Addison’s病)发病机制中的作用进行综述。展开更多
The role of vitamin D as an immune modulator has been emphasized in recent years,and low levels of the hormone were observed in several autoimmune diseases including multiple sclerosis and systemic lupus erythematosus...The role of vitamin D as an immune modulator has been emphasized in recent years,and low levels of the hormone were observed in several autoimmune diseases including multiple sclerosis and systemic lupus erythematosus.Vitamin D mediates its effect though binding to vitamin D receptor(VDR),and activation of VDR-responsive genes.While VDR gene polymorphism was found to associate with autoimmune thyroid diseases(AITDs),few studies examined levels of vitamin D in these patients and those that did yielded conflicting results.We therefore undertook to evaluate the levels of vitamin D in patients with AITDs compared to patients with non-AITDs and healthy controls.Serum vitamin D(25-OH)levels were measured in 50 patients with AITDs,42 patients with non-AITDs and 98 healthy subjects,utilizing the LIAISON chemiluminescence immunoassay(DiaSorin,Saluggia,Italy).VitaminD deficiency was designated at levels lower than 10 ng/ml.Antithyroid antibodies,thyroid functions and demographic parameters were evaluated in all patients.The prevalence of vitamin D deficiency was significantly higher in patients with AITDs compared with healthy individuals(72% versus 30.6%;P<0.001),as well as in patients with Hashimoto’s thyroiditis compared to patients with non-AITDs(79% versus 52%;P<0.05).Vitamin D deficiency also correlated to the presence of antithyroid antibodies(P=0.01)and abnormal thyroid function tests(P=0.059).Significantly low levels of vitamin D were documented in patients with AITDs that were related to the presence of anti thyroid antibodies and abnormal thyroid function tests,suggesting the involvement of vitamin D in the pathogenesis of AITDs and the advisability of supplementation.展开更多
文摘维生素D对人体健康产生广泛作用，维生素D缺乏症（ Vitamin D deficiency）可能会导致骨质疏松症进展、跌倒和骨折；同时，在西方国家出现了不一致维生素D标准和实践方案。鉴于此，中国老年学会骨质疏松委员会相关专业人员，制定了《维生素D与成年人骨骼健康应用指南》。该《指南》分为《简化版》和《标准版》，主要证据来源于2013年英国骨质疏松学会指南、2011年美国健康研究院报告，以及国内文献。该指南适用于成年人骨骼疾病，或有骨病风险患者的维生素D缺乏症管理。需说明，该指南不针对儿童期、妊娠期、以及患有严重或终末期慢性肾脏病（4～5期）的人群。该指南《标准版》在本刊已发表《简化版》的基础上进一步详述，相关内容包括中国成年人群维生素D阈值设定、维生素D状况评价、25OHD测量值解释、维生素D缺乏症治疗和监测的详细计划、预防战略等。
基金Supported by The Industrial Core Technology Development Program funded by the Ministry of Knowledge Economy,No.10033183
文摘AIM:To evaluate diagnostic value ofα-fetoprotein (AFP)-L3 and prothrombin induced by vitamin K absence-Ⅱ(PIVKA-Ⅱ)in hepatocellular carcinoma(HCC). METHODS:One hundred and sixty-eight patients during routine HCC surveillance were included in this study.Of the 168 patients,90(53.6%)had HCC including newly developed HCC(n=82)or recurrent HCC after treatment(n=8).Sera were obtained during their first evaluation for HCC development and at the time of HCC diagnosis before commencing HCC treatment.HCC was diagnosed by histological examination,appropriate imaging characteristics-computed tomography or magnetic resonance imaging.Control sera were collected from 78 patients with benign liver disease(BLD),which were obtained during routine surveillance with a suspicion of HCC.AFP,AFP-L3 and PIVKA-Ⅱwere measured in the same serum by microchip capillary electrophoresis and liquid-phase binding assay on a micro-total analysis system Wako i30 auto analyzer.The performance characteristics of three tests and combined tests for the diagnosis of HCC were obtained using receiver operating characteristic curves in all populations and subgroups with AFP<20 ng/mL. RESULTS:Of 90 HCC patients,38(42.2%)patients had AFP<20 ng/mL,20(22.2%)patients had AFP 20-200 ng/mL and 32(35.6%)patients had AFP>200 ng/mL.Of the 78 BLD patients,74(94.9%)patients had AFP<20 ng/mL.After adjustment for age and HBV infection status,AFP-L3 levels were higher in HCC than in BLD among patients with low AFP levels(<20 ng/mL)(P<0.001).In a total of 168 patients,areas under the curve(AUC)for HCC were 0.879,0.887,0.801 and 0.939 for AFP,AFP-L3,PIVKA-Ⅱand the combined markers,respectively.The combined AUC for three markers showed higher value than the AUCs of individual marker(P<0.05).AFP-L3 had higher AUC value than PIVKA-Ⅱfor HCC detection in entire patients(P =0.043).With combination of AFP-L3(cut-off>5%) and PIVKA-Ⅱ(cut-off>40 AU/L),the sensitivity were 94.4%and specificity were 75.6%in all patients.In 112 patients with low AFP levels(<20 ng/mL),AUCs
文摘维生素D是人体生命中不可缺少的营养素,由于免疫细胞同样表达1α-羟化酶和维生素D受体(vitamin D receptor,VDR),所以维生素D是一种重要的免疫调节剂,它可以调节固有免疫和适应性免疫。维生素D通过与维生素D受体结合,激活和调节多种细胞通路来发挥其生物学效应。尤其是免疫细胞(抗原递呈细胞、B细胞、T细胞)能够表达1α-羟化酶从而合成维生素D的活性代谢物,更进一步证明了维生素D的免疫调节特性。维生素D缺乏会导致诸如自身免疫性疾病等异常反应。一些观察研究表明补充维生素D有利于降低疾病的严重程度。但是,用于预防或治疗自身免疫性疾病所需补充的血浆25-羟维生素D浓度标准仍有争议。本文将对维生素D免疫调节研究进展以及维生素D在自身免疫性内分泌疾病(自身免疫性甲状腺疾病、1型糖尿病、Addison’s病)发病机制中的作用进行综述。
文摘The role of vitamin D as an immune modulator has been emphasized in recent years,and low levels of the hormone were observed in several autoimmune diseases including multiple sclerosis and systemic lupus erythematosus.Vitamin D mediates its effect though binding to vitamin D receptor(VDR),and activation of VDR-responsive genes.While VDR gene polymorphism was found to associate with autoimmune thyroid diseases(AITDs),few studies examined levels of vitamin D in these patients and those that did yielded conflicting results.We therefore undertook to evaluate the levels of vitamin D in patients with AITDs compared to patients with non-AITDs and healthy controls.Serum vitamin D(25-OH)levels were measured in 50 patients with AITDs,42 patients with non-AITDs and 98 healthy subjects,utilizing the LIAISON chemiluminescence immunoassay(DiaSorin,Saluggia,Italy).VitaminD deficiency was designated at levels lower than 10 ng/ml.Antithyroid antibodies,thyroid functions and demographic parameters were evaluated in all patients.The prevalence of vitamin D deficiency was significantly higher in patients with AITDs compared with healthy individuals(72% versus 30.6%;P<0.001),as well as in patients with Hashimoto’s thyroiditis compared to patients with non-AITDs(79% versus 52%;P<0.05).Vitamin D deficiency also correlated to the presence of antithyroid antibodies(P=0.01)and abnormal thyroid function tests(P=0.059).Significantly low levels of vitamin D were documented in patients with AITDs that were related to the presence of anti thyroid antibodies and abnormal thyroid function tests,suggesting the involvement of vitamin D in the pathogenesis of AITDs and the advisability of supplementation.
