- 24, 25-dihydroxy vitamin D and vitamin D metabolite ratio as vitamin D biomarkers in chronic kidney disease
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Seunghye Lee,Sehyun Jung,Ha Nee Jang,Se-Ho Chang,Min-Chul Cho,Hyun-Jung Kim
2022 ; 2022(1):
- 논문분류 :
- 춘계학술대회 초록집
Objectives: Vitamin D deficiency is one of causes of secondary hyperparathyroidism and common clinical manifestations of metabolic bone disease (MBD) in patients with CKD. The management of vitamin D deficiency and hyperparathyroidism is important to MBD as well as cardiovascular disorder in CKD. Recently, 24,25-dihydroxyvitamin D (24,25(OH)2D) and vitamin D metabolite ratio (VMR) which is the ratio of 24,25(OH)2D to 25(OH)D have emerged as vitamin D biomarkers. We aim to analyze which vitamin D levels is useful for evaluating MBD in patients with CKD.
Methods: We analyzed a subset of blood and urine samples from a total of 208 outpatients who diagnosed CKD stage G2 to G5 with informed consents. We compared the correlation of 25(OH)D, 24,25(OH)2D, VMR, intact parathyroid hormone (iPTH), and estimated glomerular filtration rate by creatinine-based CKD-EPI equation (eGFR).
Results: The mean values of eGFR, serum calcium, serum phosphate, iPTH, 25(OH)D, 24,25(OH)2D, and VMR were 39.4±17.5 mL/min/1.73m2, 9.4±0.6 mg/dL, 3.8±0.8 mg/dL, 58.5±44.4 pg/mL, 22.8±11.2 ng/mL, 0.8±0.6 ng/mL, and 3.6±1.9, respectively. eGFR and 24,25(OH)2D showed positive correlation (R²=0.0603, p<0.001), and eGFR and VMR showed positive correlations (R2=0.1523, p<0.001), but 25(OH)D showed no significant correlation with eGFR (R²=0.0011, p=0.632). Negative correlations were found between iPTH and eGFR (R²=-0.0874, p<0.001), between iPTH and 24,25(OH)2D (R2=-0.072, p<0.001), between iPTH and VMR (R²=-0.0689, p<0.001) and between iPTH and 25(OH)D (R2=0.0277, p=0.016). iPTH increased, and 24,25(OH)2D and VMR decreased according to CKD stage G increasing (p<0.001). There is no significant difference in 25(OH)D according to CKD stage G increasing (p=0.353).
Conclusions: According to eGFR decreasing, iPTH increased, and 24,25(OH)2D and VMR decreased in patients with CKD. 24,25(OH)2D and VMR showed significant correlation with eGFR and iPTH, but 25(OH)D showed no significant correlation with eGFR. So, 24,25(OH)2D and VMR are more useful than 25(OH) vitamin D as vitamin D markers in patients with CKD.