Clinical Information

Purpose

Vitamin D is a fat-soluble steroid prohormone mainly produced photochemically in the skin from 7-dehydrocholesterol. Two forms of vitamin D are biologically relevant - vitamin D3 (Cholecalciferol) and vitamin D2 (Ergocalciferol). Both vitamins D3 and D2 can be absorbed from food, with vitamin D2 being an artificial source, but only an estimated 10-20% of vitamin D is supplied through nutritional intake. Vitamins D3 and D2 can be found in vitamin supplements. Vitamin D is converted to the active hormone 1,25-(OH)2-vitamin D (Calcitriol) through two hydroxylation reactions: the first hydroxylation converts vitamin D into 25-OH vitamin D and occurs in the liver. The second hydroxylation converts 25-OH vitamin D into the biologically active 1,25-(OH)2-vitamin D and occurs in the kidneys as well as in many other cells of the body. Most cells express the vitamin D receptor; about 3% of the human genome is directly or indirectly regulated by the vitamin D endocrine system.

The major storage form of vitamin D is 25-OH vitamin D and is present in the blood at up to 1000-fold higher concentration compared to the active 1,25-(OH)2-vitamin D. 25-OH vitamin D has a half-life of 2-3 weeks vs. 4 hours for 1,25-(OH)2-vitamin D. Therefore, 25-OH vitamin D is the analyte of choice for determination of the vitamin D status.

Epidemiological studies have shown a high global prevalence of vitamin D insufficiency and deficiency. Risk factors for vitamin D deficiency include low sun exposure, malnutrition,

some malabsorption syndromes, and liver or kidney diseases. The measurement of vitamin D status provides opportunities for preventive and therapeutic interventions. Vitamin D deficiency is a cause of secondary hyperparathyroidism and diseases resulting in impaired bone metabolism (like rickets, osteoporosis, osteomalacia).