Original language | English (US) |
---|---|
Pages (from-to) | 2582-2583 |
Number of pages | 2 |
Journal | New England Journal of Medicine |
Volume | 380 |
Issue number | 26 |
DOIs | |
State | Published - Jun 27 2019 |
ASJC Scopus subject areas
- Medicine(all)
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Vitamin D-binding protein deficiency and homozygous deletion of the GC gene. / Baer, Alan N.; Jan De Beur, Suzanne.
In: New England Journal of Medicine, Vol. 380, No. 26, 27.06.2019, p. 2582-2583.Research output: Contribution to journal › Letter › peer-review
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TY - JOUR
T1 - Vitamin D-binding protein deficiency and homozygous deletion of the GC gene
AU - Baer, Alan N.
AU - Jan De Beur, Suzanne
N1 - Funding Information: 25(OH)D remained comparatively stable. Repeated-measures analysis confirmed that changes in vitamin D–binding protein correlated with changes in 25(OH)D between patients (repeated-measures correlation, 0.81; P=0.002), and vitamin D– binding protein and 25(OH)D levels at all time points were strongly correlated (Fig. 1B), with no correlation between 25(OH)D and PTH (repeated-measures correlation, −0.10; P=0.35). Moreover, mean (±SD) levels of PTH, calcium, and free 25(OH)D were normal (58±44 pg per milliliter, 8.5±0.9 mg per deciliter [2.12±0.22 mmol per liter], and 9.2±6.9 pg per milliliter, respectively), similar to those reported in patients with liver cirrhosis.2 (Our study was supported by a grant [R01 DK094486] from the National Institutes of Health.) Animal models3 and persons2 with genetic or acquired deficiency of vitamin D–binding protein provide excellent examples of the free-hormone hypothesis at work. Namely, they suggest that the unbound subset of 25(OH)D is the form that maintains homeostasis of bone and mineral metabolism. Our collective findings imply that in healthy states in which vitamin D–binding protein levels are unchanged, total 25(OH)D correlates with free 25(OH)D4; however, in critical illness or other chronic inflammatory states in which vitamin D–binding protein is decreased, 25(OH)D levels are largely determined by vitamin D–binding protein levels and only modestly correlate with free 25(OH)D. Analogous to evaluation of thyroid function (measuring free T4 instead of total T4), clinical sufficiency of 25(OH)D in sick patients is best determined by methods that measure the unbound fraction.
PY - 2019/6/27
Y1 - 2019/6/27
UR - http://www.scopus.com/inward/record.url?scp=85068241793&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068241793&partnerID=8YFLogxK
U2 - 10.1056/NEJMc1905282
DO - 10.1056/NEJMc1905282
M3 - Letter
C2 - 31242372
AN - SCOPUS:85068241793
VL - 380
SP - 2582
EP - 2583
JO - New England Journal of Medicine
JF - New England Journal of Medicine
SN - 0028-4793
IS - 26
ER -