? cause for another surge in Vitamin D requests see below
http://www.timesonline.co.uk/tol/comment/columnists/melanie_reid/article6524020.ece
David Simms
KIngston Hospital
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]]On Behalf Of Brian Payne
Sent: 14 June 2009 16:49
To: [log in to unmask]
Subject: Re: Vitamin D over requesting
Thanks, Reza. A fascinating paper that will give Joseph
Watine an idea the extent of the decreases in vitamin D
that might be seen in patients. The authors had seen seven
patients with Gc-globulin values more than 60% below mean
normal, one of them 80% below - all seven patients were
severely ill.
In one of their patients who had a sickle cell crisis and
chest infection the Gc-globulin had fallen by 60% of the
admission value by the second day, but then rose from 60%
below to 50% above and remained high for two weeks. A
similar pattern was seen in a study of the serial changes
in Gc-globulin in 12 patients after a standardised
orthopaedic operation resulting in major muscle damage
(Inflamm Res 2001;50:39). Total Gc-globulin fell by 87%
postoperatively and then rose to 35% above preop values by
day 5, subsequently falling to preop values by day 28. I
suggested in my email that Gc-globulin was a negative
acute phase protein; these studies suggest the opposite.
A question to which I have been unable to find an answer
is whether the newly synthesised Gc-globulin responsible
for these increases carries with it from the liver the
vitamin D sequestered when Gc-globulin-actin complexes
were removed from the circulation. If it does not, then
low vitamin D values might persist a lot longer after
tissue damage than low Gc-globulin values.
With best wishes
Brian
On Fri, 12 Jun 2009 15:11:40 +0000
Reza Morovat <[log in to unmask]> wrote:
>
> An excellent and informative article (from the days that
>clinical
> biochemists used to be able to do more basic scientific
>research) is
> this:
> http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1146295&blobtype=pdf
>
> Needless
> to say, the relation between an increase in total vit D
>and its
> availability for conversion to 1,25 or its efficacy is
>not always so straight-forward,
> as the affinities for Gc-glob can vary by quite a bit
>(as also do those
> for intracellular vit D binding proteins, and that for
>1,25 binding to
> its receptor(s) - not to mention the regulation of the
>metabolising
> enzymes!).
>
>
> Enjoy your weekends.
>
>
>
> Reza
>
>
>
>
> Reza Morovat
> Clinical Biochemist
> John Radcliffe Hospital
> Oxford
>
>
>
> Date: Fri, 12 Jun 2009 08:51:51 +0000
>From: [log in to unmask]
> Subject: Re: Vitamin D over requesting
> To: [log in to unmask]
>
>
>
>
>
>
>
>
> Thank you Brian,
>
>
>
> Does this mean that vit D decreases in inflammation in a
>way that is independent from any nutritional problem?
>
>
>
> What can the extent of such decreases be? 10% of basal
>vit D values? 20%? 30%? more?
>
>
>
> Best regards,
>
>
>
> Joseph
>
>
> Dr Joseph Watine, PH, AIHP, PharmD, AAHU, EurClinChem
> Laboratoire de Biologie Polyvalente
> Centre Hospitalier Général
> 12027 Rodez Cedex 9
>France
>
>
>
>> Date: Thu, 11 Jun 2009 11:51:57 +0100
>> From: [log in to unmask]
>> Subject: Re: Vitamin D over requesting
>> To: [log in to unmask]
>>
>> The large literature describing the association of low
>>vitamin D values with disease, morbidity and mortality
>> without classic symptoms of D deficiency seems to
>>universally ignore the evidence that vitamin D-binding
>> protein, otherwise known as Gc-globulin, is a negative
>>acute phase protein like albumin.
>>
>> In addition to binding vitamin D Gc-globulin also binds
>>actin, which is released from cells damaged by tissue
>> injury, inflammation or sepsis. The complex is then
>>cleared rapidly from the circulation, very low values
>> correlating with poor survival (reviewed by Meier et al,
>>Clin Chem 2006;52:1247-1253). So low D values do not
>> necessarily indicate D-deficiency.
>>
>> Brian Payne
>
> Souhaitez vous « être au bureau sans y être » ? Oui je
>le veux !
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