Main Article Content
Abstract
Vitamins are essential micronutrients that are either insufficiently or cannot be synthesized endogenously, and the main way that we obtain them is through our diet. Vitamins can be classified as either water-soluble or fat-soluble, and the fat-soluble vitamins—which include vitamins A, D, E, and K—are essential for many physiological processes, including coagulation, immune function, bone health, and vision. This review covers the biochemistry, transport, and functions of these vitamins, emphasizing deficiency syndromes and possible toxicities. Numerous physiological processes depend on fat-soluble vitamins, such as vitamins A, D, and E. Deficits in these vitamins have been linked over the last 20 years to a higher risk of cancer, type II diabetes, and several immune system problems. Furthermore, there is mounting evidence that these vitamins interact, particularly between A and D. This improved clinical correlation with disease has led to a large increase in laboratory requests for vitamin assays as well as translational clinical research. Measurements of the most often used blood markers for determining the body's fat-soluble vitamin (FSV) status are 25-OHD (vitamin D), retinol (vitamin A), and α-tocopherol (vitamin E). The accurate measurement of FSV in blood faces several challenges. Their physical and chemical characteristics, the lack of measurement standardization, and the shortcomings of the methods currently employed for quantification are some of these challenges. In order to identify the current obstacles for the quantification of blood vitamins A, D, and E, this study aims to provide a brief overview of the metabolism and interactions of FSV.
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References
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- 4. Stephensen CB. Vitamin A, infection, and immune function. Annu Rev Nutr. 2001;21:167–92. doi: 10.1146/annurev.nutr.21.1.167.
- 5. Herrmann M. The measurement of 25-hydroxy vitamin D - an analytical challenge. Clin Chem Lab Med. 2012;50:1873–5. doi: 10.1515/cclm-2012-0526.
- 6. Youness, R.A., Dawoud, A., ElTahtawy, O. et al. Fat-soluble vitamins: updated review of their role and orchestration in human nutrition throughout life cycle with sex differences. Nutr Metab (Lond) 19, 60 (2022). https://doi.org/10.1186/s12986-022-00696-y
- 7. Chen W, Chen G. The Roles of Vitamin A in the regulation of carbohydrate, lipid, and protein metabolism. J Clin Med. 2014;3:453–79. doi: 10.3390/jcm3020453.
- 8. D’Ambrosio DN, Clugston RD, Blaner WS. Vitamin A metabolism: an update. Nutrients. 2011;3:63–103. doi: 10.3390/nu3010063.
- 9. Haroon M, Regan MJ. Vitamin D deficiency: the time to ignore it has passed. Int J Rheum Dis. 2010;13:318–23. doi: 10.1111/j.1756-185X.2010.01559.x.
- 10. McGreevy C, Williams D. New insights about vitamin D and cardiovascular disease: a narrative review. Ann Intern Med. 2011;155:820–6. doi: 10.7326/0003-4819-155-12-201112200-00004.
- 11. Beard JA, Bearden A, Striker R. Vitamin D and the anti-viral state. J Clin Virol. 2011;50:194–200. doi: 10.1016/j.jcv.2010.12.006.
- 12. Farrell C-J, Martin S, McWhinney B, Straub I, Williams P, Herrmann M. State-of-the-art vitamin D assays: a comparison of automated immunoassays with liquid chromatography-tandem mass spectrometry methods. Clin Chem. 2012;58:531–42. doi: 10.1373/clinchem.2011.172155.
- 13. Cook-Mills JM, Avila PC. Vitamin E and D regulation of allergic asthma immunopathogenesis. Int Immunopharmacol. 2014;23:364–72. doi: 10.1016/j.intimp.2014.08.007.
- 14. Bultynck C, et al. Prevalence of vitamin K deficiency in older people with hip fracture. Acta Clin Belg. 2020;75(2):136–40.
- 15. Haugsgjerd TR, et al. Association of dietary vitamin K and risk of coronary heart disease in middle-age adults: the Hordaland health study cohort. BMJ Open. 2020;10(5): e035953. https://doi.org/10.1136/BMJOPEN-2019-035953.
- 16. Kiely A, Ferland G, Ouliass B, O’Toole PW, Purtill H, O’Connor EM. Vitamin K status and inflammation are associated with cognition in older Irish adults. Nutr Neurosci. 2018;23(8):591–9. https://doi.org/10.1080/1028415X.2018.1536411.
- 17. Shahidi F, de Camargo AC. Tocopherols and Tocotrienols in Common and Emerging Dietary Sources: Occurrence, Applications, and Health Benefits. Int J Mol Sci. 2016 Oct 20;17(10)
- 18. Kemnic TR, Coleman M. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Jul 4, 2023. Vitamin E Deficiency.
- 19. Savastano S, Barrea L, Savanelli MC, Nappi F, Di Somma C, Orio F, Colao A. Low vitamin D status and obesity: Role of nutritionist. Rev Endocr Metab Disord. 2017 Jun;18(2):215-225.
- 20. Küley-Bagheri Y, Kreuzer KA, Monsef I, Lübbert M, Skoetz N. Effects of all-trans retinoic acid (ATRA) in addition to chemotherapy for adults with acute myeloid leukaemia (AML) (non-acute promyelocytic leukaemia (non-APL)). Cochrane Database Syst Rev. 2018 Aug 06;8(8):CD011960.
References
1. Reddy P, Jialal I. Biochemistry, Fat Soluble Vitamins. [Updated 2022 Sep 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534869/
2. Albahrani AA, Greaves RF. Fat-Soluble Vitamins: Clinical Indications and Current Challenges for Chromatographic Measurement. Clin Biochem Rev. 2016 Feb;37(1):27-47.
3. Plum LA, DeLuca HF. Vitamin D, disease and therapeutic opportunities. Nat Rev Drug Discov. 2010;9:941–55. doi: 10.1038/nrd3318.
4. Stephensen CB. Vitamin A, infection, and immune function. Annu Rev Nutr. 2001;21:167–92. doi: 10.1146/annurev.nutr.21.1.167.
5. Herrmann M. The measurement of 25-hydroxy vitamin D - an analytical challenge. Clin Chem Lab Med. 2012;50:1873–5. doi: 10.1515/cclm-2012-0526.
6. Youness, R.A., Dawoud, A., ElTahtawy, O. et al. Fat-soluble vitamins: updated review of their role and orchestration in human nutrition throughout life cycle with sex differences. Nutr Metab (Lond) 19, 60 (2022). https://doi.org/10.1186/s12986-022-00696-y
7. Chen W, Chen G. The Roles of Vitamin A in the regulation of carbohydrate, lipid, and protein metabolism. J Clin Med. 2014;3:453–79. doi: 10.3390/jcm3020453.
8. D’Ambrosio DN, Clugston RD, Blaner WS. Vitamin A metabolism: an update. Nutrients. 2011;3:63–103. doi: 10.3390/nu3010063.
9. Haroon M, Regan MJ. Vitamin D deficiency: the time to ignore it has passed. Int J Rheum Dis. 2010;13:318–23. doi: 10.1111/j.1756-185X.2010.01559.x.
10. McGreevy C, Williams D. New insights about vitamin D and cardiovascular disease: a narrative review. Ann Intern Med. 2011;155:820–6. doi: 10.7326/0003-4819-155-12-201112200-00004.
11. Beard JA, Bearden A, Striker R. Vitamin D and the anti-viral state. J Clin Virol. 2011;50:194–200. doi: 10.1016/j.jcv.2010.12.006.
12. Farrell C-J, Martin S, McWhinney B, Straub I, Williams P, Herrmann M. State-of-the-art vitamin D assays: a comparison of automated immunoassays with liquid chromatography-tandem mass spectrometry methods. Clin Chem. 2012;58:531–42. doi: 10.1373/clinchem.2011.172155.
13. Cook-Mills JM, Avila PC. Vitamin E and D regulation of allergic asthma immunopathogenesis. Int Immunopharmacol. 2014;23:364–72. doi: 10.1016/j.intimp.2014.08.007.
14. Bultynck C, et al. Prevalence of vitamin K deficiency in older people with hip fracture. Acta Clin Belg. 2020;75(2):136–40.
15. Haugsgjerd TR, et al. Association of dietary vitamin K and risk of coronary heart disease in middle-age adults: the Hordaland health study cohort. BMJ Open. 2020;10(5): e035953. https://doi.org/10.1136/BMJOPEN-2019-035953.
16. Kiely A, Ferland G, Ouliass B, O’Toole PW, Purtill H, O’Connor EM. Vitamin K status and inflammation are associated with cognition in older Irish adults. Nutr Neurosci. 2018;23(8):591–9. https://doi.org/10.1080/1028415X.2018.1536411.
17. Shahidi F, de Camargo AC. Tocopherols and Tocotrienols in Common and Emerging Dietary Sources: Occurrence, Applications, and Health Benefits. Int J Mol Sci. 2016 Oct 20;17(10)
18. Kemnic TR, Coleman M. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Jul 4, 2023. Vitamin E Deficiency.
19. Savastano S, Barrea L, Savanelli MC, Nappi F, Di Somma C, Orio F, Colao A. Low vitamin D status and obesity: Role of nutritionist. Rev Endocr Metab Disord. 2017 Jun;18(2):215-225.
20. Küley-Bagheri Y, Kreuzer KA, Monsef I, Lübbert M, Skoetz N. Effects of all-trans retinoic acid (ATRA) in addition to chemotherapy for adults with acute myeloid leukaemia (AML) (non-acute promyelocytic leukaemia (non-APL)). Cochrane Database Syst Rev. 2018 Aug 06;8(8):CD011960.