Niacin (also known as vitamin B3) is one of the water-soluble B vitamins. Niacin is the generic name for nicotinic acid (pyridine-3-carboxylic acid), nicotinamide (niacinamide or pyridine-3-carboxamide), and related derivatives, such as nicotinamide riboside [1-3].
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1,25-Dihydroxy vitamin D plays a primary role in the maintenance of calcium homeostasis. A part of circulating 25-hydroxy vitamin D is converted to 1, 25-dihydroxy form in the kidneys. Patients who present with hypercalcemia, hyperphosphatemia and low PTH may suffer from unregulated conversion of vitamin D from mono-hydroxy to dihydroxy form as is seen in granulomatous diseases like Sarcoidosis and nutritionally induced Hypervitaminosis D.
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The clinical syndrome of Vitamin D deficiency can be a result of deficient production in the skin, lack of dietary intake, accelerated losses, impaired vitamin D activation or resistance to the biologic effects of vitamin D. In addition intestinal malabsorption of dietary fat leads to Vitamin D deficiency which is further exacerbated in the presence of terminal ileal disease. Intestinal calcium absorption is also controlled by vitamin D.
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Vitamin E helps in the maintenance of biomembranes of vascular and nervous systems & has anti-oxidant properties. This assay is useful for evaluating individuals with motor and sensory neuropathies. It is also useful for monitoring vitamin E status of premature infants requiring oxygenation. It is a useful test in persons with intestinal malabsorption of lipids.
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Vitamin K is required as a cofactor for the synthesis of Factors II, VII, IX & X and protein C & S. Deficiency leads to bleeding. Warfarin acts as an anticoagulant because it is a Vitamin K antagonist
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