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Cavalier E, Makris K, Heijboer AC, Herrmann M, Souberbielle JC. Vitamin D: Analytical Advances, Clinical Impact, and Ongoing Debates on Health Perspectives. Clin Chem 2024:hvae056. [PMID: 38712647 DOI: 10.1093/clinchem/hvae056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/19/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Vitamin D, acknowledged since the 1930s for its role in preventing rickets, gained additional prominence in relation to fragility fracture prevention in the late 1980s. From the early 2000s, connections between vitamin D deficiency and extra-skeletal pathologies emerged, alongside increased awareness of widespread deficits. This prompted crucial debates on optimal serum concentrations, expected to conclude when the outcomes of high-dose supplementation randomized controlled trials were available. Skepticism arose with inconclusive results from these trials. CONTENT This review begins with an exploration of vitamin D metabolism, followed by a detailed description of the measurement of vitamin D metabolites and the crucial role of standardization. Subsequent sections focus on the association of vitamin D with bone health and explore the extra-skeletal effects. The review concludes with a comprehensive discussion on the definition of vitamin D status and its implications for supplementation. SUMMARY Despite standardization efforts, assay variations and challenges still exist, especially in specific patient groups. Vitamin D supplementation has a significant impact on bone metabolism and optimal vitamin D status improves the efficacy of antiresorptive drugs such as bisphosphonates. The extra-skeletal effects of vitamin D remain debated, but may include potential benefits in conditions such as respiratory infections and cancer mortality, particularly in deficient individuals. The definition of vitamin D sufficiency is nuanced, especially when variations in population groups and analytical methods are taken into account. Despite ongoing debates and recent mega-trials tempering enthusiasm, vitamin D remains a complex and essential element in human health. Further research is needed to clarify its role in various health outcomes and guide supplementation strategies.
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Affiliation(s)
- Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CIRM, CHU de Liège, Liège, Belgium
| | | | - Annemieke C Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam Gastroenterology & Metabolism, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
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Weiler HA, Bielecki A, Fu W, Demonty I, Brooks SP. Cholesterol Interference in the Assessment of Vitamin D Status: A Canadian Health Measures Survey Biobank Project. J Nutr 2024:S0022-3166(24)00173-1. [PMID: 38582388 DOI: 10.1016/j.tjnut.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/18/2024] [Accepted: 04/02/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Matrix effects are a known problem with immunoassays measuring serum 25-hydroxyvitamin D [25(OH)D]. OBJECTIVES To determine if the inverse association between serum 25(OH)D and serum cholesterol concentrations is a function of assay method: Diasorin Liaison 25(OH) Vitamin D Total Assay (Liaison Total Assay), an immunoassay, compared with liquid chromatography tandem mass spectrometry (LC-MS/MS). METHODS Canadian Health Measures Survey data and biobank serum (White males aged 20-79 y, n = 392) were evaluated for bias in serum 25(OH)D using Bland-Altman plots. Differences in serum 25(OH)D (Liaison Total Assay - LC-MS/MS) were compared among non-HDL-cholesterol <4.2 (n = 295) compared with ≥4.2 (n = 97) mmol/L and total cholesterol groups <5.2 (n = 256) compared with ≥5.2 (n = 136) mmol/L, and associations tested between 25(OH)D and non-HDL-cholesterol or total cholesterol concentrations, using regression. RESULTS Serum 25(OH)D measured using Liaison Total Assay ranged from 10.7 to 137.0 nmol/L and 14.4 to 137.9 nmol/L by LC-MS/MS. Liaison Total Assay - LC-MS/MS showed a negative bias of 5.5 (95% limits of agreement -23.8, 12.7) nmol/L. Differences in 25(OH)D were -4.0 ± 9.0 (±SD) nmol/L if non-HDL-cholesterol was <4.2 mmol/L and -10.2 ± 8.7 nmol/L if ≥4.2 mmol/L (P < 0.0001). Differences in 25(OH)D, if total cholesterol was <5.2 mmol/L, were -3.4 ± 8.6 nmol/L and -9.6 ± 9.3 nmol/L if ≥5.2 mmol/L (P < 0.0001). Serum non-HDL-cholesterol (beta -3.17, P = 0.0014) and total cholesterol (beta -2.77, P = 0.0046) were inversely associated with Liaison Total Assay 25(OH)D (adjusted for age, fasting, and body mass index), but not with LC-MS/MS measured 25(OH)D. Interference by these lipoproteins was not eliminated by standardization of the Liaison Total Assay. Similar associations were observed with triglycerides as for the lipoproteins. CONCLUSIONS Total cholesterol inversely associates with 25(OH)D, which is likely due to elevated non-HDL-cholesterol lipoprotein or triglyceride interference with the Liaison Total Assay. This is important as elevated cholesterol is common, and an underestimation of vitamin D status could be an unnecessary cause for concern.
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Affiliation(s)
- Hope A Weiler
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada.
| | - Agnieszka Bielecki
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Wen Fu
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Isabelle Demonty
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Stephen Pj Brooks
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
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Ganmaa D, Hemmings S, Jolliffe DA, Buyanjargal U, Garmaa G, Adiya U, Tumurbaatar T, Dorjnamjil K, Tserenkhuu E, Erdenenbaatar S, Tsendjav E, Enkhamgalan N, Achtai CE, Talhaasuren Y, Byambasuren T, Ganbaatar E, Purevdorj E, Martineau AR. Influence of vitamin D supplementation on muscle strength and exercise capacity in Mongolian schoolchildren: a randomised controlled trial. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.03.27.24304943. [PMID: 38585948 PMCID: PMC10996754 DOI: 10.1101/2024.03.27.24304943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Objective To determine whether weekly oral vitamin D supplementation influences grip strength, explosive leg power, cardiorespiratory fitness or spirometric lung volumes in Mongolian schoolchildren. Methods Multicentre, randomised, double-blind, placebo-controlled clinical trial conducted in children aged 6-13 years at baseline attending 18 schools in Ulaanbaatar. The intervention was weekly oral doses of 14,000 IU vitamin D3 (n=4418) or placebo (n=4433) for 3 years. Outcome measures were grip strength, standing long jump distance and serum 25-hydroxyvitamin D (25[OH]D) concentrations (determined in all participants), peak oxygen uptake (VO2peak, determined in a subset of 632 participants using 20-metre multi-stage shuttle run tests) and spirometric outcomes (determined in a subset of 1,343 participants). Results 99.8% of participants had serum 25(OH)D concentrations <75 nmol/L at baseline, and mean end-study 25(OH)D concentrations in children randomised to vitamin D vs. placebo were 77.4 vs. 26.7 nmol/L (mean difference 50.7 nmol/L, 95% CI, 49.7 to 51.4). However, vitamin D supplementation did not influence mean grip strength, standing long jump distance, VO2peak, spirometric lung volumes or peak expiratory flow rate, either overall or within sub-groups defined by sex, baseline 25(OH)D concentration <25 vs. ≥25 nmol/L or calcium intake <500 vs. ≥500 mg/day. Conclusion A 3-year course of weekly oral supplementation with 14,000 IU vitamin D3 elevated serum 25(OH)D concentrations in Mongolian schoolchildren with a high baseline prevalence of vitamin D deficiency. However, this intervention did not influence grip strength, explosive leg power, peak oxygen uptake or spirometric lung volumes, either overall or in sub-group analyses.
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Affiliation(s)
- Davaasambuu Ganmaa
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Stephanie Hemmings
- School of Sport and Health Sciences, University of Brighton, Eastbourne BN20 7SP, UK
| | - David A. Jolliffe
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
| | - Uyanga Buyanjargal
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar 13312, Mongolia
| | - Gantsetseg Garmaa
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar 13312, Mongolia
| | - Unaganshagai Adiya
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar 13312, Mongolia
| | - Tumenulzii Tumurbaatar
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar 13312, Mongolia
| | - Khulan Dorjnamjil
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar 13312, Mongolia
| | | | - Sumiya Erdenenbaatar
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar 13312, Mongolia
| | - Enkhjargal Tsendjav
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar 13312, Mongolia
| | - Nomin Enkhamgalan
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar 13312, Mongolia
| | - Chuluun-Erdene Achtai
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar 13312, Mongolia
| | | | - Tuya Byambasuren
- Mongolian Ministry of Health, Sukhbaatar District, Ulaanbaatar 14210, Mongolia
| | - Erdenetuya Ganbaatar
- Mongolian National University of Medical Sciences, Sukhbaatar District, Ulaanbaatar 14210, Mongolia
| | - Erkhembulgan Purevdorj
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar 13312, Mongolia
| | - Adrian R Martineau
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK
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Fassio A, Porciello G, Carioli G, Palumbo E, Vitale S, Luongo A, Montagnese C, Prete M, Grimaldi M, Pica R, Rotondo E, Falzone L, Calabrese I, Minopoli A, Grilli B, Cuomo M, Fiorillo PC, Evangelista C, Cavalcanti E, De Laurentiis M, Cianniello D, Pacilio C, Pinto M, Thomas G, Rinaldo M, D'Aiuto M, Serraino D, Massarut S, Steffan A, Ferraù F, Rossello R, Messina F, Catalano F, Adami G, Bertoldo F, Libra M, Crispo A, Celentano E, La Vecchia C, Augustin LSA, Gatti D. Post-diagnosis serum 25-hydroxyvitamin D concentrations in women treated for breast cancer participating in a lifestyle trial in Italy. Reumatismo 2024; 76. [PMID: 38523582 DOI: 10.4081/reumatismo.2024.1632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/30/2023] [Indexed: 03/26/2024] Open
Abstract
OBJECTIVE To report cross-sectionally serum levels of 25-hydroxyvitamin D [25(OH)D] in women living in Italy within 12 months from breast cancer (BC) diagnosis. METHODS Baseline data were obtained from 394 women diagnosed with primary BC, enrolled from 2016 to 2019 in a lifestyle trial conducted in Italy. Subjects' characteristics were compared between two 25(OH)D concentrations (hypovitaminosis D<20 and ≥20 ng/mL) with the Chi-squared test or Fisher's exact test for small-expected counts. Using multiple logistic regression-adjusted models, we estimated odds ratios (ORs) of hypovitaminosis D with 95% confidence intervals (CIs) in the total sample and in the unsupplemented subgroup. RESULTS Hypovitaminosis D was found in 39% of all subjects, 60% in unsupplemented subjects, and 10% in supplemented subjects. Increasing ORs of hypovitaminosis D were found with increasing body mass index, 25-30, >30, and ≥35 versus <25 kg/m2 (ORs: 2.50, 4.64, and 5.81, respectively, in the total cohort and ORs: 2.68, 5.38, and 7.08 in the unsupplemented); living in the most southern Italian region (OR 2.50, 95%CI 1.22-5.13); and with hypertriglyceridemia (OR 2.46; 95%CI 1.16-5.22), chemotherapy history (OR 1.86, 95%CI 1.03-3.38), and inversely with anti-estrogenic therapy (OR 0.43, 95%CI 0.24-0.75) in the total sample. CONCLUSIONS Hypovitaminosis D in women recently diagnosed with BC and participating in a lifestyle trial in Italy was widespread and highest with obesity, hypertriglyceridemia, and chemotherapy use. Considering that hypovitaminosis D is a risk factor for lower efficacy of bone density treatments and possibly BC mortality, our results suggest the need to promptly address and treat vitamin D deficiency.
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Affiliation(s)
- A Fassio
- Rheumatology Unit, University of Verona.
| | - G Porciello
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - G Carioli
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano.
| | - E Palumbo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - S Vitale
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - A Luongo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | | | - M Prete
- Division of Radiotherapy, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - M Grimaldi
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - R Pica
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - E Rotondo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - L Falzone
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - I Calabrese
- Healthcare Direction, "A. Cardarelli" Hospital, Napoli.
| | - A Minopoli
- aboratory Medicine Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - B Grilli
- Virology and Microbiology Unit, Università degli Studi di Napoli "Luigi Vanvitelli", Napoli.
| | - M Cuomo
- Laboratory Medicine Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - P C Fiorillo
- Laboratory of Chemical, Clinical and Microbiological Analysis, Department of "Strutturale dei Servizi", Ospedale S. Giacomo, Novi Ligure.
| | - C Evangelista
- Immunopathology and Cancer Biomarkers Unit, Centro di Riferimento Oncologico (CRO) IRCCS, Aviano.
| | - E Cavalcanti
- Laboratory Medicine Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - M De Laurentiis
- Division of Breast Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - D Cianniello
- Division of Breast Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - C Pacilio
- Division of Breast Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - M Pinto
- Rehabilitation Medicine Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | | | - M Rinaldo
- Breast Unit, Clinica Villa Fiorita, Aversa.
| | - M D'Aiuto
- Breast Unit, Clinica Villa Fiorita, Aversa.
| | - D Serraino
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCSS, Aviano.
| | - S Massarut
- Department of Surgery, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano.
| | - A Steffan
- Immunopathology and Cancer Biomarkers Unit, Centro di Riferimento Oncologico (CRO) IRCCS, Aviano.
| | - F Ferraù
- Division of Medical Oncology, Ospedale San Vincenzo, Taormina.
| | - R Rossello
- Division of Medical Oncology, Ospedale San Vincenzo, Taormina.
| | - F Messina
- Ospedale Evangelico Betania, Napoli.
| | | | - G Adami
- Rheumatology Unit, University of Verona.
| | - F Bertoldo
- Department of Medicine, University of Verona.
| | - M Libra
- Oncologic, Clinical and General Pathology Section, Department of Biomedical and Biotechnological Sciences, University of Catania.
| | - A Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - E Celentano
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - C La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano.
| | - L S A Augustin
- pidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli.
| | - D Gatti
- Rheumatology Unit, University of Verona.
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Ganmaa D, Khudyakov P, Buyanjargal U, Tserenkhuu E, Erdenenbaatar S, Achtai CE, Yansanjav N, Delgererekh B, Ankhbat M, Tsendjav E, Ochirbat B, Jargalsaikhan B, Enkhmaa D, Martineau AR. Vitamin D supplements for fracture prevention in schoolchildren in Mongolia: analysis of secondary outcomes from a multicentre, double-blind, randomised, placebo-controlled trial. Lancet Diabetes Endocrinol 2024; 12:29-38. [PMID: 38048799 DOI: 10.1016/s2213-8587(23)00317-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/09/2023] [Accepted: 10/17/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Vitamin D supplementation has been shown to increase total hip areal bone mineral density in healthy children and adolescents. We aimed to investigate whether supplementing schoolchildren living in Mongolia with weekly vitamin D3 for 3 years affected fracture risk. METHODS We did a multicentre, double-blind, randomised, placebo-controlled trial across 18 public schools in Ulaanbaatar, Mongolia. Schoolchildren were eligible if they were aged 6-13 years at screening, had a negative QuantiFERON-TB Gold In-tube assay (QFT) result, were not hypersensitive to vitamin D or immunocompromised, did not use vitamin D supplements, did not have clinical signs of rickets, and had no intention of leaving Ulaanbaatar within 3 years. Participants were randomly assigned (1:1) to receive either vitamin D (oral dose of 14 000 international units [IU] vitamin D3, once per week) or placebo for 3 years using permuted block randomisation stratified by school of attendance. Participants, care providers, and all trial staff were masked to group assignment during the intervention. Prespecified secondary outcomes were incidence of fractures and adverse events, ascertained using questionnaires. The fracture and safety analyses included participants who completed at least one follow-up fracture questionnaire. We estimated adjusted risk ratios (RRs) and 95% CIs using generalised linear models with binomial distribution and a log link function with adjustment for school of attendance. The trial is registered with ClinicalTrials.gov, NCT02276755, and the intervention ended in May, 2019. FINDINGS Between Sept 2, 2015, and March 20, 2017, 11 475 children were invited to participate in the study and 8851 were recruited and randomly assigned to receive either vitamin D (n=4418) or placebo (n=4433). 8348 participants were included in the fracture and safety analyses (4176 [94·5%] in the vitamin D group and 4172 [94·1%] in the placebo group). Of these, 4125 (49·4%) were female, 4223 (50·6%) were male, and 7701 (92·2%) were of Khalkh ancestry. Median age was 9·2 years (IQR 8·0-10·7) and 7975 (95·5%) participants had baseline serum 25-hydroxyvitamin D concentrations less than 50 nmol/L. During a median follow-up of 3·0 years (IQR 2·9-3·1), 268 (6·4%) participants in the vitamin D group and 253 (6·1%) in the placebo group reported one or more fractures (adjusted RR 1·10, 95% CI 0·93-1·29; p=0·27). Incidence of adverse events did not differ between study groups. INTERPRETATION Oral vitamin D supplementation at a dose of 14 000 IU/week for 3 years was safe, but did not influence fracture risk in schoolchildren living in Mongolia who had a high baseline prevalence of vitamin D deficiency. FUNDING US National Institutes of Health.
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Affiliation(s)
- Davaasambuu Ganmaa
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | - Adrian R Martineau
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
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Cavalier E, Fraser CG, Bhattoa HP, Heijboer AC, Makris K, Vasikaran S, Huyghebaert L, Peeters S, Le Goff C, Herrmann M, Carobene A. Analytical performance specifications for the measurement uncertainty of 24,25-dihydroxyvitamin D examinations. Clin Chem Lab Med 2023; 61:1561-1566. [PMID: 36995129 DOI: 10.1515/cclm-2023-0176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/19/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVES The exploration of the metabolites in the degradation pathways of vitamin D (VTD) has gained importance in recent years and simultaneous quantitation of twenty-five-hydroxy vitamin D (25(OH)D) mass concentration together with 24,25-dihydroxyvitamin D (24,25(OH)2D) has been proposed as a newer approach to define VTD deficiency. Yet, no data are available on 24,25(OH)2D biological variation (BV). In this study, we evaluated 24,25(OH)2D's BV on the European Biological Variation Study (EuBIVAS) cohort samples to determine if analytical performance specifications (APS) for 24,25(OH)2D could be generated. METHODS Six European laboratories recruited 91 healthy participants. 25(OH)D and 24,25(OH)2D concentrations in K3-EDTA plasma were examined weekly for up to 10 weeks in duplicate with a validated LC-MS/MS method. The Vitamin D Metabolite Ratio (24,25(OH)2D divided by 25(OH)D × 100) was also calculated at each time point. RESULTS Linear regression of the mean 24,25(OH)2D concentrations at each blood collection showed participants were not in steady state. Variations of 24,25(OH)2D over time were significantly positively associated with the slopes of 25(OH)D concentrations over time and the concentration of 25(OH)D of the participant at inclusion, and negatively associated with body mass index (BMI), but not with age, gender, or location of the participant. The variation of the 24,25(OH)2D concentration in participants over a 10 weeks period was 34.6%. Methods that would detect a significant change linked to the natural production of 24,25(OH)2D over this period at p<0.05 would need a relative measurement uncertainty (u%)<14.9% while at p<0.01, relative measurement uncertainty should be <10.5%. CONCLUSIONS We have defined for the first time APS for 24,25(OH)2D examinations. According to the growing interest in this metabolite, several laboratories and manufacturers might aim to develop specific methods for its determination. The results presented in this paper are thus necessary prerequisites for the validation of such methods.
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Affiliation(s)
- Etienne Cavalier
- Department of Clinical Chemistry, University of Liege, CHU de Liege, CIRM, Liege, Belgium
| | - Callum G Fraser
- Centre for Research into Cancer Prevention and Screening, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland
| | - Harjit Pal Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Annemieke C Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam Gastroenterology & Metabolism, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Samuel Vasikaran
- PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Loreen Huyghebaert
- Department of Clinical Chemistry, University of Liege, CHU de Liege, CIRM, Liege, Belgium
| | - Stéphanie Peeters
- Department of Clinical Chemistry, University of Liege, CHU de Liege, CIRM, Liege, Belgium
| | - Caroline Le Goff
- Department of Clinical Chemistry, University of Liege, CHU de Liege, CIRM, Liege, Belgium
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Anna Carobene
- Laboratory Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Alexandridou A, Volmer DA. 2-fluoro-1-methylpyridinium p-toluene sulfonate: a new LC-MS/MS derivatization reagent for vitamin D metabolites. J Lipid Res 2023; 64:100409. [PMID: 37406930 PMCID: PMC10410174 DOI: 10.1016/j.jlr.2023.100409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023] Open
Abstract
Vitamin D analysis by MS faces several analytical challenges, including inefficient ionization, nonspecific fragmentation, interferences from epimers, isomers, and isobars, as well as very low concentration levels. In this study, we used 2-fluoro-1-methylpyridinium (FMP) p-toluene sulfonate for derivatization of vitamin D3 metabolites to increase detection sensitivity and allow for full chromatographic separation of vitamin D isomers and epimers. UHPLC-MS/MS was used for measurement of five vitamin D3 metabolites in human serum. Compared with Amplifex and 4-phenyl-1,2,4-triazolin-3,5-dion, the FMP p-toluene sulfonate reaction required less time to be performed. The method was optimized and validated to ensure accuracy, precision, and reliability. In-house and commercial quality control samples were used to assure the quality of the results for 25-hydroxyvitamin D3. The method showed very good linearity and intraday and interday accuracy and precision; coefficients of determination (r2) ranged between 0.9977 and 0.9992, relative recovery from 95 to 111%, and coefficient of variation from 0.9 to 11.3. Stability tests showed that the extracted derivatized serum samples were stable for 24 h after storage at -20°C; 24,25-dihydroxyvitamin D3 and 1,25-dihydroxyvitamin D3-FMP derivatives were stable for 1 week at -80°C. The method was applied to samples of healthy individuals for quantitative determination of vitamin D3, the two epimers of 25-hydroxyvitamin D3 and 24,25-dihydroxyvitamin D3.
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Affiliation(s)
| | - Dietrich A Volmer
- Bioanalytical Chemistry, Humboldt University Berlin, Berlin, Germany.
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Hsu S, Zelnick LR, Bansal N, Brown J, Denburg M, Feldman HI, Ginsberg C, Hoofnagle AN, Isakova T, Leonard MB, Lidgard B, Robinson‐Cohen C, Wolf M, Xie D, Kestenbaum BR, de Boer IH. Vitamin D Metabolites and Risk of Cardiovascular Disease in Chronic Kidney Disease: The CRIC Study. J Am Heart Assoc 2023; 12:e028561. [PMID: 37421259 PMCID: PMC10382125 DOI: 10.1161/jaha.122.028561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 04/18/2023] [Indexed: 07/10/2023]
Abstract
Background The ratio of 24,25-dihydroxyvitamin D3/25-hydroxyvitamin D3 (vitamin D metabolite ratio [VDMR]) may reflect functional vitamin D activity. We examined associations of the VDMR, 25-hydroxyvitamin D (25[OH]D), and 1,25-dihydroxyvitamin D (1,25[OH]2D) with cardiovascular disease (CVD) in patients with chronic kidney disease. Methods and Results This study included longitudinal and cross-sectional analyses of 1786 participants from the CRIC (Chronic Renal Insufficiency Cohort) Study. Serum 24,25-dihydroxyvitamin D3, 25(OH)D, and 1,25(OH)2D were measured by liquid chromatography-tandem mass spectrometry 1 year after enrollment. The primary outcome was composite CVD (heart failure, myocardial infarction, stroke, and peripheral arterial disease). We used Cox regression with regression-calibrated weights to test associations of the VDMR, 25(OH)D, and 1,25(OH)2D with incident CVD. We examined cross-sectional associations of these metabolites with left ventricular mass index using linear regression. Analytic models adjusted for demographics, comorbidity, medications, estimated glomerular filtration rate, and proteinuria. The cohort was 42% non-Hispanic White race and ethnicity, 42% non-Hispanic Black race and ethnicity, and 12% Hispanic ethnicity. Mean age was 59 years, and 43% were women. Among 1066 participants without prevalent CVD, there were 298 composite first CVD events over a mean follow-up of 8.6 years. Lower VDMR and 1,25(OH)2D were associated with incident CVD before, but not after, adjustment for estimated glomerular filtration rate and proteinuria (hazard ratio, 1.11 per 1 SD lower VDMR [95% CI, 0.95-1.31]). Only 25(OH)D was associated with left ventricular mass index after full covariate adjustment (0.6 g/m2.7 per 10 ng/mL lower [95% CI, 0.0-1.3]). Conclusions Despite modest associations of 25(OH)D with left ventricular mass index, 25(OH)D, the VDMR, and 1,25(OH)2D were not associated with incident CVD in chronic kidney disease.
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Affiliation(s)
- Simon Hsu
- Division of Nephrology and Kidney Research Institute, Department of MedicineUniversity of WashingtonSeattleWA
| | - Leila R. Zelnick
- Division of Nephrology and Kidney Research Institute, Department of MedicineUniversity of WashingtonSeattleWA
| | - Nisha Bansal
- Division of Nephrology and Kidney Research Institute, Department of MedicineUniversity of WashingtonSeattleWA
| | - Julia Brown
- Division of Nephrology and Hypertension, Department of MedicineLoyola University of ChicagoMaywoodIL
| | - Michelle Denburg
- Division of Pediatric NephrologyDepartment of Pediatrics, The Children’s Hospital of PhiladelphiaPhiladelphiaPA
- Department of Biostatistics, Epidemiology, and InformaticsPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaPA
| | - Harold I. Feldman
- Department of Biostatistics, Epidemiology, and InformaticsPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaPA
- Center for Clinical Epidemiology and BiostatisticsPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaPA
| | - Charles Ginsberg
- Division of Nephrology‐HypertensionUniversity of California, San DiegoSan DiegoCA
| | | | - Tamara Isakova
- Division of Nephrology and Hypertension, Center for Translational Metabolism and Health, Institute for Public Health and MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | - Mary B. Leonard
- Division of Nephrology, Lucile Packard Children’s HospitalStanford University School of MedicinePalo AltoCA
| | - Benjamin Lidgard
- Division of Nephrology and Kidney Research Institute, Department of MedicineUniversity of WashingtonSeattleWA
| | | | - Myles Wolf
- Division of Nephrology, Department of Medicine, Duke Clinical Research InstituteDuke University School of MedicineDurhamNCUSA
| | - Dawei Xie
- Department of Biostatistics, Epidemiology, and InformaticsPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaPA
- Center for Clinical Epidemiology and BiostatisticsPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaPA
| | - Bryan R. Kestenbaum
- Division of Nephrology and Kidney Research Institute, Department of MedicineUniversity of WashingtonSeattleWA
| | - Ian H. de Boer
- Division of Nephrology and Kidney Research Institute, Department of MedicineUniversity of WashingtonSeattleWA
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9
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Craven BC, Cirnigliaro CM, Carbone LD, Tsang P, Morse LR. The Pathophysiology, Identification and Management of Fracture Risk, Sublesional Osteoporosis and Fracture among Adults with Spinal Cord Injury. J Pers Med 2023; 13:966. [PMID: 37373955 DOI: 10.3390/jpm13060966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/26/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The prevention of lower extremity fractures and fracture-related morbidity and mortality is a critical component of health services for adults living with chronic spinal cord injury (SCI). METHODS Established best practices and guideline recommendations are articulated in recent international consensus documents from the International Society of Clinical Densitometry, the Paralyzed Veterans of America Consortium for Spinal Cord Medicine and the Orthopedic Trauma Association. RESULTS This review is a synthesis of the aforementioned consensus documents, which highlight the pathophysiology of lower extremity bone mineral density (BMD) decline after acute SCI. The role and actions treating clinicians should take to screen, diagnose and initiate the appropriate treatment of established low bone mass/osteoporosis of the hip, distal femur or proximal tibia regions associated with moderate or high fracture risk or diagnose and manage a lower extremity fracture among adults with chronic SCI are articulated. Guidance regarding the prescription of dietary calcium, vitamin D supplements, rehabilitation interventions (passive standing, functional electrical stimulation (FES) or neuromuscular electrical stimulation (NMES)) to modify bone mass and/or anti-resorptive drug therapy (Alendronate, Denosumab, or Zoledronic Acid) is provided. In the event of lower extremity fracture, the need for timely orthopedic consultation for fracture diagnosis and interprofessional care following definitive fracture management to prevent health complications (venous thromboembolism, pressure injury, and autonomic dysreflexia) and rehabilitation interventions to return the individual to his/her pre-fracture functional abilities is emphasized. CONCLUSIONS Interprofessional care teams should use recent consensus publications to drive sustained practice change to mitigate fracture incidence and fracture-related morbidity and mortality among adults with chronic SCI.
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Affiliation(s)
- Beverley Catharine Craven
- KITE Research Institute, 520 Sutherland Dr, Toronto, ON M4G 3V9, Canada
- Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, ON M5S 1A8, Canada
| | - Christopher M Cirnigliaro
- Department of Veterans Affairs Rehabilitation, Research, and Development Service, Spinal Cord Damage Research Center, Bronx, NY 10468, USA
| | - Laura D Carbone
- Department of Medicine: Rheumatology, Medical College of Georgia, Augusta University, 1120 15th St, Augusta, GA 30912, USA
| | - Philemon Tsang
- KITE Research Institute, 520 Sutherland Dr, Toronto, ON M4G 3V9, Canada
| | - Leslie R Morse
- Department of Rehabilitation Medicine, University of Minnesota, 500 Harvard St SE, Minneapolis, MN 55455, USA
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10
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Passeri G, Giannini S. Benefits of Vitamin D in Health and Diseases. Nutrients 2023; 15:nu15112419. [PMID: 37299383 DOI: 10.3390/nu15112419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/17/2023] [Indexed: 06/12/2023] Open
Abstract
This Special Issue of Nutrients, titled "Benefits of Vitamin D in health and diseases", includes a total of twenty-five publications that consider different aspects of vitamin D, both at the cellular/preclinical and clinical levels, in neonates or children, in pregnant women, in adults and in elderly subjects [...].
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Affiliation(s)
- Giovanni Passeri
- Unit of Clinica e Terapia Medica, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Sandro Giannini
- Clinica Medica 1, Department of Medicine, University of Padova, 35128 Padova, Italy
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11
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Wise SA, Hahm G, Burdette CQ, Tai SSC, Camara JE, Sempos CT, Williams EL. Determination of 24,25-Dihydroxyvitamin D 3 [24,25(OH) 2D 3] in Archived Vitamin D External Quality Assessment Scheme (DEQAS) Samples using a Reference Measurement Procedure with Comparison to DEQAS Participant Results and Assessment of Contribution of 24,25(OH) 2D 3 to DEQAS Assay Results. J Steroid Biochem Mol Biol 2023; 231:106318. [PMID: 37169270 DOI: 10.1016/j.jsbmb.2023.106318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/19/2023] [Accepted: 05/03/2023] [Indexed: 05/13/2023]
Abstract
Ninety archived human serum samples from the Vitamin D External Quality Assessment Scheme (DEQAS) were analyzed using a reference measurement procedure (RMP) based on isotope dilution liquid chromatography - tandem mass spectrometry (ID LC-MS/MS) for the determination of 24,25-dihydroxyvitamin D3 [24,25(OH)2D3]. These 24,25(OH)2D3 results, in conjunction with concentration values assigned using RMPs for 25-hydroxyvitamin D2 [25(OH)D2] and 25-hydroxyvitamin D3 [25(OH)D3], provide a valuable resource for assessing the accuracy of measurements for 24,25(OH)2D3 and for investigating the relationship between 24,25(OH)2D3 and 25(OH)D3. Results for 24,25(OH)2D3 using the RMP were compared to DEQAS consensus values demonstrating that the consensus values were not sufficient to assess the accuracy of measurements among different laboratories and methods. A multivariable regression analysis approach using historical DEQAS consensus values for various total 25(OH)D assays was used to assess the contribution of 24,25(OH)2D3 concentration on the assay response. The response of several ligand binding assays for total 25(OH)D was shown to be impacted by the presence of 24,25(OH)2D3.
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Affiliation(s)
- Stephen A Wise
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD 20892, USA
| | - Grace Hahm
- National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA
| | - Carolyn Q Burdette
- National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA
| | - Susan S-C Tai
- National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA
| | - Johanna E Camara
- National Institute of Standards and Technology (NIST), Gaithersburg, MD 20899, USA
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12
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Weiler HA, Sarafin K, Martineau C, Daoust JL, Esslinger K, Greene-Finestone LS, Loukine L, Dorais V. Vitamin D Status of People 3 to 79 Years of Age from the Canadian Health Measures Survey 2012-2019. J Nutr 2023; 153:1150-1161. [PMID: 36848989 DOI: 10.1016/j.tjnut.2023.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/09/2023] [Accepted: 02/22/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Vitamin D is recognized in bone health and the prevention of rickets and osteomalacia. OBJECTIVE This study aimed to assess vitamin D status of people in Canada and to identify factors associated with vitamin D inadequacy and deficiency. METHODS Serum 25-hydroxyvitamin D (25(OH)D) from the Canadian Health Measures Survey (cycles 3-6, n = 21,770, 3-79 y) were evaluated for geometric means and proportions <40 (inadequate) and <30 (risk of deficiency) nmol/L. Factors associated with inadequacy or deficiency were tested using logistic regression. RESULTS Mean serum 25(OH)D was 57.9 (95% CI: 55.4, 60.5) nmol/L; the prevalence of inadequacy was 19.0% (95% CI: 15.7, 22.3) and risk of deficiency was 8.4% (95% CI: 6.5, 10.3). Prominent dietary factors associated with inadequacy in adults included: not consuming fish compared with ≥1/wk (adjusted ORadj: 1.60; 95% CI: 1.21, 2.11), none compared with ≥1/d for cow's milk (ORadj: 1.41; 95% CI: 1.02, 1.94) or margarine (ORadj: 1.42; 95% CI: 1.08, 1.88); or nonuser compared with user of vitamin D supplements (ORadj: 5.21; 95% CI: 3.88, 7.01). Notable demographic factors included: younger adults compared with 71 to 79 y (19-30 y ORadj: 2.33; 95% CI: 1.66, 3.29); BMI ≥30 compared with <25 kg/m2 (ORadj: 2.30; 95% CI: 1.79, 2.95); lower household income quartile 1 compared with 4 (ORadj: 1.46; 95% CI: 1.00, 2.15); and self-reported Black (ORadj: 8.06; 95% CI: 4.71, 13.81), East/Southeast Asian (ORadj: 3.83; 95% CI: 2.14, 6.85), Middle Eastern (ORadj: 4.57; 95% CI: 3.02, 6.92), and South Asian (ORadj: 4.63; 95% CI: 2.62, 8.19) race compared with White. Similar factors were observed in children and for deficiency. CONCLUSIONS Most people in Canada have adequate vitamin D status; nonetheless, racialized groups have an elevated prevalence of inadequacy. Further research is required to evaluate if current strategies to improve vitamin D status, including increasing vitamin D in fortified foods and supplements, and dietary guidance to include a source of vitamin D every day help to reduce health inequality in Canada.
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Affiliation(s)
- Hope A Weiler
- Nutrition Research Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada.
| | - Kurtis Sarafin
- Nutrition Research Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Chantal Martineau
- Nutrition Regulations and Standards Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Janice L Daoust
- Nutrition Regulations and Standards Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Krista Esslinger
- Office of Nutrition Policy and Promotion, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | | | - Lidia Loukine
- Bureau of Food Surveillance and Science Integration, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Veronique Dorais
- Bureau of Food Surveillance and Science Integration, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
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13
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Fischer PR, Sempos CT, Pettifor JM, Fraser DR, Munns CF, Durazo-Arvizu RA, Thacher TD. Serum 1,25-dihydroxyvitamin D levels in the diagnosis and pathogenesis of nutritional rickets - a multivariable re-analysis of a case-control study. Am J Clin Nutr 2023; 117:998-1004. [PMID: 36801463 DOI: 10.1016/j.ajcnut.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND A multivariable logistic regression model resulting from a case-control study of nutritional rickets in Nigerian children suggested that higher levels of serum 25(OH)D may be required to prevent nutritional rickets in populations with low-calcium intakes. OBJECTIVES This current study evaluates if adding serum 1,25-dihydroxyvitamin D [1,25(OH)2D] to that model shows that increased levels of serum 1,25(OH)2D are independently associated with risk of children on low-calcium diets having nutritional rickets. METHODS Multivariable logistic regression analysis was used to model the association between serum 1,25(OH)2D and risk of having nutritional rickets in cases (n = 108) and controls (n = 115) after adjusting for age, sex, weight-for age z-score, religion, phosphorus intake and age began walking and the interaction between serum 25(OH)D and dietary calcium intake (Full Model). RESULTS Serum 1,25(OH)2D levels were significantly higher (320 pmol/L vs. 280 pmol/L) (P = 0.002), and 25(OH)D levels were lower (33 nmol/L vs. 52 nmol/L) (P < 0.0001) in children with rickets than in control children. Serum calcium levels were lower in children with rickets (1.9 mmol/L) than in control children (2.2 mmol/L) (P < 0.001). Dietary calcium intakes were similarly low in both groups (212 mg/d) (P = 0.973). In the multivariable logistic model, 1,25(OH)2D was independently associated with risk of having rickets [coefficient = 0.007 (95% confidence limits: 0.002-0.011)] after adjusting for all variables in the Full Model. CONCLUSIONS Results confirmed theoretical models that in children with low dietary calcium intake, 1,25(OH)2D serum concentrations are higher in children with rickets than in children without rickets. The difference in 1,25(OH)2D levels is consistent with the hypothesis that children with rickets have lower serum calcium concentrations which prompt the elevation of PTH levels resulting in an elevation of 1,25(OH)2D levels. These results support the need for additional studies to identify dietary and environmental risks for nutritional rickets.
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Affiliation(s)
- Philip R Fischer
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, United States, Department of Pediatrics, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates and Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates.
| | | | - John M Pettifor
- Department of Pediatrics, SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - David R Fraser
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, Australia
| | - Craig F Munns
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia and Department of Endocrinology and Diabetes, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Ramon A Durazo-Arvizu
- Biostatistical Core, The Sabin Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Tom D Thacher
- Department of Family Medicine, Jos University Teaching Hospital, Jos, Nigeria
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14
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Ganmaa D, Bromage S, Khudyakov P, Erdenenbaatar S, Delgererekh B, Martineau AR. Influence of Vitamin D Supplementation on Growth, Body Composition, and Pubertal Development Among School-aged Children in an Area With a High Prevalence of Vitamin D Deficiency: A Randomized Clinical Trial. JAMA Pediatr 2023; 177:32-41. [PMID: 36441522 PMCID: PMC9706398 DOI: 10.1001/jamapediatrics.2022.4581] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/28/2022] [Indexed: 11/29/2022]
Abstract
Importance Vitamin D deficiency (defined as 25-hydroxyvitamin D [25(OH)D] <20 ng/mL) is prevalent among children living in temperate climates and has been reported to associate independently with stunting, obesity, and early activation of the hypothalamic-pituitary-gonadal axis. Phase 3 randomized clinical trials to investigate the influence of long-term vitamin D replacement on growth, body composition, and pubertal development of school-aged children with vitamin D deficiency are lacking. Objective To determine whether weekly oral vitamin D supplementation influences linear growth, body composition, or pubertal development in school-aged children living in a setting where vitamin D deficiency is highly prevalent. Design, Setting, and Participants This secondary analysis of a double-blind, placebo-controlled randomized clinical trial was conducted from June 2016 to June 2019 at 18 grade schools in Ulaanbaatar, Mongolia. School-aged children (6 to 13 years at baseline) attending participating schools were included. Exclusion criteria included a positive QuantiFERON-TB Gold in-tube assay result, conditions or medications associated with altered vitamin D metabolism, use of vitamin D supplements, signs of rickets, or intention to move from Ulaanbaatar within 4 years. Of 11 475 children invited to participate in the study, 9814 underwent QFT testing, and 8851 with negative results were included in the study. All but 1 participant in the placebo group completed follow-up and were included in the present analysis. Data were analyzed from November 2021 to February 2022. Interventions Weekly oral doses of vitamin D3, 14 000 IU, (n = 4418), or placebo (n = 4433) for 3 years. Main Outcomes and Measures Mean z scores for height for age, body mass index for age, and waist-to-height ratio; mean percentage body fat, fat mass, and fat-free mass; and mean Tanner scores for pubertal development. Results Of 8851 participants, 4366 (49.3%) were female, and 8165 (92.2%) were of Khalkh ethnicity; the mean (SD) age was 9.4 (1.6) years. A total of 8453 participants (95.5%) were vitamin D deficient at baseline, and mean end-of-study 25(OH)D concentrations among participants randomized to vitamin D vs placebo were 31.0 vs 10.7 ng/mL (mean difference, 20.3; 95% CI; 19.9-20.6). However, vitamin D supplementation did not influence mean height for age, body mass index for age, waist-to-height ratio, percentage body fat, fat mass, fat-free mass, or Tanner scores, either overall or within subgroups defined by baseline 25(OH)D concentration less than 10 ng/mL vs 10 ng/mL or greater, estimated calcium intake less than 500 mg/d vs 500 mg/d or greater, or male vs female sex. Conclusions and Relevance In school-aged children in this study with low baseline vitamin D status, oral vitamin D3 supplementation at a dose of 14 000 IU per week for 3 years was effective in elevating 25(OH)D concentrations but did not influence growth, body composition, or pubertal development. Trial Registration ClinicalTrials.gov Identifier: NCT02276755.
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Affiliation(s)
- Davaasambuu Ganmaa
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Sabri Bromage
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Sumiya Erdenenbaatar
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar, Mongolia
| | - Baigal Delgererekh
- Global Laboratory, Royal Plaza, Bayanzurkh District, Ulaanbaatar, Mongolia
| | - Adrian R. Martineau
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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15
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Janoušek J, Pilařová V, Macáková K, Nomura A, Veiga-Matos J, Silva DDD, Remião F, Saso L, Malá-Ládová K, Malý J, Nováková L, Mladěnka P. Vitamin D: sources, physiological role, biokinetics, deficiency, therapeutic use, toxicity, and overview of analytical methods for detection of vitamin D and its metabolites. Crit Rev Clin Lab Sci 2022; 59:517-554. [PMID: 35575431 DOI: 10.1080/10408363.2022.2070595] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Vitamin D has a well-known role in the calcium homeostasis associated with the maintenance of healthy bones. It increases the efficiency of the intestinal absorption of dietary calcium, reduces calcium losses in urine, and mobilizes calcium stored in the skeleton. However, vitamin D receptors are present ubiquitously in the human body and indeed, vitamin D has a plethora of non-calcemic functions. In contrast to most vitamins, sufficient vitamin D can be synthesized in human skin. However, its production can be markedly decreased due to factors such as clothing, sunscreens, intentional avoidance of the direct sunlight, or the high latitude of the residence. Indeed, more than one billion people worldwide are vitamin D deficient, and the deficiency is frequently undiagnosed. The chronic deficiency is not only associated with rickets/osteomalacia/osteoporosis but it is also linked to a higher risk of hypertension, type 1 diabetes, multiple sclerosis, or cancer. Supplementation of vitamin D may be hence beneficial, but the intake of vitamin D should be under the supervision of health professionals because overdosing leads to intoxication with severe health consequences. For monitoring vitamin D, several analytical methods are employed, and their advantages and disadvantages are discussed in detail in this review.
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Affiliation(s)
- Jiří Janoušek
- Department of Pharmacognosy, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Veronika Pilařová
- Department of Analytical Chemistry, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Kateřina Macáková
- Department of Pharmacognosy, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Anderson Nomura
- UCIBIO - Applied Molecular Biosciences Unit, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Jéssica Veiga-Matos
- UCIBIO - Applied Molecular Biosciences Unit, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Diana Dias da Silva
- UCIBIO - Applied Molecular Biosciences Unit, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal.,TOXRUN - Toxicology Research Unit, University Institute of Health Sciences, CESPU CRL, Gandra, Portugal
| | - Fernando Remião
- UCIBIO - Applied Molecular Biosciences Unit, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Luciano Saso
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Kateřina Malá-Ládová
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Josef Malý
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Lucie Nováková
- Department of Analytical Chemistry, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Přemysl Mladěnka
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
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16
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Towards harmonization of directly measured free 25-hydroxyvitamin D using an enzyme-linked immunosorbent assay. Anal Bioanal Chem 2022; 414:7793-7803. [PMID: 36109397 PMCID: PMC9568476 DOI: 10.1007/s00216-022-04313-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/19/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022]
Abstract
The majority of circulating 25-hydroxyvitamin D (25(OH)D) is protein bound and perhaps less available than the free fraction of 25(OH)D; therefore, researchers have proposed that the measurement of free 25(OH)D in human serum may be a better indicator of vitamin D health status than total 25(OH)D. The availability of a new enzyme-linked immunosorbent assay (ELISA) for the determination of free 25(OH)D provides a method for direct measurement of the low levels of non-protein bound 25(OH)D. As an initial step towards harmonization of measurements of free 25(OH)D, the ELISA was used to measure free 25(OH)D in three existing Standard Reference Materials (SRMs): SRM 972a Vitamin D Metabolites in Frozen Human Serum, SRM 2973 Vitamin D Metabolites in Frozen Human Serum (High Level), and SRM 1949 Frozen Prenatal Human Serum. Target values for free 25(OH)D in the nine SRM serum pools, obtained by combining the results from two laboratories, ranged from 3.76 ± 0.36 to 10.0 ± 0.58 pg/mL. Of particular significance is the assignment of free 25(OH)D target values to SRM 1949, which consists of four serum pools from non-pregnant female donors of reproductive age and pregnant women in each of the three trimesters and which also has values assigned for vitamin D binding protein, which increases during pregnancy. The availability of target values for free 25(OH)D in these SRMs will allow researchers to validate new analytical methods and to compare their results with other researchers as an initial step towards harmonization of measurements among different studies and laboratories.
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Wang J, Li X, Gan Y, Fan T, Yang J, Rao F, Yang J. Comparison of the Serum Total 25-Hydroxyvitamin D Concentrations Using Chemiluminescent Immunoassay and Liquid Chromatography-Tandem Mass Spectrometry in Children. J Nutr Sci Vitaminol (Tokyo) 2022; 68:181-188. [PMID: 35768249 DOI: 10.3177/jnsv.68.181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We aimed to assess the difference and agreement between the CL-series Vitamin D Total assay (Mindray), which was a kind of chemiluminescent immunoassay (CLIA) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) in the measurement of serum 25-hydroxyvitamin D [25(OH)D] concentrations in children. We compared the 25(OH)D concentrations of 92 children using the CLIA and LC-MS/MS. Paired samples t-test was used to compare the two groups. Linear regression was used to show the correlation between CLIA and LC-MS/MS. The difference and bias between 2 methods were revealed in Bland-Altman plot. Agreement in classification of deficiency between CLIA and LC-MS/MS was assessed using Cohen's Kappa. p value<0.05 was considered statistically significant. Using Shapiro-Wilk Test to assess whether the data follows a normal distribution. Using 95% children's serum 25(OH)D concentrations by LC-MS/MS as the reference interval. The regression equation was CLIA=1.185×LC-MS/MS-3.328. The fitness adjusted r2 was 0.589. The CLIA showed positive bias compared to LC-MS/MS, p<0.05, bias=(1.94±16.56) ng/mL. Cohen's Kappa=0.53, p<0.001. The agreement of 2 methods in diagnosing "deficiency" was good. According to Shapiro-Wilk Test, the data followed a normal distribution (W=0.99). The reference interval of children's serum 25(OH)D concentrations by LC-MS/MS was 11.35-44.57 ng/mL. In measuring 25(OH)D concentration of children, CLIA represented higher levels than LC-MS/MS. The two methods were consistent in diagnosing vitamin D deficiency. The reference interval of children's serum 25(OH)D concentrations by LC-MS/MS was 11.35-44.57 ng/mL in our area in summer.
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Affiliation(s)
- Jie Wang
- Department of Transfusion, The Affiliated Hospital of Southwest Medical University
| | | | - Yongyi Gan
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province.,Institute of Nuclear Medicine, Southwest Medical University
| | - Tianxing Fan
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province.,Institute of Nuclear Medicine, Southwest Medical University
| | - Jing Yang
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province.,Institute of Nuclear Medicine, Southwest Medical University
| | - Fang Rao
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province.,Institute of Nuclear Medicine, Southwest Medical University
| | - Jianbo Yang
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University.,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province.,Institute of Nuclear Medicine, Southwest Medical University
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18
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Alexandridou A, Schorr P, Stokes CS, Volmer DA. Analysis of vitamin D metabolic markers by mass spectrometry: Recent progress regarding the "gold standard" method and integration into clinical practice. MASS SPECTROMETRY REVIEWS 2021. [PMID: 34967037 DOI: 10.1002/mas.21768] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/03/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
Liquid chromatography/tandem mass spectrometry is firmly established today as the gold standard technique for analysis of vitamin D, both for vitamin D status assessments as well as for measuring complex and intricate vitamin D metabolic fingerprints. While the actual mass spectrometry technology has seen only incremental performance increases in recent years, there have been major, very impactful changes in the front- and back-end of MS-based vitamin D assays; for example, the extension to new types of biological sample matrices analyzed for an increasing number of different vitamin D metabolites, novel sample preparation techniques, new powerful chemical derivatization reagents, as well the continued integration of high resolution mass spectrometers into clinical laboratories, replacing established triple-quadrupole instruments. At the same time, the sustainability of mass spectrometry operation in the vitamin D field is now firmly established through proven analytical harmonization and standardization programs. The present review summarizes the most important of these recent developments.
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Affiliation(s)
| | - Pascal Schorr
- Department of Bioanalytical Chemistry, Humboldt University Berlin, Berlin, Germany
| | - Caroline S Stokes
- Food and Health Research Group, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Molecular Toxicology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
| | - Dietrich A Volmer
- Department of Bioanalytical Chemistry, Humboldt University Berlin, Berlin, Germany
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19
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Hsu S, Prince DK, Williams K, Allen NB, Burke GL, Hoofnagle AN, Li X, Liu KJ, McClelland RL, Michos ED, Psaty BM, Shea SJ, Rice KM, Rotter JI, Siscovick D, Tracy RP, Watson KE, Kestenbaum BR, de Boer IH. Clinical and biomarker modifiers of vitamin D treatment response: the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr 2021; 115:914-924. [PMID: 34849546 PMCID: PMC8895207 DOI: 10.1093/ajcn/nqab390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/19/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Different 25-hydroxyvitamin D [25(OH)D] thresholds for treatment with vitamin D supplementation have been suggested and are derived almost exclusively from observational studies. Whether other characteristics, including race/ethnicity, BMI, and estimated glomerular filtration rate (eGFR), should also influence the threshold for treatment is unknown. OBJECTIVES The aim was to identify clinical and biomarker characteristics that modify the response to vitamin D supplementation. METHODS A total of 666 older adults in the Multi-Ethnic Study of Atherosclerosis (MESA) were randomly assigned to 16 wk of oral vitamin D3 (2000 IU/d; n = 499) or placebo (n = 167). Primary outcomes were changes in serum parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D [1,25(OH)2D] concentrations from baseline to 16 wk. RESULTS Among 666 participants randomly assigned (mean age: 72 y; 53% female; 66% racial/ethnic minority), 611 (92%) completed the study. The mean (SD) change in PTH was -3 (16) pg/mL with vitamin D3 compared with 2 (18) pg/mL with placebo (estimated mean difference: -5; 95% CI: -8, -2 pg/mL). Within the vitamin D3 group, lower baseline 25-hydroxyvitamin D [25(OH)D] was associated with a larger decline in PTH in a nonlinear fashion. With baseline 25(OH)D ≥30 ng/mL as the reference, 25(OH)D <20 ng/mL was associated with a larger decline in PTH with vitamin D3 supplementation (-10; 95% CI: -15, -6 pg/mL), whereas 25(OH)D of 20-30 ng/mL was not (-2; 95% CI: -6, 1 pg/mL). A segmented threshold model identified a baseline 25(OH)D concentration of 21 (95% CI: 13, 31) ng/mL as an inflection point for difference in change in PTH. Race/ethnicity, BMI, and eGFR did not modify vitamin D treatment response. There was no significant change in 1,25(OH)2D in either treatment group. CONCLUSIONS Of characteristics most commonly associated with vitamin D metabolism, only baseline 25(OH)D <20 ng/mL modified the PTH response to vitamin D supplementation, providing support from a clinical trial to use this threshold to define insufficiency. This trial was registered at clinicaltrials.gov as NCT02925195.
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Affiliation(s)
- Simon Hsu
- Address correspondence to SH (E-mail: )
| | - David K Prince
- Division of Nephrology and Kidney Research Institute, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Kayleen Williams
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Norrina B Allen
- Department of Internal Medicine, Northwestern University, Chicago, IL, USA
| | - Gregory L Burke
- Division of Public Health Sciences Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Xiaohui Li
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Kiang J Liu
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | | | - Erin D Michos
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services, University of Washington, Seattle, WA, USA
| | - Steven J Shea
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Kenneth M Rice
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Jerome I Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | | | - Russell P Tracy
- Department of Biochemistry, University of Vermont, Burlington, VT, USA
| | - Karol E Watson
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Bryan R Kestenbaum
- Division of Nephrology and Kidney Research Institute, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Ian H de Boer
- Division of Nephrology and Kidney Research Institute, Department of Medicine, University of Washington, Seattle, WA, USA
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20
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Bater J, Bromage S, Jambal T, Tsendjav E, Lkhagvasuren E, Jutmann Y, Martineau AR, Ganmaa D. Prevalence and Determinants of Vitamin D Deficiency in 9595 Mongolian Schoolchildren: A Cross-Sectional Study. Nutrients 2021; 13:nu13114175. [PMID: 34836430 PMCID: PMC8625867 DOI: 10.3390/nu13114175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 02/04/2023] Open
Abstract
Population-based data relating to vitamin D status of children in Northeast Asia are lacking. We conducted a cross-sectional study to determine the prevalence and determinants of vitamin D deficiency in 9595 schoolchildren aged 6-13 years in Ulaanbaatar (UB), the capital city of Mongolia. Risk factors for vitamin D deficiency were collected by questionnaire, and serum 25-hydroxyvitamin D (25[OH]D) concentrations were measured using an enzyme-linked fluorescent assay, standardized and categorized as deficient (25[OH]D <10 ng/mL) or not. Odds ratios for associations between independent variables and risk of vitamin D deficiency were calculated using multivariate analysis with adjustment for potential confounders. The prevalence of vitamins D deficiency was 40.6% (95% CI 39.7% to 41.6%). It was independently associated with female gender (adjusted odds ratio [aOR] for girls vs. boys 1.23, 95% CI 1.11-1.35), month of sampling (aORs for December-February vs. June-November 5.28 [4.53-6.15], March-May vs. June-November 14.85 [12.46-17.74]), lower levels of parental education (P for trend <0.001), lower frequency of egg consumption (P for trend <0.001), active tuberculosis (aOR 1.40 [1.03-1.94]), household smoking (aOR 1.13 [1.02 to1.25]), and shorter time outdoors (P for trend <0.001). We report a very high prevalence of vitamin D deficiency among Mongolian schoolchildren, which requires addressing as a public health priority.
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Affiliation(s)
- Jorick Bater
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (S.B.); (D.G.)
- Correspondence: ; Tel.: +1-636-579-4312
| | - Sabri Bromage
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (S.B.); (D.G.)
| | - Tuyatsetseg Jambal
- T School of Industrial Technology, Mongolian University of Science & Technology, Ulaanbaatar 14210, Mongolia;
| | | | - Enkhsaikhan Lkhagvasuren
- Ministry of Health, Ulaanbaatar 14210, Mongolia;
- Department of Immunology, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia
| | - Yanjmaa Jutmann
- Department of Math and Statistics, University of North Carolina at Charlotte, Charlootte, NC 28223, USA;
| | - Adrian R. Martineau
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK;
| | - Davaasambuu Ganmaa
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (S.B.); (D.G.)
- Channing Division of Network Medicine, Department of Medicine, Brigham and Wome’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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21
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Brooks SPJ, Ratnayake WMN, Rondeau I, Swist E, Sarafin K, Weiler HA. Inadequate vitamin D status is associated with lower food plus supplemental intake of vitamin D in children of South Asian ethnicity living in the National Capital Region of Canada. Appl Physiol Nutr Metab 2021; 47:1-8. [PMID: 34516934 DOI: 10.1139/apnm-2021-0203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Vitamin D status, measured in a Vitamin D Standardization Program certified laboratory, was assessed among children of South Asian and European ethnicity living in the national capital region of Canada to explore factors that may account for inadequate status. Demographic information, dietary and supplemental vitamin D over 30 d prior to measurement of serum 25-hydroxyvitamin D (25OHD), and anthropometry were measured (age 6.0-18.9 y; n = 58/group; February-March 2015). No group related differences in age, height and body mass index (BMI) Z-scores or in food vitamin D intakes were observed. Standardized serum 25OHD was lower in South Asian children (mean ± SD: 39.0 ± 16.8 nmol/L vs. European: 58.4 ± 15.8 nmol/L). A greater proportion of South Asian children had serum 25OHD <40 nmol/L (56.9 vs. 8.6%, P < 0.0001) and fewer took supplements (31 vs. 50%, P = 0.0389). In a multi-factorial model (r2 = 0.54), lower vitamin D status was associated with overweight/obese BMI and older age (14-18 y); no interaction with ethnicity was observed. Lower vitamin D status was associated with lower total vitamin D intake only in South Asian children. This study reinforces the importance of public health actions towards meeting vitamin D intake recommendations among those of high-risk deficiency. Novelty: A higher proportion of South Asian vs. European children had inadequate vitamin D status. Lower vitamin D status was associated with a BMI in the overweight/obese range. Lower vitamin D status was associated with lower total vitamin D intake in South Asian but not European children.
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Affiliation(s)
- Stephen P J Brooks
- Bureau of Nutritional Sciences, Food Directorate, Health Canada, Ottawa, ON K1A 0L2, Canada
| | - W M Nimal Ratnayake
- Bureau of Nutritional Sciences, Food Directorate, Health Canada, Ottawa, ON K1A 0L2, Canada
| | - Isabelle Rondeau
- Bureau of Food Surveillance and Science Integration, Food Directorate, Health Canada, Ottawa, ON K1Y 0M1, Canada
| | - Eleonora Swist
- Bureau of Nutritional Sciences, Food Directorate, Health Canada, Ottawa, ON K1A 0L2, Canada
| | - Kurtis Sarafin
- Bureau of Nutritional Sciences, Food Directorate, Health Canada, Ottawa, ON K1A 0L2, Canada
| | - Hope A Weiler
- Bureau of Nutritional Sciences, Food Directorate, Health Canada, Ottawa, ON K1A 0L2, Canada
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22
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Al-Daghri NM, Hussain SD, Ansari MGA, Khattak MNK, Aljohani N, Al-Saleh Y, Al-Harbi MY, Sabico S, Alokail MS. Decreasing prevalence of vitamin D deficiency in the central region of Saudi Arabia (2008-2017). J Steroid Biochem Mol Biol 2021; 212:105920. [PMID: 34004334 DOI: 10.1016/j.jsbmb.2021.105920] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/05/2021] [Accepted: 05/04/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Widespread vitamin D deficiency (serum 25-hydroxyvitamin D < 50 nmol/L) in Saudi Arabia (SA) has been documented, yet a time trend is needed to establish where the prevalence is headed. This study aims to fill this gap. STUDY DESIGN AND SETTING This cross-sectional series (N = 7360) were conducted in the central region of SA from 2008 to 2017. Participants of all ages were taken from multiple cohorts that included the Biomarker Screening in Riyadh (2008-2010; N = 1460), the Osteoporosis Registry (2014-2017; N = 1225), Gestational Diabetes Mellitus cohort (2014-2017, N = 281), Vitamin D School Project (2011-2017; N = 3039) and Prediabetes cohort (2012-2017; N = 1355) master databases. RESULTS Vitamin D deficiency in SA has a 10-year prevalence of 73.2 %. Between 2008-2017, the prevalence of vitamin D deficiency decreased from 87.1% to 64.7% for participants aged 18-40 years (p-trend<0.001), and from 86.2% to 45.7% in participants aged > 40 years (p-trend<0.001). During this period, vitamin D deficiency in females decreased from 80.1% to 69.6% (p-trend<0.001), whereas in males, it decreased from 93.2% to 49.3% (p-trend<0.001). Serum 25(OH)D was observed to have an overall increase of 2.2 ± 0.1 nmol/l (p < 0.001) along with the seasonally adjusted annual increase of 1.3 ± 0.2 nmol/l from 2008 to 2017 (p < 0.001). CONCLUSION The decreasing trend in vitamin D deficiency in SA across all demographics suggests successful public health campaigns over time. It will be interesting to investigate further whether the general improvement in the vitamin D status at the community level also translated in lesser incidences of vitamin d-related diseases over time.
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Affiliation(s)
- Nasser M Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Riyadh Biochemistry Department, College of Science, King Saud University, 11451, Riyadh, Saudi Arabia.
| | - Syed Danish Hussain
- Chair for Biomarkers of Chronic Diseases, Riyadh Biochemistry Department, College of Science, King Saud University, 11451, Riyadh, Saudi Arabia
| | - Mohammed G A Ansari
- Chair for Biomarkers of Chronic Diseases, Riyadh Biochemistry Department, College of Science, King Saud University, 11451, Riyadh, Saudi Arabia
| | - Malak N K Khattak
- Chair for Biomarkers of Chronic Diseases, Riyadh Biochemistry Department, College of Science, King Saud University, 11451, Riyadh, Saudi Arabia
| | - Naji Aljohani
- Obesity, Endocrine and Metabolism Center, King Fahad Medical City, Faculty of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, 11525, Saudi Arabia
| | - Yousef Al-Saleh
- Chair for Biomarkers of Chronic Diseases, Riyadh Biochemistry Department, College of Science, King Saud University, 11451, Riyadh, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia; Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mohammed Y Al-Harbi
- Diabetes Centers and Units Administration, Ministry of Health, Riyadh, Saudi Arabia
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Riyadh Biochemistry Department, College of Science, King Saud University, 11451, Riyadh, Saudi Arabia
| | - Majed S Alokail
- Chair for Biomarkers of Chronic Diseases, Riyadh Biochemistry Department, College of Science, King Saud University, 11451, Riyadh, Saudi Arabia
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23
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Camara JE, Wise SA, Hoofnagle AN, Williams EL, Carter GD, Jones J, Burdette CQ, Hahm G, Nalin F, Kuszak AJ, Merkel J, Durazo-Arvizu RA, Lukas P, Cavalier É, Popp C, Beckert C, Schultess J, Van Slooten G, Tourneur C, Pease C, Kaul R, Villarreal A, Ivison F, Fischer R, van den Ouweland JMW, Ho CS, Law EWK, Simard JN, Gonthier R, Holmquist B, Batista MC, Pham H, Bennett A, Meadows S, Cox L, Jansen E, Khan DA, Robyak K, Creer MH, Kilbane M, Twomey PJ, Freeman J, Parker N, Yuan J, Fitzgerald R, Mushtaq S, Clarke MW, Breen N, Simpson C, Sempos CT. Assessment of serum total 25-hydroxyvitamin D assay commutability of Standard Reference Materials and College of American Pathologists Accuracy-Based Vitamin D (ABVD) Scheme and Vitamin D External Quality Assessment Scheme (DEQAS) materials: Vitamin D Standardization Program (VDSP) Commutability Study 2. Anal Bioanal Chem 2021; 413:5067-5084. [PMID: 34184102 PMCID: PMC8431775 DOI: 10.1007/s00216-021-03470-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/29/2021] [Accepted: 06/09/2021] [Indexed: 10/21/2022]
Abstract
An interlaboratory study was conducted through the Vitamin D Standardization Program (VDSP) to assess commutability of Standard Reference Materials® (SRMs) and proficiency testing/external quality assessment (PT/EQA) samples for determination of serum total 25-hydroxyvitamin D [25(OH)D] using ligand binding assays and liquid chromatography-tandem mass spectrometry (LC-MS/MS). A set of 50 single-donor serum samples were assigned target values for 25-hydroxyvitamin D2 [25(OH)D2] and 25-hydroxyvitamin D3 [25(OH)D3] using reference measurement procedures (RMPs). SRM and PT/EQA samples evaluated included SRM 972a (four levels), SRM 2973, six College of American Pathologists (CAP) Accuracy-Based Vitamin D (ABVD) samples, and nine Vitamin D External Quality Assessment Scheme (DEQAS) samples. Results were received from 28 different laboratories using 20 ligand binding assays and 14 LC-MS/MS methods. Using the test assay results for total serum 25(OH)D (i.e., the sum of 25(OH)D2 and 25(OH)D3) determined for the single-donor samples and the RMP target values, the linear regression and 95% prediction intervals (PIs) were calculated. Using a subset of 42 samples that had concentrations of 25(OH)D2 below 30 nmol/L, one or more of the SRM and PT/EQA samples with high concentrations of 25(OH)D2 were deemed non-commutable using 5 of 11 unique ligand binding assays. SRM 972a (level 4), which has high exogenous concentration of 3-epi-25(OH)D3, was deemed non-commutable for 50% of the LC-MS/MS assays.
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Affiliation(s)
- Johanna E Camara
- Chemical Sciences Division, National Institute of Standards and Technology (NIST), Gaithersburg, MD, 20899, USA
| | - Stephen A Wise
- Scientist Emeritus, National Institute of Standards and Technology (NIST), Gaithersburg, MD, 20899, USA.
- Office of Dietary Supplements (ODS), National Institutes of Health (NIH), Bethesda, MD, 20892, USA.
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, WA, 98185, USA
| | | | | | - Julia Jones
- Imperial Healthcare NHS Trust, London, W6 8RF, UK
| | - Carolyn Q Burdette
- Chemical Sciences Division, National Institute of Standards and Technology (NIST), Gaithersburg, MD, 20899, USA
| | - Grace Hahm
- Chemical Sciences Division, National Institute of Standards and Technology (NIST), Gaithersburg, MD, 20899, USA
| | - Federica Nalin
- Chemical Sciences Division, National Institute of Standards and Technology (NIST), Gaithersburg, MD, 20899, USA
| | - Adam J Kuszak
- Office of Dietary Supplements (ODS), National Institutes of Health (NIH), Bethesda, MD, 20892, USA
| | - Joyce Merkel
- Office of Dietary Supplements (ODS), National Institutes of Health (NIH), Bethesda, MD, 20892, USA
| | - Ramón A Durazo-Arvizu
- Biostatistics Core, The Sabin Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90027, USA
| | - Pierre Lukas
- Clinical Chemistry, University of Liège, CHU de Liège, 4000, Liège, Belgium
| | - Étienne Cavalier
- Clinical Chemistry, University of Liège, CHU de Liège, 4000, Liège, Belgium
| | - Christian Popp
- Abbott Laboratories, ADD Wiesbaden Abbott GmbH, 65205, Wiesbaden, Germany
| | - Christian Beckert
- Abbott Laboratories, ADD Wiesbaden Abbott GmbH, 65205, Wiesbaden, Germany
| | - Jan Schultess
- Abbott Laboratories, ADD Wiesbaden Abbott GmbH, 65205, Wiesbaden, Germany
| | | | | | | | - Ravi Kaul
- Clinical Diagnostics, Bio-Rad Laboratories, Clinical Diagnostics, Hercules, CA, 94547, USA
| | - Alfredo Villarreal
- Clinical Diagnostics, Bio-Rad Laboratories, Clinical Diagnostics, Hercules, CA, 94547, USA
| | - Fiona Ivison
- Central Manchester Foundation Trust, Manchester, M13 9WL, UK
| | - Ralf Fischer
- Chromsystems Instruments & Chemicals GmbH, 82166, Gräfelfing, Germany
| | | | - Chung S Ho
- Biomedical Mass Spectrometry Unit, Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, 999077, Hong Kong
| | - Emmett W K Law
- Biomedical Mass Spectrometry Unit, Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, 999077, Hong Kong
| | | | | | - Brett Holmquist
- LabCorp Specialty Testing Group, Endocrine Sciences, Agoura Hills, CA, 91301, USA
| | | | - Heather Pham
- Immunodiagnostic Systems (IDS), Boldon, NE35 9PD, UK
| | - Alex Bennett
- Immunodiagnostic Systems (IDS), Boldon, NE35 9PD, UK
| | - Sarah Meadows
- Medical Research Council (MRC) Elsie Widdowson Laboratory (closed Dec. 2018), Cambridge, CB2 0SL, UK
- NIHR BRC Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0SL, UK
| | - Lorna Cox
- Medical Research Council (MRC) Elsie Widdowson Laboratory (closed Dec. 2018), Cambridge, CB2 0SL, UK
- NIHR BRC Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0SL, UK
| | - Eugene Jansen
- National Institute of Public Health and the Environment (RIVM), 3720 BA, Bilthoven, The Netherlands
| | - Dilshad Ahmed Khan
- National University of Medical Sciences (NUMS), Rawalpindi, Punjab, 46000, Pakistan
| | - Kimberly Robyak
- College of Medicine, Penn State University, Hershey, PA, 17033, USA
| | - Michael H Creer
- College of Medicine, Penn State University, Hershey, PA, 17033, USA
| | - Mark Kilbane
- Clinical Chemistry, St. Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland
| | - Patrick J Twomey
- Clinical Chemistry, St. Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland
| | | | - Neil Parker
- Siemens-Healthineers, Tarrytown, NY, 10591, USA
| | - Jinyun Yuan
- SNIBE, Shenzhen, 518122, People's Republic of China
| | - Robert Fitzgerald
- University of California at San Diego, Health Clinical Laboratories, La Jolla, CA, 92093, USA
| | | | - Michael W Clarke
- Metabolomics Australia, Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Perth, WA, 6009, Australia
| | - Norma Breen
- Waters Technologies Ireland Ltd., Wexford, Y35 D431, Ireland
| | | | - Christopher T Sempos
- Office of Dietary Supplements (ODS), National Institutes of Health (NIH), Bethesda, MD, 20892, USA
- Vitamin D Standardization Program LLC, Havre de Grace, MD, 21078, USA
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Sempos CT, Durazo-Arvizu RA, Fischer PR, Munns CF, Pettifor JM, Thacher TD. Serum 25-hydroxyvitamin D requirements to prevent nutritional rickets in Nigerian children on a low-calcium diet-a multivariable reanalysis. Am J Clin Nutr 2021; 114:231-237. [PMID: 33742199 DOI: 10.1093/ajcn/nqab048] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 02/09/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Nutritional rickets is believed to result from the interaction of inadequate serum 25-hydroxyvitamin D [25(OH)D] concentration and dietary calcium intake, but this interaction has not been confirmed in children with rickets. Determining the vitamin D requirements to prevent nutritional rickets has been thwarted by inconsistent case definition, inadequate adjustment for calcium intake and other confounders, and 25(OH)D assay variability. OBJECTIVES To model the 25(OH)D concentration associated with nutritional rickets in calcium-deprived Nigerian children, adjusted for confounding factors, and develop a general approach to define vitamin D status while accounting for calcium intake. METHODS Logistic regression was used to model the association of serum 25(OH)D with having rickets adjusted for calcium intake in a reanalysis of a case-control study in Nigerian children. The matching variables age, sex, weight-for-age z score, and 4 additional significant variables were selected [religion, age began walking, phosphorus intake, and the 25(OH)D × calcium intake interaction] using a rigorous 7-step algorithm. RESULTS Cases had significantly (P < 0.0001) lower mean ± SD 25(OH)D than controls (33 ± 13 compared with 51 ± 16 nmol/L, respectively), whereas cases and controls had similarly (P = 0.81) low mean dietary calcium intakes (216 ± 88 and 213 ± 95 mg/d, respectively). There was a significant interaction between 25(OH)D and calcium intake [coefficient (95% CI): -0.0006 (-0.0009, -0.0002)]. Accordingly, as calcium intake increased from 130 to 300 mg/d, the adjusted odds of having rickets decreased dramatically with increasing 25(OH)D such that at 200 mg/d, the adjusted odds of having rickets at 47.5 nmol/L was 0.80, whereas it was 0.2 at 62.5 nmol/L. Moreover, at a calcium intake of 300 mg/d, the adjusted odds was 0.16 at a 25(OH)D concentration of 47.5 nmol/L and 0.02 at 62.5 nmol/L. CONCLUSIONS The vitamin D requirement to prevent nutritional rickets varies inversely with calcium intake and vice versa. Also, application of multivariable modeling is essential in defining vitamin D requirements.
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Affiliation(s)
| | - Ramón A Durazo-Arvizu
- Biostatistical Core, The Sabin Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Philip R Fischer
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.,Pediatrics Department, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Craig F Munns
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - John M Pettifor
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Tom D Thacher
- Department of Family Medicine, Mayo Clinic, Rochester, MN, USA
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Makris K, Bhattoa HP, Cavalier E, Phinney K, Sempos CT, Ulmer CZ, Vasikaran SD, Vesper H, Heijboer AC. Recommendations on the measurement and the clinical use of vitamin D metabolites and vitamin D binding protein - A position paper from the IFCC Committee on bone metabolism. Clin Chim Acta 2021; 517:171-197. [PMID: 33713690 DOI: 10.1016/j.cca.2021.03.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/10/2021] [Accepted: 03/04/2021] [Indexed: 02/08/2023]
Abstract
Vitamin D, an important hormone with a central role in calcium and phosphate homeostasis, is required for bone and muscle development as well as preservation of musculoskeletal function. The most abundant vitamin D metabolite is 25-hydroxyvitamin D [25(OH)D], which is currently considered the best marker to evaluate overall vitamin D status. 25(OH)D is therefore the most commonly measured metabolite in clinical practice. However, several other metabolites, although not broadly measured, are useful in certain clinical situations. Vitamin D and all its metabolites are circulating in blood bound to vitamin D binding protein, (VDBP). This highly polymorphic protein is not only the major transport protein which, along with albumin, binds over 99% of the circulating vitamin D metabolites, but also participates in the transport of the 25(OH)D into the cell via a megalin/cubilin complex. The accurate measurement of 25(OH)D has proved a difficult task. Although a reference method and standardization program are available for 25(OH)D, the other vitamin D metabolites still lack this. Interpretation of results, creation of clinical supplementation, and generation of therapeutic guidelines require not only accurate measurements of vitamin D metabolites, but also the accurate measurements of several other "molecules" related with bone metabolism. IFCC understood this priority and a committee has been established with the task to support and continue the standardization processes of vitamin D metabolites along with other bone-related biomarkers. In this review, we present the position of this IFCC Committee on Bone Metabolism on the latest developments concerning the measurement and standardization of vitamin D metabolites and its binding protein, as well as clinical indications for their measurement and interpretation of the results.
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Affiliation(s)
- Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, 14561 Athens, Greece; Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", Medical School, University of Athens, Athens, Greece.
| | - Harjit P Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU de Liège, Domaine du Sart-Tilman, B-4000 Liège, Belgium
| | - Karen Phinney
- Biomolecular Measurement Division, National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - Christopher T Sempos
- Coordinator, Vitamin D Standardization Program (VDSP), Havre de Grace, MD 21078, USA
| | - Candice Z Ulmer
- Clinical Chemistry Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Samuel D Vasikaran
- PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Hubert Vesper
- Clinical Chemistry Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Annemieke C Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam Gastroenterology Endocrinology & Metabolism, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
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Cavalier E, Fraser CG, Bhattoa HP, Heijboer AC, Makris K, Ulmer CZ, Vesper HW, Vasikaran S, Lukas P, Delanaye P, Carobene A. Analytical Performance Specifications for 25-Hydroxyvitamin D Examinations. Nutrients 2021; 13:431. [PMID: 33525653 PMCID: PMC7911223 DOI: 10.3390/nu13020431] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 12/21/2022] Open
Abstract
Currently the 25-hydroxy vitamin D (25(OH)D) concentration is thought to be the best estimate of the vitamin D status of an individual. Unfortunately, its measurement remains complex, despite recent technological advances. We evaluated the biological variation (BV) of 25(OH)D in order to set analytical performance specifications (APS) for measurement uncertainty (MU). Six European laboratories recruited 91 healthy participants. The 25(OH)D concentrations in K3-EDTA plasma were examined weekly for up to 10 weeks in duplicate on a Lumipulse G1200 (Fujirebio, Tokyo, Japan). The linear regression of the mean 25(OH)D concentrations at each blood collection showed that participants were not in a steady state. The dissection of the 10-sample collection into two subsets, namely collections 1-5 and 6-10, did not allow for correction of the lack of homogeneity: estimates of the within-subject BV ranged from 5.8% to 7.1% and the between-subject BV ranged from 25.0% to 39.2%. Methods that would differentiate a difference induced by 25(OH)D supplementation at p < 0.05 should have MU < 13.6%, while at p < 0.01, the MU should be <9.6%. The development of APS using BV assumes a steady state of patients. The findings in this study suggest that patients are not in steady state. Therefore, APS that are based on MU appear to be more appropriate.
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Affiliation(s)
- Etienne Cavalier
- CHU de Liège and Centre de Recherche Intégré sur les Médicaments (CIRM), Department of Clinical Chemistry, University of Liège, Domaine du Sart-Tilman, B-4000 Liège, Belgium;
| | - Callum G. Fraser
- Centre for Research into Cancer Prevention and Screening, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK;
| | - Harjit P. Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary;
| | - Annemieke C. Heijboer
- Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam Gastroenterology & Metabolism, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam UMC, 1081 HVAmsterdam, The Netherlands;
| | - Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, GR-14561 Athens, Greece;
| | - Candice Z. Ulmer
- National Center for Environmental Health, Centers for Disease Control and Prevention, Division of Laboratory Sciences, Atlanta, GA 30329, USA; (C.Z.U.); (H.W.V.)
| | - Hubert W. Vesper
- National Center for Environmental Health, Centers for Disease Control and Prevention, Division of Laboratory Sciences, Atlanta, GA 30329, USA; (C.Z.U.); (H.W.V.)
| | - Samuel Vasikaran
- PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch 6150, Australia;
| | - Pierre Lukas
- CHU de Liège and Centre de Recherche Intégré sur les Médicaments (CIRM), Department of Clinical Chemistry, University of Liège, Domaine du Sart-Tilman, B-4000 Liège, Belgium;
| | - Pierre Delanaye
- Department of Nephrology, Dialysis and Transplantation, University of Liege, CHU de Liege, B-4000 Liège, Belgium;
- Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Caremeau, 30900 Nîmes, France
| | - Anna Carobene
- Laboratory Medicine, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
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Sempos CT, Tian L. Adjusting Coronavirus Prevalence Estimates for Laboratory Test Kit Error. Am J Epidemiol 2021; 190:109-115. [PMID: 32803245 PMCID: PMC7454308 DOI: 10.1093/aje/kwaa174] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 08/07/2020] [Accepted: 08/12/2020] [Indexed: 02/07/2023] Open
Abstract
Testing representative populations to determine the prevalence or the percentage of the population with active severe acute respiratory syndrome coronavirus 2 infection and/or antibodies to infection is being recommended as essential for making public policy decisions to ease restrictions or to continue enforcing national, state, and local government rules to shelter in place. However, all laboratory tests are imperfect and have estimates of sensitivity and specificity less than 100%-in some cases, considerably less than 100%. That error will lead to biased prevalence estimates. If the true prevalence is low, possibly in the range of 1%-5%, then testing error will lead to a constant background of bias that most likely will be larger, and possibly much larger, than the true prevalence itself. As a result, what is needed is a method for adjusting prevalence estimates for testing error. Methods are outlined in this article for adjusting prevalence estimates for testing error both prospectively in studies being planned and retrospectively in studies that have been conducted. If used, these methods also would help harmonize study results within countries and worldwide. Adjustment can lead to more accurate prevalence estimates and to better policy decisions. However, adjustment will not improve the accuracy of an individual test.
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Affiliation(s)
- Christopher T Sempos
- Correspondence to: Dr. Christopher T. Sempos, Vitamin D Standardization Program, 520 Ferdinand Drive, Havre de Grace, MD 21078 ()
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Windrichova J, Broz P, Fuchsova R, Topolcan O, Pecen L, Mayer O, Kucera R. Comparison of four routinely used vitamin D automated immunoassays. J Med Biochem 2021; 40:277-285. [PMID: 34177372 PMCID: PMC8199437 DOI: 10.5937/jomb0-27531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 11/05/2020] [Indexed: 11/09/2022] Open
Abstract
Background To compare four automated immunoassays for the measurement of 25(OH)-vitamin D (25-OHD) and to assess the impact on the results obtained from a healthy population. Methods We analysed 100 serum samples on Unicel DxI 800 (Beckman Coulter), Architect i1000 (Abbott), Cobas e411 (Roche) and Liaison XL (DiaSorin). Passing-Bablok regression and Bland-Altman plots were used for method comparison. In order to categorise the obtained values, results were categorised into the following groups: 0-25 nmol/L, 25-50 nmol/L, 50-75 nmol/L and above 75 nmol/L and compared. The percentage of samples below 75 nmol/L, and below 50 nmol/L was then calculated for every method. Results According to paired comparisons, each method differs from others (p<0.0001) except Cobas vs Architect, which do not show a statistically significant difference (p=0.39). The strongest correlation was found between Liaison and Architect (ρ=0.94, p<0.0001). The percentage of samples below the recommended value of 75 nmol/L were: 70% (Architect), 92% (Liaison), 71% (Cobas) and 89% (Unicel). The percentage of samples below the value of 50 nmol/L were: 17% (Architect), 55% (Liaison), 28% (Cobas) and 47% (Unicel). Conclusions The observed differences stem from the use of different analytical systems for 25-OHD concentration analysis and can result in different outcomes. The recommended values should be established for each assay in accordance with the data provided by the manufacturer or in the laboratory, in accordance with proper standardisation.
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Affiliation(s)
- Jindra Windrichova
- University Hospital Pilsen, Department of Immunochemistry Diagnostics, Czech Republic
| | - Pavel Broz
- University Hospital Pilsen, Department of Immunochemistry Diagnostics, Czech Republic
| | - Radka Fuchsova
- University Hospital Pilsen, Institute of Clinical Biochemistry and Hematology, Czech Republic
| | - Ondrej Topolcan
- University Hospital Pilsen, Department of Immunochemistry Diagnostics, Czech Republic
| | - Ladislav Pecen
- University Hospital Pilsen, Department of Immunochemistry Diagnostics, Czech Republic
| | - Otto Mayer
- University Hospital Pilsen, Second Internal Clinic, Czech Republic
| | - Radek Kucera
- University Hospital Pilsen, Department of Immunochemistry Diagnostics, Czech Republic
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Ganmaa D, Uyanga B, Zhou X, Gantsetseg G, Delgerekh B, Enkhmaa D, Khulan D, Ariunzaya S, Sumiya E, Bolortuya B, Yanjmaa J, Enkhtsetseg T, Munkhzaya A, Tunsag M, Khudyakov P, Seddon JA, Marais BJ, Batbayar O, Erdenetuya G, Amarsaikhan B, Spiegelman D, Tsolmon J, Martineau AR. Vitamin D Supplements for Prevention of Tuberculosis Infection and Disease. N Engl J Med 2020; 383:359-368. [PMID: 32706534 PMCID: PMC7476371 DOI: 10.1056/nejmoa1915176] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Vitamin D metabolites support innate immune responses to Mycobacterium tuberculosis. Data from phase 3, randomized, controlled trials of vitamin D supplementation to prevent tuberculosis infection are lacking. METHODS We randomly assigned children who had negative results for M. tuberculosis infection according to the QuantiFERON-TB Gold In-Tube assay (QFT) to receive a weekly oral dose of either 14,000 IU of vitamin D3 or placebo for 3 years. The primary outcome was a positive QFT result at the 3-year follow-up, expressed as a proportion of children. Secondary outcomes included the serum 25-hydroxyvitamin D (25[OH]D) level at the end of the trial and the incidence of tuberculosis disease, acute respiratory infection, and adverse events. RESULTS A total of 8851 children underwent randomization: 4418 were assigned to the vitamin D group, and 4433 to the placebo group; 95.6% of children had a baseline serum 25(OH)D level of less than 20 ng per milliliter. Among children with a valid QFT result at the end of the trial, the percentage with a positive result was 3.6% (147 of 4074 children) in the vitamin D group and 3.3% (134 of 4043) in the placebo group (adjusted risk ratio, 1.10; 95% confidence interval [CI], 0.87 to 1.38; P = 0.42). The mean 25(OH)D level at the end of the trial was 31.0 ng per milliliter in the vitamin D group and 10.7 ng per milliliter in the placebo group (mean between-group difference, 20.3 ng per milliliter; 95% CI, 19.9 to 20.6). Tuberculosis disease was diagnosed in 21 children in the vitamin D group and in 25 children in the placebo group (adjusted risk ratio, 0.87; 95% CI, 0.49 to 1.55). A total of 29 children in the vitamin D group and 34 in the placebo group were hospitalized for treatment of acute respiratory infection (adjusted risk ratio, 0.86; 95% CI, 0.52 to 1.40). The incidence of adverse events did not differ significantly between the two groups. CONCLUSIONS Vitamin D supplementation did not result in a lower risk of tuberculosis infection, tuberculosis disease, or acute respiratory infection than placebo among vitamin D-deficient schoolchildren in Mongolia. (Funded by the National Institutes of Health; ClinicalTrials.gov number, NCT02276755.).
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Affiliation(s)
- Davaasambuu Ganmaa
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Buyanjargal Uyanga
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Xin Zhou
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Garmaa Gantsetseg
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Baigali Delgerekh
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Davaasambuu Enkhmaa
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Dorjnamjil Khulan
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Saranjav Ariunzaya
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Erdenebaatar Sumiya
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Batbileg Bolortuya
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Jutmaan Yanjmaa
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Tserenkhuu Enkhtsetseg
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Ankhbat Munkhzaya
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Murneren Tunsag
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Polyna Khudyakov
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - James A Seddon
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Ben J Marais
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Ochirbat Batbayar
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Ganbaatar Erdenetuya
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Bazarsaikhan Amarsaikhan
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Donna Spiegelman
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Jadambaa Tsolmon
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
| | - Adrian R Martineau
- From the Harvard T.H. Chan School of Public Health (D.G., P.K., D.S.) and the Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School (D.G.) - all in Boston; the Mongolian Health Initiative (D.G., B.U., G.G., D.E., D.K., S.A., E.S., B.B., J.Y., T.E., O.B.) and Global Laboratory (B.D., A.M.), Royal Plaza, Bayanzurkh District, the National Center for Communicable Diseases (M.T.), and the Mongolian National University of Medical Sciences (G.E., B.A., J.T.) - all in Ulaanbaatar, Mongolia; Yale School of Public Health, New Haven, CT (X.Z., D.S.); the Faculty of Medicine, Imperial College (J.A.S.), and the Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London (A.R.M.) - all in London; the Desmond Tutu Tuberculosis Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa (J.A.S.); and the Faculty of Medicine and Health, University of Sydney, Sydney (B.J.M.)
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Makris K, Sempos C, Cavalier E. The measurement of vitamin D metabolites: part I-metabolism of vitamin D and the measurement of 25-hydroxyvitamin D. Hormones (Athens) 2020; 19:81-96. [PMID: 31919677 DOI: 10.1007/s42000-019-00169-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022]
Abstract
It has been more than 80 years since the discovery of vitamin D and its ability to cure rickets in children. Vitamin D is a secosteroid and comes in two distinct forms, vitamin D2 and vitamin D3. During the last 40 years, the synthesis and metabolism of vitamin D were elucidated and more than 50 metabolites of vitamin D have been discovered, though commercial measurement procedures have been developed for only a few of them. The clinical significance of vitamin D in calcium and phosphorus homeostasis is well appreciated. However, recent epidemiological data have indicated that it has several extra-skeletal physiologic actions which are still a matter of scientific debate. Both research findings and the debate around the interpretation of the research results have created increased interest in more measurements of vitamin D. With the ever growing family of measurable vitamin D metabolites and the measuring techniques comes a question: What metabolic product will provide the right answers and which is the best way to measure it. The right choice of analytical technique is connected with the question of which metabolite we aim to measure, what is its serum concentration, and the purpose of the measurement. The aim of the first part of this review is to provide a brief overview of vitamin D metabolism and a more detailed analysis of the existing methods and the status of standardization for the measurement of 25-hydroxyvitamin D.
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Affiliation(s)
- Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, Kifissia, Athens, Greece.
| | - Christopher Sempos
- Vitamin D Standardization Program (VDSP), Havre de Grace, MD, 21078, USA
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liege, CHU de Liege, Liege, Belgium
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Vitamin D testing: advantages and limits of the current assays. Eur J Clin Nutr 2020; 74:231-247. [DOI: 10.1038/s41430-019-0553-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 12/25/2022]
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Durazo-Arvizu RA, Pacheco-Dominguez RL, Sempos CT, Kramer H, Hoofnagle AN, Pirzada A, Cooper RS, Daviglus ML. The Association between Cardiovascular Disease Risk Factors and 25-Hydroxivitamin D and Related Analytes among Hispanic/Latino Adults: A Pilot Study. Nutrients 2019; 11:E1959. [PMID: 31434350 PMCID: PMC6723220 DOI: 10.3390/nu11081959] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 12/18/2022] Open
Abstract
Although the association of vitamin D levels with cardiovascular risk profiles among Hispanics/Latinos has been studied, little is known about this association among Hispanics/Latinos with chronic conditions. This pilot study determined serum vitamin D and parathyroid hormone (PTH) levels in a sample of participants from the University of Illinois at the Chicago Cohort of Patients, Family and Friends (UIC Cohort) and examined their association with traditional cardiovascular disease risk factors. From July 2012 to June 2016, the UIC Cohort study enrolled and conducted clinical examinations on men and women ages 18 years and older, who had one or more diagnosed chronic diseases/conditions (excluding cancer). This pilot study sample included 40 participants from the six main Hispanic/Latino background groups in the United States, namely Dominican, Cuban, Puerto Rican, Mexican, Central American, and South American, and were grouped by Caribbean or mainland origin. No substantial differences were noted in the vitamin D-related measures by Hispanic/Latino background, but the PTH levels were somewhat higher in the Caribbean vs. mainland group (43.0 ± 4.6 vs. 38.6 ± 2.7 pg/mL). The associations between selected CVD risk factors (systolic and diastolic blood pressure (SBP, DBP), total cholesterol, glucose) and PTH and vitamin D-related analytes were investigated using interval-censored multivariate regression models adjusted for age, sex, percent body fat, serum albumin/calcium, and Hispanic/Latino background. A negative association between total 25[OH]D and blood pressure was corroborated (SBP: β = -1.2, 95%CI = -2.0, -0.3; DBP: β = -0.7, 95% CI = -1.2, -0.1), whereas a positive association with total cholesterol was observed (β = 1.9, 95% CI = 0.02, 3.7). Levels of 1, 25[OH]2D were not associated with CVD risk factors, whereas 24, 25[OH]2D3 was associated with blood pressure (SBP: β = -13.0, 95% CI = -20.7, -5.2; DBP: β = -6.3, 95% CI = -11.6, -1.0). Estimated free 25[OH]D was inversely associated with both SBP (β = -3.5, 95% CI = -6.1, -0.9) and DBP (β = -2.1, 95% CI = -3.8, -0.3). Similarly, calculated bioavailable 25[OH]D was inversely associated with both SBP (β = -9.2, 95% CI = -15.9, -2.4) and DBP(β = -5.3, 95% CI = -9.8, -0.8). In conclusion, a negative association between 25[OH]D with BP was observed and a positive association with lipids is suggested. Due to the small sample size, most associations did not reach statistical significance.
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Affiliation(s)
- Ramon A Durazo-Arvizu
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL 60153, USA.
| | - Reyna L Pacheco-Dominguez
- Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, México City 04510, Mexico
| | - Christopher T Sempos
- Vitamin D Standardization Program (VDSP), 520 Ferdinand Dr, Havre de Grace, MD 21078, USA
| | - Holly Kramer
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL 60153, USA
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine, Washington University School of Medicine, Seattle, WA 98185, USA
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Richard S Cooper
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL 60153, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL 60612, USA
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Ganmaa D, Khudyakov P, Buyanjargal U, Jargalsaikhan B, Baigal D, Munkhjargal O, Yansan N, Bolormaa S, Lkhagvasuren E, Sempos CT, Bromage S, Wu Z, Ochirbat B, Gunchin B, Martineau AR. Prevalence and Determinants of QuantiFERON-Diagnosed Tuberculosis Infection in 9810 Mongolian Schoolchildren. Clin Infect Dis 2019; 69:813-819. [PMID: 30481273 PMCID: PMC6695506 DOI: 10.1093/cid/ciy975] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 11/26/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND There is controversy regarding the potential influence of vitamin D deficiency, exposure to environmental tobacco smoke, BCG vaccination, season, and body habitus on susceptibility to Mycobacterium tuberculosis (MTB) infection. METHODS We conducted a cross-sectional analysis to identify determinants of a positive QuantiFERON-TB Gold (QFT) assay result in children aged 6-13 years attending 18 schools in Ulaanbaatar, Mongolia. Data relating to potential risk factors for MTB infection were collected by questionnaire, physical examination, and determination of serum 25-hydroxyvitamin D (25[OH]D) concentrations. Risk ratios (RRs) were calculated with adjustment for potential confounders, and population attributable fractions (PAFs) were calculated for modifiable risk factors identified. RESULTS Nine hundred forty-six of 9810 (9.6%) participants had a positive QFT result. QFT positivity was independently associated with household exposure to pulmonary tuberculosis (adjusted RR [aRR], 4.75 [95% confidence interval {CI}, 4.13-5.46, P < .001]; PAF, 13.1% [95% CI, 11.1%-15.0%]), vitamin D deficiency (aRR, 1.23 [95% CI, 1.08-1.40], P = .002; PAF, 5.7% [95% CI, 1.9%-9.3%]), exposure to environmental tobacco smoke (1 indoor smoker, aRR, 1.19 [95% CI, 1.04-1.35]; ≥2 indoor smokers, aRR, 1.30 [95% CI, 1.02-1.64]; P for trend = .006; PAF, 7.2% [95% CI, 2.2%-12.0%]), and increasing age (aRR per additional year, 1.14 [95% CI, 1.10-1.19], P < .001). No statistically significant independent association was seen for presence of a BCG scar, season of sampling, or body mass index. CONCLUSIONS Vitamin D deficiency and exposure to environmental tobacco smoke are potentially modifiable risk factors for MTB infection.
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Affiliation(s)
- Davaasambuu Ganmaa
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Mongolian Health Initiative, Ulaanbaatar
| | - Polyna Khudyakov
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Uyanga Buyanjargal
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland
| | | | | | | | | | | | - Enkhsaikhan Lkhagvasuren
- Mongolian Health Initiative, Ulaanbaatar
- Mongolian National Health Sciences University, Ulaanbaatar
| | - Christopher T Sempos
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland
| | | | - Zhenqiang Wu
- School of Population Health, University of Auckland, New Zealand
| | | | - Batbaatar Gunchin
- Mongolian Health Initiative, Ulaanbaatar
- Mongolian National Health Sciences University, Ulaanbaatar
| | - Adrian R Martineau
- Blizard Institute, Barts and London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
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Pitarch-Motellón J, Roig-Navarro AF, Le Goff C, Cavalier E, Fabregat-Cabello N. Re-certification of hydroxyvitamin D standards by isotope pattern deconvolution. J Chromatogr B Analyt Technol Biomed Life Sci 2019; 1120:89-94. [PMID: 31071583 DOI: 10.1016/j.jchromb.2019.04.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/01/2019] [Accepted: 04/21/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Vitamin D testing in analytical clinical laboratories has been experiencing a rapid increase of demand over the last years, as it plays a key role in several disorders. Due to the narrow ranges of medical significance regarding its concentration levels in human serum, accurate and precise determinations of vitamin D metabolites are required. METHODS We present an isotope dilution mass spectrometry quantification method for the re-certification of routine commercial standards used in method validation steps, isotope pattern deconvolution (IPD) based on LC-MS/MS. RESULTS IPD allowed to compensate for the observed biases of +4.7% for 25(OH)D3, -29% for 25(OH)D2 and -30% for 24,25(OH)2D3 standard concentrations, respectively in an easy, cheap and straightforward way. CONCLUSIONS Is has been observed that, in some cases, discrepancies may exist between stated purity or amount of routinely used commercial standards and actual values, which would lead to unwanted bias in the developed methodologies. The present correction has helped meeting the regulations established by international standardization programs, including Vitamin D Standardization Program (VDSP).
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Affiliation(s)
- J Pitarch-Motellón
- Research Institute for Pesticides and Water, Universitat Jaume I, Castelló, Spain
| | - A F Roig-Navarro
- Research Institute for Pesticides and Water, Universitat Jaume I, Castelló, Spain
| | - C Le Goff
- Department of Clinical Chemistry, University of Liège, CHU Sart-Tilman, Liège, Belgium
| | - E Cavalier
- Department of Clinical Chemistry, University of Liège, CHU Sart-Tilman, Liège, Belgium
| | - N Fabregat-Cabello
- Department of Clinical Chemistry, University of Liège, CHU Sart-Tilman, Liège, Belgium.
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Ganmaa D, Khudyakov P, Buyanjargal U, Baigal D, Baatar M, Enkhamgalan N, Erdenebaatar S, Ochirbat B, Burneebaatar B, Purevdorj E, Purevsuren Y, Garmaa G, Ganbaatar E, Martineau AR. Risk factors for active tuberculosis in 938 QuantiFERON-positive schoolchildren in Mongolia: a community-based cross-sectional study. BMC Infect Dis 2019; 19:532. [PMID: 31208362 PMCID: PMC6580591 DOI: 10.1186/s12879-019-4160-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 06/04/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND There is controversy regarding the relative influence of 'exogenous' versus 'endogenous' factors on the risk of progression from latent tuberculosis infection to active tuberculosis (TB) disease in children. METHODS We conducted a cross-sectional analysis to identify risk factors for active tuberculosis in QuantiFERON®-TB Gold (QFT-G)-positive children aged 6-13 years attending 18 schools in Ulaanbaatar, Mongolia. Children underwent clinical and radiological screening for active tuberculosis, and data relating to potential risk factors for disease progression were collected by questionnaire and determination of serum 25-hydroxyvitamin D (25[OH]D) concentrations. Risk ratios were calculated using generalized estimating equations with adjustment for potential confounders. RESULTS 129/938 (13.8%) QFT-positive children were diagnosed with active tuberculosis. Risk of active tuberculosis was independently associated with household exposure to pulmonary TB (adjusted risk ratio [aRR] 2.40, 95% CI 1.74 to 3.30, P < 0.001), month of sampling (adjusted risk ratio [aRR] for March-May vs. June-November 3.31, 95% CI 1.63 to 6.74, P < 0.001; aRR for December-February vs. June-November 2.53, 95% CI 1.23 to 5.19, P = 0.01) and active smoking by the child (aRR 5.23, 95% CI 2.70 to 10.12, P < 0.001). No statistically significant independent association was seen for age, sex, socio-economic factors, presence of a Bacillus Calmette-Guérin (BCG) scar, tobacco exposure or vitamin D status. CONCLUSIONS Household exposure to active TB, winter or spring season and active smoking were independently associated with risk of active tuberculosis in QFT-positive children. Our findings highlight the potentially high yield of screening child household contacts of infectious index cases for active tuberculosis in low- and middle-income countries.
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Affiliation(s)
- Davaasambuu Ganmaa
- Harvard T.H. Chan School of Public Health, Building 2, Room 211, 655 Huntington Ave, Boston, MA 02115 USA
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar, Mongolia
| | - Polyna Khudyakov
- Harvard T.H. Chan School of Public Health, Building 2, Room 211, 655 Huntington Ave, Boston, MA 02115 USA
| | - Uyanga Buyanjargal
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar, Mongolia
| | - Delgerekh Baigal
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar, Mongolia
| | - Munkhzul Baatar
- National Center for Communicable Disease, Ulaanbaatar, Mongolia
| | - Nomin Enkhamgalan
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar, Mongolia
| | - Sumiya Erdenebaatar
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar, Mongolia
| | - Batbayar Ochirbat
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar, Mongolia
| | | | | | | | - Gantsetseg Garmaa
- Mongolian Health Initiative, Royal Plaza, Bayanzurkh District, Ulaanbaatar, Mongolia
| | | | - Adrian R. Martineau
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, E1 2AB, London, UK
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Cavalier E, Sagou Yayo E, Attoungbre-Hauhouot ML, Konan JL, Yao-Yapo C, Monnet D, Gnionsahé A, Souberbielle JC, Delanaye P. Vitamin D, bone alkaline phosphatase and parathyroid hormone in healthy subjects and haemodialysed patients from West Africa: impact of reference ranges and parathyroid hormone generation assays on the KDIGO guidelines. Clin Kidney J 2019; 12:288-293. [PMID: 30976410 PMCID: PMC6452202 DOI: 10.1093/ckj/sfy074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend targets based on multiples of the upper limit of normal (ULN) of parathyroid hormone (PTH) concentration. However, the ULN has not always been correctly established by manufacturers. While it is known that the ULN is supposed to be higher in African Americans than in Caucasians, it is largely unknown in Africans. METHODS We established the ULN of PTH concentration in a population of 240 healthy Ivorians using second- and third-generation PTH assays before and after supplementation with 100 000 IU of cholecalferol. We measured the levels of PTH, bone alkaline phosphatase, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D in 100 haemodialysed Ivorian patients. RESULTS The prevalence of vitamin D deficiency in Ivory Coast is low. The ULN obtained using the third-generation PTH assay was similar to that obtained in Caucasians but was higher when PTH was measured using the second-generation PTH assay. According to the KDIGO guidelines, ∼20% of the haemodialysed patients were below twice the ULN and 30% were above nine times the ULN. Approximately 25% of the patients were even >12 times the ULN. We observed a discrepancy in the results between the two PTH assays (14%) that was relatively more important than what we observed from previous studies in Caucasians using the same strategy. CONCLUSIONS We found a low prevalence of vitamin D deficiency in a tropical country like Ivory Coast. We also established the PTH reference range, which could prove useful for the follow-up of haemodialysed patients, particularly for the large number of patients suffering from secondary hyperparathyroidism who are at high risk of adverse bone events.
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Affiliation(s)
- Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU de Liège, Liège, Belgium
| | - Eric Sagou Yayo
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
- Service d’Hémodialyse Publique de Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Marie-Laure Attoungbre-Hauhouot
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
- Service d’Hémodialyse Publique de Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Institut de Cardiologie d’Abidjan, Abidjan, Côte d’Ivoire
| | - Jean-Louis Konan
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
- Service d’Hémodialyse Publique de Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Institut de Cardiologie d’Abidjan, Abidjan, Côte d’Ivoire
| | - Carine Yao-Yapo
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
- Service d’Hémodialyse Publique de Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Dagui Monnet
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
| | - Appolinaire Gnionsahé
- Service d’Hémodialyse Publique de Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Institut de Cardiologie d’Abidjan, Abidjan, Côte d’Ivoire
- Département de Néphrologie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
| | | | - Pierre Delanaye
- Department of Nephrology, Dialysis and Transplantation, University of Liège, CHU de Liège, Liège, Belgium
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French CB, McDonnell SL, Vieth R. 25-Hydroxyvitamin D variability within-person due to diurnal rhythm and illness: a case report. J Med Case Rep 2019; 13:29. [PMID: 30712514 PMCID: PMC6360762 DOI: 10.1186/s13256-018-1948-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 12/10/2018] [Indexed: 11/17/2022] Open
Abstract
Background Vitamin D nutrition research requires accurate measures of circulating 25-hydroxyvitamin D. Our objectives were to test whether a diurnal fluctuation in blood-spot concentrations of 25-hydroxyvitamin D can be demonstrated statistically in a single individual, and whether such fluctuation is affected by the pre-dose versus post-dose timing of the blood draw. Case presentation The participant in this case study was a generally healthy Caucasian woman in her 40s who has taken 5000 IU vitamin D3 supplement at midday for over 1 year. Each blood sample was drawn individually from a finger prick onto filter paper at morning, midday, or night, on 4 days (three groups of five individual blood samples per collection day). On days 1 and 2, the midday samples were collected approximately 1 hour after the supplement was taken; on days 3 and 4, the midday samples were collected within an hour prior to supplementation (the classical, daily “trough” value for a drug). There was a significant daily pattern of variation in 25-hydroxyvitamin D concentrations (analysis of variance p ≤ 0.02 for 3 of the 4 days): peak midday mean 25-hydroxyvitamin D was approximately 20% higher than in the morning, and approximately 13% higher than in the evening. Trough sampling produced no significant difference in 25-hydroxyvitamin D compared to sampling an hour after the dose. An incidental finding was that acute illness during the study was related to acutely lower 25-hydroxyvitamin D at every sampling time in the day (p < 0.00001). Conclusions There was a consistent diurnal variation in 25-hydroxyvitamin D, with the peak at midday. There was no difference between trough versus post-dose blood draws. Acute illness may acutely lower serum 25-hydroxyvitamin D levels. Because within-person, within-day variability in 25-hydroxyvitamin D is approximately 20%, sampling time introduces systematic error in vitamin D nutritional assessment that is bigger than random analytical error or choice of assay method. Electronic supplementary material The online version of this article (10.1186/s13256-018-1948-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Christine B French
- GrassrootsHealth, 315 S. Coast Hwy 101, Suite U-87, Encinitas, CA, 92024, USA.
| | - Sharon L McDonnell
- GrassrootsHealth, 315 S. Coast Hwy 101, Suite U-87, Encinitas, CA, 92024, USA
| | - Reinhold Vieth
- Department of Nutritional Sciences, and Department of Laboratory Medicine and Pathobiology, University of Toronto, 27 King's College Circle, Toronto, Ontario, M5S 1A1, Canada
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Giustina A, Adler RA, Binkley N, Bouillon R, Ebeling PR, Lazaretti-Castro M, Marcocci C, Rizzoli R, Sempos CT, Bilezikian JP. Controversies in Vitamin D: Summary Statement From an International Conference. J Clin Endocrinol Metab 2019; 104:234-240. [PMID: 30383226 DOI: 10.1210/jc.2018-01414] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 10/26/2018] [Indexed: 12/14/2022]
Abstract
CONTEXT Vitamin D is classically recognized as a regulator of calcium and phosphorus metabolism. Recent advances in the measurement of vitamin D metabolites, diagnosis of vitamin D deficiency, and clinical observations have led to an appreciation that along with its role in skeletal metabolism, vitamin D may well have an important role in nonclassical settings. Measurement of the circulating form of vitamin D that best describes total body stores, namely 25-hydroxyvitamin D, can be unreliable despite many sophisticated methodologies that have been proposed and implemented. Likewise, evidence from clinical studies showing a beneficial role of vitamin D in different disease states has been controversial and at times speculative. Moreover, the target concentrations of 25-hydroxyvitamin D to address a number of putative links between vitamin D inadequacy and nonskeletal diseases are further areas of uncertainty. SETTING To address these issues, an international conference on "Controversies in Vitamin D" was held in Pisa, Italy, in June 2017. Three main topics were addressed: (i) vitamin D assays and the definition of hypovitaminosis D; (ii) skeletal and extraskeletal effects of vitamin D; (iii) therapeutics of vitamin D. RESULTS This report provides a summary of the deliberations of the expert panels of the conference. CONCLUSIONS Despite great advances in our appreciation of vitamin D metabolism, measurements, biological actions on classical and nonclassical tissues, and therapeutics, all of which this report summarizes, much more work remains to be done so that our knowledge base can become even more secure.
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Affiliation(s)
- Andrea Giustina
- Endocrinology and Metabolism, Vita-Salute San Raffaele University, Milano, Italy
| | - Robert A Adler
- McGuire Veterans Affairs Medical Center and Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Neil Binkley
- Osteoporosis Clinical Research Program and Institute on Aging, University of Wisconsin-Madison, Madison, Wisconsin
| | - Roger Bouillon
- Department of Chronic Diseases, Metabolism and Ageing, Laboratory of Clinical and Experimental Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Marise Lazaretti-Castro
- Division of Endocrinology, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Rene Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Christopher T Sempos
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - John P Bilezikian
- Endocrinology Division, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
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Rahme M, Al-Shaar L, Singh R, Baddoura R, Halaby G, Arabi A, Habib RH, Daher R, Bassil D, El-Ferkh K, Hoteit M, El-Hajj Fuleihan G. Limitations of platform assays to measure serum 25OHD level impact on guidelines and practice decision making. Metabolism 2018; 89:1-7. [PMID: 30227144 PMCID: PMC6258831 DOI: 10.1016/j.metabol.2018.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/29/2018] [Accepted: 09/13/2018] [Indexed: 12/27/2022]
Abstract
CONTEXT Liquid Chromatography Mass Spectroscopy (LC-MS/MS) is the preferred method to measure 25 hydroxyvitamin D (25OHD) levels, but laboratories are increasingly adopting automated platform assays. OBJECTIVE We assessed the performance of commonly used automated immunoassays, with that of LC-MS/MS, and the National Institute of Standards and Technology (NIST) reference values, to measure 25OHD levels. METHODS/SETTING We compared serum 25OHD levels obtained from 219 elderly subjects, enrolled in a vitamin D trial, using the Diasorin Liaison platform assay, and the tandem LC-MS/MS method. We also assessed the performance of the Diasorin and Roche automated assays, expressed as mean % bias from the NIST standards, based on the vitamin D External Quality Assessment Scheme (DEQAS) reports, from 2013 to 2017. RESULTS Serum 25OHD levels were significantly lower in the Diasorin compared to LC-MS/MS assay at baseline, 18.5 ± 7.8 vs 20.5 ± 7.6 ng/ml (p < 0.001), and all other time points. Diasorin (25OHD) = 0.76 × LC-MS/MS (25OHD) + 4.3, R2 = 0.596. The absolute bias was independent of 25OHD values, and the pattern unfit for any cross-calibration. The proportion of subjects considered for vitamin D treatment based on pre-set cut-offs differed significantly between the 2 assays. There also was wide variability in the performance of both automated assays, compared to NIST reference values. CONCLUSION The performance of most widely used automated assays is sub-optimal. Our findings underscore the pressing need to re-consider current practices with regard to 25OHD measurements, interpretation of results from research studies, meta-analyses, the development of vitamin D guidelines, and their relevance to optimizing health.
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Affiliation(s)
- Maya Rahme
- Department of Internal Medicine, Division of Endocrinology, Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Laila Al-Shaar
- Department of Internal Medicine, Division of Endocrinology, Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ravinder Singh
- Division of Clinical Biochemistry and Immunology, Mayo Clinic Laboratories, Mayo Clinic, Rochester, MN, USA
| | - Rafic Baddoura
- Department of Rheumatology, Hotel Dieu de France, St Joseph University, Beirut, Lebanon
| | - Georges Halaby
- Department of Endocrinology, Hotel Dieu de France, St Joseph University, Beirut, Lebanon
| | - Asma Arabi
- Department of Internal Medicine, Division of Endocrinology, Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Robert H Habib
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rose Daher
- Department of Pathology & Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Darina Bassil
- Department of Internal Medicine, Division of Endocrinology, Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Karim El-Ferkh
- Department of Internal Medicine, Division of Endocrinology, Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maha Hoteit
- Department of Internal Medicine, Division of Endocrinology, Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghada El-Hajj Fuleihan
- Department of Internal Medicine, Division of Endocrinology, Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon.
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Sempos CT, Heijboer AC, Bikle DD, Bollerslev J, Bouillon R, Brannon PM, DeLuca HF, Jones G, Munns CF, Bilezikian JP, Giustina A, Binkley N. Vitamin D assays and the definition of hypovitaminosis D: results from the First International Conference on Controversies in Vitamin D. Br J Clin Pharmacol 2018; 84:2194-2207. [PMID: 29851137 PMCID: PMC6138489 DOI: 10.1111/bcp.13652] [Citation(s) in RCA: 176] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 05/11/2018] [Accepted: 05/17/2018] [Indexed: 01/02/2023] Open
Abstract
The First International Conference on Controversies in Vitamin D was held in Pisa, Italy, 14-16 June 2017. The meeting's purpose was to address controversies in vitamin D research, review the data available, to help resolve them, and suggest a research agenda to clarify areas of uncertainty. The serum 25-hydroxyvitamin D [25(OH)D] concentration [i.e. the sum of 25(OH)D3 and 25(OH)D2 ] remains the critical measurement for defining vitamin D status. Assay variation for 25(OH)D has contributed to the current chaos surrounding efforts to define hypovitaminosis D. An essential requirement to develop a consensus on vitamin D status is that measurement of 25(OH)D and, in the future, other potential vitamin D biomarkers [e.g. 1α,25(OH)2 D3 , 3-epi-25(OH)D, 24,25(OH)2 D3, vitamin D-binding protein, free/bioavailable 25(OH)D and parathyroid hormone] be standardized/harmonized, to allow pooling of research data. Vitamin D Standardization Program tools are described and recommended for standardizing 25(OH)D measurement in research. In the future, similar methodology, based on National Institute for Standards and Technology standard reference materials, must be developed for other candidate markers of vitamin D status. Failure to standardize/harmonize vitamin D metabolite measurements is destined to promulgate continued chaos. At this time, 25(OH)D values below 12 ng ml-1 (30 nmol l-1 ) should be considered to be associated with an increased risk of rickets/osteomalacia, whereas 25(OH)D concentrations between 20 ng ml-1 and 50 ng ml-1 (50-125 nmol l-1 ) appear to be safe and sufficient in the general population for skeletal health. In an effort to bridge knowledge gaps in defining hypovitaminosis D, an international study on rickets as a multifactorial disease is proposed.
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Affiliation(s)
| | - Annemieke C. Heijboer
- Endocrine Laboratory, Department of Clinical ChemistryVU University Medical CenterAmsterdamThe Netherlands
- Laboratory of EndocrinologyAcademic Medical CenterAmsterdamThe Netherlands
| | - Daniel D. Bikle
- San Francisco, San Francisco Department of Veterans Affairs Medical Center, Endocrine Research UnitUniversity of CaliforniaSan FranciscoCAUSA
| | - Jens Bollerslev
- Section of Specialized Endocrinology, Department of EndocrinologyOslo University Hospital, RikshospitaletOsloNorway
- Faculty of MedicineUniversity of OsloOsloNorway
| | - Roger Bouillon
- Department of Chronic Diseases, Metabolism and AgeingLaboratory of Clinical and Experimental EndocrinologyKULeuvenBelgium
| | | | - Hector F. DeLuca
- Department of BiochemistryUniversity of Wisconsin‐MadisonMadisonWIUSA
| | - Glenville Jones
- Department of Biomedical and Molecular SciencesQueen's UniversityKingstonONCanada
| | - Craig F. Munns
- Institute of Endocrinology and DiabetesThe Children's Hospital at WestmeadSydneyNSWAustralia
| | - John P. Bilezikian
- Department of Medicine, Endocrinology Division, College of Physicians and SurgeonsColumbia UniversityNew YorkNYUSA
| | - Andrea Giustina
- Division of EndocrinologySan Raffaele University HospitalMilanItaly
| | - Neil Binkley
- Osteoporosis Clinical Research Program and Institute on AgingUniversity of Wisconsin‐MadisonMadisonWIUSA
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Healthy changes in some cardiometabolic risk factors accompany the higher summertime serum 25-hydroxyvitamin D concentrations in Iranian children: National Food and Nutrition Surveillance. Public Health Nutr 2018; 21:2013-2021. [PMID: 29580303 DOI: 10.1017/s1368980018000630] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate seasonal variations of vitamin D status at different latitudes and if these changes are accompanied by corresponding variations in certain health parameters in children living in a broad latitudinal range in Iran. DESIGN Longitudinal study. SUBJECTS In total, 530 apparently healthy children aged 5-18 years were randomly selected from six regions of Iran with a latitudinal gradient from 29°N to 37·5°N. All anthropometric and biochemical assessments were performed twice during a year (summer, winter). High BMI (Z-score >1), low HDL cholesterol (150 mg/dl) were considered cardiometabolic risk factors. RESULTS Serum 25-hydroxyvitamin D (25(OH)D) showed between-season variation, with significantly higher concentrations (mean (sd)) in summer v. winter (43 (29) v. 27 (18) nmol/l; P33°N v. <33°N: 4·5; 0·09, 9·0; P=0·04) were predictors of change of serum 25(OH)D between two seasons. CONCLUSIONS Summertime improvement of vitamin D status was accompanied by certain improved cardiometabolic risk factors, notably serum TAG, total cholesterol and BMI, in children.
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