An Underestimation of 25-OH Vitamin D in Patients with Renal Disease by the Abbott Architect Immunoassay

Brock, Ashton T.; Strickland, Sydney Webb; Bazydlo, Lindsay A.L.; Haverstick, Doris M.

doi:10.1373/jalm.2017.024331

Cited by 2 publications

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References 1 publication

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“…Using the method in the insert, calculated median cross-reactivity for both 25-OH-D2 (37%) and 25-OH-D3 (85%) was lower than indicated for the Architect assay. This is consistent with reports from other investigators [7,8]. The Cobas Vitamin D assay also performed more poorly than manufacturer specifications.…”

Section: Discussionsupporting

confidence: 91%

Efficacy of two vitamin D immunoassays to detect 25-OH vitamin D2 and D3

Garnett

Rajapakshe

et al. 2019

Practical Laboratory Medicine

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Objectives Assessment of Vitamin D status by measurement of 25-Hydroxyvitamin D (25-OH-D) is widely performed by immunoassay. Yet, the ability of these assays to detect Vitamin D2 (as 25-OH-D2) or Vitamin D3 (as 25-OH-D3) varies. It is important to recognize the ability of an assay to quantitate either form of 25-OH-D to evaluate Vitamin D status of supplemented patients. We evaluated detection of 25-OH-D2 and 25-OH-D3 by two assays in our medical center. Design and methods The Abbott Architect i1000 SR 25-OH Vitamin D assay and Roche Cobas 8000 Vitamin D assay were compared for their recovery of 25-OH-D2 or D3 from spiked serum samples. Samples with known endogenous concentrations of 25-OH-D2 or D3 by LC-MS/MS were also measured to calculate bias between our assays and LC-MS/MS. Results Recovery of 25-OH-D3 in spiked samples was similar by Architect (84–87%) and Cobas (90%). Recovery of 25-OH-D2 was lower than 25-OH-D3, and was poorer by Architect (37–40%) than by Cobas (69–71%). In measurement of samples with known 25-OH-D concentrations, performance of Architect and Cobas assays was similar for 25-OH-D3. However, at concentrations >50 nmol/L 25-OH-D2, the Architect assay exhibited large average negative bias (−27%). Conclusions While the Architect and Cobas assays performed similarly in detection of 25-OH-D3, the Architect assay was significantly poorer at detecting 25-OH-D2 than Cobas, with poorer recovery and significant negative bias at higher concentrations of 25-OH-D2. This agrees with other studies, and indicates that caution should be used in interpreting Architect 25-OH-D results in patients supplemented with Vitamin D2.

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Section: Discussionsupporting

confidence: 91%

Efficacy of two vitamin D immunoassays to detect 25-OH vitamin D2 and D3

Garnett

Rajapakshe

et al. 2019

Practical Laboratory Medicine

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“…As mentioned before, 25(OH)D may be present in one of two forms, 25(OH)D 2 or 25(OH)D 3 . Immunoassays are generally not able to distinguish the two, and report these together as total 25(OH)D. As the antibodies in the immunoassay do not bind 25(OH)D 2 to a similar extent as they bind 25(OH)D 3, this leads to the under- or over-estimation of total 25(OH)D [ 60 , 61 , 62 , 63 , 64 ]. Alarmingly, many automated immunoassay manufacturers report considerably different cross-reactivity percentages for 25(OH)D 2 compared to the observed values by independent researchers [ 65 , 66 ].…”

Section: How: Importance Of the Choice Of Methodsmentioning

confidence: 99%

The When, What & How of Measuring Vitamin D Metabolism in Clinical Medicine

et al. 2018

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We now have the ability to measure a number of different vitamin D metabolites with very accurate methods. The most abundant vitamin D metabolite, 25-hydroxyvitamin D, is currently the best marker for overall vitamin D status and is therefore most commonly measured in clinical medicine. The added value of measuring metabolites beyond 25-hydroxyvitamin D, like 1,25-, and 24,25-dihydroxyvitamin D is not broadly appreciated. Yet, in some more complicated cases, these metabolites may provide just the information needed for a legitimate diagnosis. The problem at present, is knowing when to measure, what to measure and how to measure. For 25-hydroxyvitamin D, the most frequently used automated immunoassays do not meet the requirements of today’s standards for certain patient groups and liquid chromatography-tandem mass spectrometry is the desired method of choice in these individuals. The less frequently measured 1,25-dihydroxyvitamin D metabolite enables us to identify a number of conditions, including 1α-hydroxylase deficiency, hereditary vitamin D-resistant rickets and a number of granulomatous diseases or lymphoproliferative diseases accompanied by hypercalcaemia. Furthermore, it discriminates between the FGF23-mediated and non-FGF23-mediated hypophosphatemic syndromes. The 24,25-dihydroxyvitamin D metabolite has proven its value in the diagnosis of idiopathic infantile hypercalcaemia and has the potential of having value in identifying other diseases. For both metabolites, the understanding of the origin of differences between assays is limited and requires further attention. Nonetheless, in every way, appropriate measurement of vitamin D metabolism in the clinical laboratory hinges eminently on the comprehension of the value of the different metabolites, and the importance of the choice of method.

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An Underestimation of 25-OH Vitamin D in Patients with Renal Disease by the Abbott Architect Immunoassay

Cited by 2 publications

References 1 publication

Efficacy of two vitamin D immunoassays to detect 25-OH vitamin D2 and D3

Efficacy of two vitamin D immunoassays to detect 25-OH vitamin D2 and D3

The When, What & How of Measuring Vitamin D Metabolism in Clinical Medicine

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