LC–MS/MS based 25(OH)D status in a large Southern European outpatient cohort: gender- and age-specific differences

Giuliani, Silvia; Barbieri, Verena; Pierro, Angela Maria Di; Rossi, Fábio; Widmann, Thomas; Lucchiari, Manuela; Pusceddu, Irene; Pilz, Stefan; Obermayer–Pietsch, Barbara; Herrmann, Markus

doi:10.1007/s00394-018-1803-1

Cited by 18 publications

(11 citation statements)

References 36 publications

(59 reference statements)

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“…25(OH)D 2 is one of the main interfering substances in the immunoassay of vitamin D [38]. Our results showed that the prevalence of quantifiable 25(OH)D 2 was higher in our studied population than in a study from Southern Europe [8]. In addition, the average 25(OH)D 2 concentration was higher in males than in females ( Table 7, 9.41 vs. 7.93 ng/mL, P < 0.01).…”

Section: Discussioncontrasting

confidence: 56%

“…Feitong Wu et al also found that the concentration of 25(OH)D in Chinese men was higher than that in women [26], and other studies also reported consistent results [27]. However, numerous studies showed that the 25(OH)D concentration in females was higher than that in males [8,28] or that there was no gender difference in their studies [29,30]. These differences may be due to different lifestyles, such as the duration of outdoor activities, different working environments and trace element supplementation [5].…”

Section: Discussionmentioning

confidence: 87%

“…Akhtar et al concluded that vitamin D deficiency was highly prevalent among the South Asian population, including that of India, Pakistan, Bangladesh and Sri Lanka [7]. Silvia Giulianil found that approximately 30% of the population had a deficient 25(OH)D concentration in a large Southern European population [8]. Reports on the vitamin D status in Chinese populations come from Hong Kong, Taiwan and northeastern China populations [6,9,10], but there are few studies on the current status of vitamin D in South Chinese individuals, who have a different diet, lifestyle and climate than those of northeastern China populations.…”

Section: Introductionmentioning

confidence: 99%

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Determination of serum 25-hydroxyvitamin D status among population in southern China by a high accuracy LC-MS/MS method traced to reference measurement procedure

et al. 2020

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Objective: We aimed to describe the 25-hydroxyvitamin D (25(OH)D) status of southern Chinese individuals by a high-accuracy liquid chromatography tandem mass spectrometry (LC-MS/MS) method which can trace to reference measurement procedure. Materials and methods: From January 2018 to June 2019, a total of 4775 southern Chinese individuals were evaluated in our study. The serum levels of parathyroid hormone (PTH) were detected simultaneously in 162 cases. 25(OH)D was determined by LC-MS/MS, and PTH was detected using routine automated analysers. The distribution of the concentration, prevalence and seasonal variability of 25(OH)D in males and females of different age groups were studied. Results: The mean 25(OH)D concentration in our study was 32.57 ng/mL (4.20-101.40 ng/mL). The global 25(OH)D concentration in males was higher than that in females of different age group. The prevalence of vitamin D deficiency (< 20 ng/mL) in females (16.65%) was higher than that in males (6.83%). The prevalence of vitamin D deficiency (< 20 ng/mL) was most common in winter (22.98% of all women and 15.49% of all men). 25(OH)D concentrations were higher in those from whom blood samples were collected in summer and autumn than in winter and spring. 25(OH)D 2 was detected in 672 serum samples (14.07%). In addition, there was a negative correlation between the concentrations of 25(OH)D and serum PTH (r = − 0.149, P < 0.05). Conclusion: Our study demonstrated that the average serum 25(OH)D concentration in southern Chinese individuals was higher than that in other Chinese cohorts by a high-accuracy LC-MS/MS method. The global 25(OH)D concentration in males was higher than that in females of different ages, and the prevalence of vitamin D deficiency in females was higher than that in males. Seasonal change was an important aspect of 25(OH)D concentration in young and middle-aged people but became less relevant for that in older subjects. 25(OH)D 2 detection was of minor practical significance in our study. In addition, we also found that there was a negative correlation between the serum levels of 25(OH)D and PTH in southern Chinese individuals.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

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Determination of serum 25-hydroxyvitamin D status among population in southern China by a high accuracy LC-MS/MS method traced to reference measurement procedure

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“…Although robust evidence is lacking, some clinicians and researchers believe that every person has an individual set point above which vitamin D supplementation has no beneficial effects. In many persons this set point is probably below the commonly used cut-off of 50 nmol/L for sufficiency [28]. The interpretation of 24,25(OH) 2 The data presented by Cavalier show that amongst individuals with a 25(OH)D concentration above 52 nmol/L over 99% exhibit detectable amounts of 24,25(OH) 2 D and thus are probably vitamin D sufficient.…”

mentioning

confidence: 98%

“…This information would help physicians judging their patients' metabolic status in a more dynamic fashion and leave the historical concept of vitamin D deficiency on the basis of a universal 25(OH)D cut-off [19][20][21][22]. With the established 25(OH)D cut-offs a large portion of the population has vitamin D deficiency or at least insufficiency, which, in many cases, would trigger vitamin D supplementation even in the absence of risk factors for metabolic bone disease or manifest osteoporosis [20,28,29]. Although robust evidence is lacking, some clinicians and researchers believe that every person has an individual set point above which vitamin D supplementation has no beneficial effects.…”

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confidence: 99%

Towards a personalized assessment of vitamin D status

Herrmann

2019

Clinical Chemistry and Laboratory Medicine (CCLM)

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The growing interest in vitamin D has stimulated intensive research activities aiming to address unresolved analytical, clinical and physiological aspects of vitamin D [1][2][3][4]. This work has led to an increasing awareness that our knowledge about vitamin D metabolism and its assessment in clinical practice harbours substantial limitations. For example, Blacks have a markedly lower average 25(OH) D concentration than Whites [2, 5, 6], but exhibit higher bone mineral density (BMD) and a lower risk of fragility fracture [7][8][9]. Also, the relationship between 25(OH)D and parathyroid hormone (PTH) seems to differ between races [2]. These findings have led researchers to look for other markers that are capable of providing more accurate information about the adequacy of patients' vitamin D supply. Several studies suggested that free and bioavailable 25(OH)D reflect vitamin D metabolism better than 25(OH) D [2, 10, 11]. However, both markers require the measurement of vitamin D binding protein (VDBP). Early studies quantified VDBP with either monoclonal or polyclonal immunoassays. However, later studies that employed LC-MS/MS based methods have demonstrated that these immunoassay are strongly biased due to common genetic polymorphisms [4]. The limited number of laboratories that offer VDBP measurement by LC-MS/MS and the lack of a reference measurement procedure hamper a wider use of free and bioavailable 25(OH)D in clinical studies. Another potential surrogate marker of vitamin D metabolism is 24,25(OH) 2 D, the major product of 25(OH)D catabolism. The circulating concentrations of both metabolites are strongly correlated [12] and can reliably be measured by LC-MS/MS [13][14][15][16]. The simultaneous quantitation of 24,25(OH) 2 D and 25(OH)D has been proposed as a dynamic measure of vitamin D metabolism that allows distinguishing CYP24A1 deficiency from vitamin D intoxication and granulomatous disease. However, the interpretation of 25(OH)D and 24,25(OH) 2 D results is still a matter of intensive debate. Previous studies have established reference intervals [17,18] and clinical cut-offs [19][20][21][22]. However, the close relationship between 25(OH)D and 24,25(OH) 2 D implies that a meaningful interpretation is only possible when both metabolites are considered together. This has led to the idea of a ratio between 24,25(OH) 2 D and 25(OH) D, also known as vitamin D metabolite ratio (VMR) [23]. Theoretically, a higher VMR indicates better supply with vitamin D so that excessive 25(OH)D is catabolized to 24,25(OH) 2 D. Several studies have investigated the clinical utility of VMR, but results are inconclusive [3,[24][25][26]. In addition, the VMR cannot be calculated when 24,25(OH) 2 D is below the limit of quantitation. When one measurand has a much lower concentration than the other, calculating the ratio between the two enhances the intrinsic measurement uncertainty. In this issue of Clinical Chemistry and Laboratory Medicine (CCLM) a study by Cavalier et al. has analyzed 24,25(OH) 2 D and 25(OH)D simultaneo...

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Vitamin D Metabolites: Analytical Challenges and Clinical Relevance

et al. 2022

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Recent research activities have provided new insights in vitamin D metabolism in various conditions. Furthermore, substantial progress has been made in the analysis of vitamin D metabolites and related biomarkers, such as vitamin D binding protein. Liquid chromatography tandem mass spectrometric (LC–MS/MS) methods are capable of accurately measuring multiple vitamin D metabolites in parallel. Nevertheless, only 25(OH)D and the biologically active form 1,25(OH)2D are routinely measured in clinical practice. While 25(OH)D remains the analyte of choice for the diagnosis of vitamin D deficiency, 1,25(OH)2D is only recommended in a few conditions with a dysregulated D metabolism. 24,25(OH)2D, free and bioavailable 25(OH)D, and the vitamin D metabolite ratio (VMR) have shown promising results, but technical pitfalls in their quantification, limited clinical data and the lack of reference values, impede their use in clinical practice. LC–MS/MS is the preferred method for the measurement of all vitamin D related analytes as it offers high sensitivity and specificity. In particular, 25(OH)D and 24,25(OH)2D can accurately be measured with this technology. When interpreted together, they seem to provide a functional measure of vitamin D metabolism beyond the analysis of 25(OH)D alone. The determination of VDBP, free and bioavailable 25(OH)D is compromised by unresolved analytical issues, lacking reference intervals and insufficient clinical data. Therefore, future research activities should focus on analytical standardization and exploration of their clinical value. This review provides an overview on established and new vitamin D related biomarkers including their pathophysiological role, preanalytical and analytical aspects, expected values, indications and influencing conditions.

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LC–MS/MS based 25(OH)D status in a large Southern European outpatient cohort: gender- and age-specific differences

Cited by 18 publications

References 36 publications

Determination of serum 25-hydroxyvitamin D status among population in southern China by a high accuracy LC-MS/MS method traced to reference measurement procedure

Determination of serum 25-hydroxyvitamin D status among population in southern China by a high accuracy LC-MS/MS method traced to reference measurement procedure

Towards a personalized assessment of vitamin D status

Vitamin D Metabolites: Analytical Challenges and Clinical Relevance

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