1
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Munar A, Clinton Frazee C, Garg U. Quantification of 25-Hydroxyvitamin D2 and D3 Using Liquid Chromatography-Tandem Mass Spectrometry. Methods Mol Biol 2022; 2546:539-544. [PMID: 36127620 DOI: 10.1007/978-1-0716-2565-1_48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Vitamin D plays an important role not only in bone health but also in many other body functions. Vitamin D deficiency is very common in the general population. Measurement of blood 25-hydroxyvitamin D is a common practice to evaluate vitamin D deficiency. Immunoassays and liquid chromatography tandem mass spectrometry (LC-MS/MS) are the most commonly used methods for the measurement of 25-hydroxyvitamin D. Immunoassays suffer from specificity issues and do not distinguish between 25-hydroxyvitamin D2 and D3. Therefore, LC-MS/MS is a preferred method for quantification of 25-hydroxyvitamin. We describe an LC-MS/MS method, which involves protein precipitation and analysis of the extract using atmospheric pressure chemical ionization and multiple reaction monitoring. 25-hydroxyvitamin D3-d6 is used as an internal standard. The method is linear from 1-100 ng/mL for both 25-hydroxyvitamin D2 and D3 and has imprecision of <10%.
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Affiliation(s)
- Ada Munar
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, MO, USA.,University of Missouri School of Medicine, Kansas City, MO, USA
| | - C Clinton Frazee
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, MO, USA.,University of Missouri School of Medicine, Kansas City, MO, USA
| | - Uttam Garg
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, MO, USA. .,University of Missouri School of Medicine, Kansas City, MO, USA.
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2
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Bach A, Fleischer H, Wijayawardena B, Thurow K. Optimization of Automated Sample Preparation for Vitamin D Determination on a Biomek i7 Workstation. SLAS Technol 2021; 26:615-629. [PMID: 34282678 DOI: 10.1177/24726303211030291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Vitamin D belongs to the fat-soluble vitamins and is an integral part of bone metabolism. In the human body, a decreased vitamin D level can be an additional risk factor for diseases like cancer, diabetes, and mental diseases. As a result, an enormous increase in the demand for vitamin D testing has been observed in recent years, increasing the demand for powerful methods for vitamin D determination at the same time.Automation is the key factor in increasing sample throughput. This study compares three fully automated sample preparation methods for the determination of 25(OH)D2 and 25(OH)D3 in plasma and serum samples. Starting from a semiautomated reference method, the method is tested manually and subsequently fully automated on the Biomek i7 Workstation by integrating a centrifuge and a positive pressure extractor into the workstation. Alternatively, the centrifugation for the separation of protein aggregates and supernatant is replaced by a filter plate. Finally, the sample throughput is further increased by using phospholipid removal cartridges. The results show that phospholipid removal significantly increases the recovery rates in liquid chromatography-mass spectrometry. With the phospholipid removal cartridges, recovery rates of 97.36% for 25(OH)D2 and 102.5% for 25(OH)D3 were achieved, whereas with the automated classic automated preparation method, the recovery rates were 83.31% for 25(OH)D2 and 86.54% for 25(OH)D3. In addition to the technical evaluation, the different methods were also examined with regard to their economic efficiency. Finally, the qualitative and quantitative performance of the developed methods is benchmarked with a selected semiautomatic reference method.
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Affiliation(s)
- Anna Bach
- Center for Life Science Automation, University of Rostock, Rostock, Germany
| | - Heidi Fleischer
- Institute of Automation, University of Rostock, Rostock, Germany
| | | | - Kerstin Thurow
- Center for Life Science Automation, University of Rostock, Rostock, Germany
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3
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Mena-Bravo A, Calderón-Santiago M, Lope V, Kogevinas M, Pollán M, Luque de Castro MD, Priego-Capote F. Vitamin D 3 levels in women and factors contributing to explain metabolic variations. J Steroid Biochem Mol Biol 2021; 211:105884. [PMID: 33775819 DOI: 10.1016/j.jsbmb.2021.105884] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 02/16/2021] [Accepted: 03/23/2021] [Indexed: 01/28/2023]
Abstract
The elucidated metabolism of vitamin D3 in humans has been the support to explain the high involvement of this liposoluble vitamin in physiological functions. Clinical studies have associated levels of vitamin D3 metabolites with several disorders. Despite this knowledge, there is a controversy regarding the estimation of deficiency and the physiological and supraphysiological levels of vitamin D3 metabolites. The association between serum concentrations of vitamin D3 metabolites and several potentially influential factors (namely, age and anthropometric, seasonal, spatial and metabolic factors) is analyzed in this study. For this purpose, 558 women were recruited and interviewed in several Spanish provinces before blood sampling. Serum vitamin D3 and its metabolites were determined using an SPE-LC-MS/MS platform. The concentration range for vitamin D3 was 1.7-21.1 nmol/L and was influenced by body mass index (BMI), waist-to-hip ratio (WHR) and seasonal period. 25-hydroxyvitamin D3 levels were within 4.8-147.2 nmol/L and were related to WHR, season, latitude and calcium intake. The range of 24,25-dihydroxyvitamin D3, 0.3-15.0 nmol/L, was associated to BMI, WHR, season, latitude and calcium intake. Finally, energy intake influenced the vitamin D 25-hydroxylase through the 25-hydroxyvitamin D3/vitamin D3 ratio, which regulates the synthesis of the circulating form. According to these results, it is worth emphasizing the relevance of all these factors to explain the variability in serum levels of vitamin D3 and its metabolites. All these factors should be considered in future studies assessing the alteration of vitamin D3 metabolism.
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Affiliation(s)
- A Mena-Bravo
- Department of Analytical Chemistry, University of Córdoba, Spain; University Institute of Nanochemistry, University of Córdoba, Spain; Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Spain; Consortium for Biomedical Research in Frailty & Healthy Ageing, CIBERFES, Carlos III Institute of Health, Spain
| | - M Calderón-Santiago
- Department of Analytical Chemistry, University of Córdoba, Spain; University Institute of Nanochemistry, University of Córdoba, Spain; Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Spain; Consortium for Biomedical Research in Frailty & Healthy Ageing, CIBERFES, Carlos III Institute of Health, Spain
| | - V Lope
- Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Carlos III Institute of Health, Spain
| | - M Kogevinas
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Carlos III Institute of Health, Spain; Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain
| | - M Pollán
- Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Carlos III Institute of Health, Spain
| | - M D Luque de Castro
- Department of Analytical Chemistry, University of Córdoba, Spain; University Institute of Nanochemistry, University of Córdoba, Spain; Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Spain; Consortium for Biomedical Research in Frailty & Healthy Ageing, CIBERFES, Carlos III Institute of Health, Spain.
| | - F Priego-Capote
- Department of Analytical Chemistry, University of Córdoba, Spain; University Institute of Nanochemistry, University of Córdoba, Spain; Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Spain; Consortium for Biomedical Research in Frailty & Healthy Ageing, CIBERFES, Carlos III Institute of Health, Spain.
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4
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Kaur A, Rana S, Bharti A, Chaudhary GR, Prabhakar N. Voltammetric detection of vitamin D employing Au-MoS 2 hybrid as immunosensing platform. Mikrochim Acta 2021; 188:222. [PMID: 34086134 PMCID: PMC8176887 DOI: 10.1007/s00604-021-04862-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/13/2021] [Indexed: 11/30/2022]
Abstract
A voltammetric immunosensor based on molybdenum sulphide (MoS2) and gold nanoparticles (Au NPs) for the determination of 25-hydroxy vitamin D3 (25(OH)D3) is reported. Anti-vit D (Ab-25(OH)D3) was immobilized onto the cysteamine-modified MoS2 and Au NPs which were deposited onto a fluoride tin oxide (FTO) electrode (Ab/Cys/Au/MoS2/FTO). The MoS2 sheets were prepared by hydrothermal method followed by an in situ growth of Au film onto the MoS2/FTO surface. Self-assembled monolayer (SAM) of cysteamine was synthesized onto the Au/MoS2/FTO which acts as a linker to covalently bind Ab-25(OH)D3. The Ab-25(OH)D3-immobilized Cys/Au/MoS2/FTO was used to detect 25(OH)D3 using differential pulse voltammetry. The electrochemical system provided an anodic peak current at a potential of +0.21 V vs. Ag/AgCl (satd. KCl) of ferricyanide/ferrocyanide redox couple. The detection principle relies on the inhibition of electron transfer at the electrode surface owing to the hindrance caused by the formation of immune complex between Ab-25(OH)D3 and 25(OH)D3. The immunosensor shows linear response from 1 pg mL-1 to 100 ng mL-1 25(OH)D3 and a sensitivity of 189 μA [log (pg mL-1)]-1 cm-2 along with a low limit of detection (LOD) of 0.38 pg mL-1. The immunosensor is highly selective towards 25(OH)D3 and presented a long shelf life of 28 days. Also, the immunosensor exhibits satisfactory performance towards spiked human serum samples with recovery between 95.1 and 102% (RSD 1.15-3.22%).
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Affiliation(s)
- Amandeep Kaur
- Department of Biochemistry, Panjab University, Chandigarh, 160014, India
- Department of Chemistry and Centre for Advanced Studies in Chemistry, Panjab University, Chandigarh, 160014, India
| | - Shilpa Rana
- Department of Biochemistry, Panjab University, Chandigarh, 160014, India
| | - Anu Bharti
- Department of Biochemistry, Panjab University, Chandigarh, 160014, India
| | - Ganga Ram Chaudhary
- Department of Chemistry and Centre for Advanced Studies in Chemistry, Panjab University, Chandigarh, 160014, India
- SAIF/CIL, Panjab University, Chandigarh, 160014, India
| | - Nirmal Prabhakar
- Department of Biochemistry, Panjab University, Chandigarh, 160014, India.
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Nikolac Gabaj N, Unic A, Miler M, Pavicic T, Culej J, Bolanca I, Herman Mahecic D, Milevoj Kopcinovic L, Vrtaric A. In sickness and in health: pivotal role of vitamin D. Biochem Med (Zagreb) 2021; 30:020501. [PMID: 32550812 PMCID: PMC7271749 DOI: 10.11613/bm.2020.020501] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/19/2020] [Indexed: 12/15/2022] Open
Abstract
Within the last several years, frequency of vitamin D testing has multiplied substantially all over the world, since it has been shown to have an important role in many diseases and conditions. Even though liquid chromatography - tandem mass spectrometry (LC-MS/MS) has been identified as "gold standard" method for vitamin D measurement, most laboratories still use immunochemistry methods. Besides analytical problems (hydrophobicity, low circulating concentrations, ability to bind to lipids, albumins and vitamin D binding protein, presence of multiple vitamin D metabolites and variable ratios of 25(OH)D2 and 25(OH)D3 in the blood), vitamin D shows great preanalytical variability, since its concentration is drastically influenced by seasonal changes, exposure to sun, type of clothes or sun block creams. Vitamin D is mostly measured in serum or plasma, but new studies are showing importance of measuring vitamin D in pleural effusions, breast milk, urine, synovial fluid and saliva. Besides the main role in calcium homeostasis and bone metabolism, many studies linked vitamin D deficiency with cancer, cardiovascular diseases, diabetes, fertility and many other conditions. However, even though initial observational studies indicated that supplementation with vitamin D might be beneficial in disease development and progression; first results of well-designed randomized controlled prospective studies did not find differences in frequency of cardiovascular events or invasive cancer between patients taking vitamin D supplementation compared to placebo. In the light of these recent findings, validity of excessive vitamin D testing remains an open question.
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Affiliation(s)
- Nora Nikolac Gabaj
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.,Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - Adriana Unic
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Marijana Miler
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Tomislav Pavicic
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Jelena Culej
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Ivan Bolanca
- Department of Human Reproduction, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Davorka Herman Mahecic
- Department for Endocrinology, Dieabetes and Metabolism, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Lara Milevoj Kopcinovic
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Alen Vrtaric
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
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6
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Faisal S, Mirza FS. Sublingual Vitamin D3 Effective In A Patient Resistant To Conventional Vitamin D Supplementation. AACE Clin Case Rep 2020; 6:e342-e345. [DOI: 10.4158/accr-2020-0282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 08/04/2020] [Indexed: 11/15/2022] Open
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7
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Kaur A, Kapoor S, Bharti A, Rana S, Chaudhary GR, Prabhakar N. Gold‑platinum bimetallic nanoparticles coated 3-(aminopropyl)triethoxysilane (APTES) based electrochemical immunosensor for vitamin D estimation. J Electroanal Chem (Lausanne) 2020. [DOI: 10.1016/j.jelechem.2020.114400] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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8
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Qiu X, Chen X, Zuo S, Ji Y, Wen Z, Wei L, Wu S, Diao L, Li B, Zhao J, Chen T. Assessing vitamin D related genetic variants, status, and influence factors in pregnant women in Eastern and Central China. Food Sci Nutr 2020; 8:4078-4085. [PMID: 32884689 PMCID: PMC7455978 DOI: 10.1002/fsn3.1674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 05/09/2020] [Accepted: 05/11/2020] [Indexed: 01/08/2023] Open
Abstract
Vitamin D deficiency has recently become a global public health problem. However, it is still unclear if gene polymorphisms in the vitamin D pathway influence vitamin D levels among pregnant women in Eastern and Central China. The objective of this study was to assess factors influencing vitamin D levels in pregnant women. A total of 326 participants in Shandong and Henan provinces in China were enrolled from August 2017 to April 2019. Serum 25(OH)D levels and single nucleotide polymorphisms (SNPs) in the vitamin D pathway were measured using the blood samples collected in the first trimester, second trimester, and third trimester. Data on demographics, lifestyle, and health behavior were collected using a questionnaire. Statistical analyses were performed using the R software. The prevalence of 25(OH)D deficiency was significantly more severe in pregnant women. The average 25(OH)D value of all enrolled pregnant women was 14.57 ± 7.21 ng/ml (deficiency). Only 15 (4.60%) participants had a 25(OH)D concentration ≥30 ng/ml (sufficient). The prevalence of four ranks of vitamin D levels from severe 25(OH)D deficiency to 25(OH)D sufficiency (<10, 10-20, 20-30, and ≥30 ng/ml) was 29.14%, 52.45%, 13.80%, and 4.60%, respectively. Variants of GC (rs1155563) and CYP24A1 (rs6013897) were significantly associated with both 25(OH)D concentrations and vitamin D deficiency among pregnant women, respectively. Our findings suggest that pregnant women in Eastern and Central China are at high risk of vitamin D deficiency. Genetic mutants in the vitamin D pathway (GC and CYP24A1) were significantly associated with 25(OH)D levels in pregnant women in Eastern and Central China.
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Affiliation(s)
- Xiaofei Qiu
- Department of Gynaecology and ObstetricsCentral People's Hospital of TengzhouTengzhouChina
| | - Xinhao Chen
- Endocrine Department of NephropathyCentral Hospital of DengzhouDengzhouChina
| | - Shangming Zuo
- Department of PediatricsCentral Hospital of DengzhouDengzhouChina
| | - Yuan Ji
- Endocrine Department of NephropathyCentral Hospital of DengzhouDengzhouChina
| | - Zheng Wen
- Department of PediatricsCentral Hospital of DengzhouDengzhouChina
| | - Linna Wei
- Neonatal Intensive Care CenterCentral Hospital of DengzhouDengzhouChina
| | - Shouxin Wu
- Zhangjiang Center for Translational MedicineBiotecan Medical Diagnostics Co., Ltd.ShanghaiChina
| | - Le Diao
- Zhangjiang Center for Translational MedicineBiotecan Medical Diagnostics Co., Ltd.ShanghaiChina
| | - Bo Li
- Department of Orthopedic OncologyChangzheng HospitalSecond Military Medical UniversityShanghaiChina
| | - Jiangman Zhao
- Zhangjiang Center for Translational MedicineBiotecan Medical Diagnostics Co., Ltd.ShanghaiChina
| | - Tianrui Chen
- Zhangjiang Center for Translational MedicineBiotecan Medical Diagnostics Co., Ltd.ShanghaiChina
- Department of Orthopedic OncologyChangzheng HospitalSecond Military Medical UniversityShanghaiChina
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9
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Abstract
Introduction Vitamin D is a micronutrient that plays a large role in bone disease, and researchers are now discovering that it also does so in non-skeletal disease, thus making high-quality analytical determination necessary. To make this determination, a series of immunochemical and physical methods are used. These methods present a series of different ways of handling samples as well as different methodologies that bring a series of advantages and limitations based on the scope of work in which the vitamin D analysis methodology is applied. Although the Liquid Chromatography-tandem Mass Spectrometry (LC-MS/MS) is the gold standard method of analytical vitamin D determination, and is the only one to offer a more complete and accurate view of all metabolites of this vitamin, it is necessary to standardize all the analysis methodologies that allow accurate, reliable and quality analytical determination, since it is essential to obtain results that can reliably be extrapolated to the population, and that can be decisive in assessing a large number of pathologies.
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10
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Pacifico L, Osborn JF, Bonci E, Pierimarchi P, Chiesa C. Association between Vitamin D Levels and Nonalcoholic Fatty Liver Disease: Potential Confounding Variables. Mini Rev Med Chem 2019; 19:310-332. [PMID: 30360708 DOI: 10.2174/1389557518666181025153712] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/16/2017] [Accepted: 08/25/2017] [Indexed: 02/06/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD), historically considered to be the hepatic component of the metabolic syndrome, is a spectrum of fat-associated liver conditions, in the absence of secondary causes, that may progress to nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. Disease progression is closely associated with body weight or fatness, dyslipidemia, insulin resistance, oxidative stress, and inflammation. Recently, vitamin D deficiency has been linked to the pathogenesis and severity of NAFLD because of vitamin D "pleiotropic" functions, with roles in immune modulation, cell differentiation and proliferation, and regulation of inflammation. Indeed, several studies have reported an association between vitamin D and NAFLD/NASH. However, other studies have failed to find an association. Therefore, we sought to critically review the current evidence on the association between vitamin D deficiency and NAFLD/NASH, and to analyze and discuss some key variables that may interfere with this evaluation, such as host-, environment-, and heritability-related factors regulating vitamin D synthesis and metabolism; definitions of deficient or optimal vitamin D status with respect to skeletal and nonskeletal outcomes including NAFLD/NASH; methods of measuring 25(OH)D; and methods of diagnosing NAFLD as well as quantifying adiposity, the cardinal link between vitamin D deficiency and NAFLD.
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Affiliation(s)
- Lucia Pacifico
- Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena, 324 00161-Rome, Italy
| | - John F Osborn
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale Regina Elena, 324 00161- Rome, Italy
| | - Enea Bonci
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena, 324 00161- Rome, Italy
| | - Pasquale Pierimarchi
- Institute of Translational Pharmacology, National Research Council, Via Fosso del Cavaliere, 100 00133- Rome, Italy
| | - Claudio Chiesa
- Institute of Translational Pharmacology, National Research Council, Via Fosso del Cavaliere, 100 00133- Rome, Italy
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11
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Yu S, Zhang R, Zhou W, Cheng X, Cheng Q, Xia L, Xie S, Yin Y, Sun D, Su W, Qiu L. Is it necessary for all samples to quantify 25OHD2 and 25OHD3 using LC-MS/MS in clinical practice? Clin Chem Lab Med 2019; 56:273-277. [PMID: 28822224 DOI: 10.1515/cclm-2017-0520] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 07/08/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND The demand for vitamin D testing is increasing in China. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) immunoassay is specific and accurate but requires expensive equipment, experienced operators, and complicated pretreatment of serum. Automated immunoassays are simple and convenient but only determine total 25-hydroxyvitamin D (25OHD). The objective of this study was to quantify 25OHD2 and 25OHD3 in patients to assist clinical physicians and laboratory directors in choosing the most appropriate method to determine 25OHD. METHODS Vitamin D testing was conducted for 23,695 patients in Peking Union Medical College Hospital from May 2015 to January 2017. Using this large data set, the prevalence and levels of 25OHD2 were analyzed. LC-MS/MS was used to separately determine 25OHD2 and 25OHD3. RESULTS 25OHD2 (≥2.5 ng/mL) was detected in 16.4% (3877/23,695) of patients. Males had a significantly lower incidence of detectable 25OHD2 (p<0.01); 1077 (13.9%) samples contained detectable 25OHD2 (median: 3.7 ng/mL; 2.5%-97.5%: 2.5-17.2 ng/mL). For females, 2800 (17.5%) samples contained detectable 25OHD2 (median: 4.0 ng/mL; range: 2.5-20.6 ng/mL). Of the 3877 patients with detectable 25OHD2, males had a significantly higher level of 25OHD3 (p<0.01). There was no significant difference in total 25OHD. The proportion of 25OHD2 in total 25OHD was 1.3%-100%; 87.5% (3391/3877) of the samples contained <10 ng/mL 25OHD2. 25OHD2 negatively correlated with 25OHD3 (r=-0.197, p<0.01) and positively correlated with total 25OHD (r=0.217, p<0.01). CONCLUSIONS Prevalence of 25OHD2 in patients tested for vitamin D is relatively high in China. 25OHD2 is significantly negatively correlated with 25OHD3.
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Affiliation(s)
- Songlin Yu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Ruiping Zhang
- Department of Clinical Laboratory, China-Japan Friendship Hospital, Beijing, P.R. China
| | - Weiyan Zhou
- Beijing Hospital National Center for Clinical Laboratories, Ministry of Health, Beijing, P.R. China
| | - Xinqi Cheng
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Qian Cheng
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Liangyu Xia
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Shaowei Xie
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Yicong Yin
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Dandan Sun
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Wei Su
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Ling Qiu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China
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12
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Rodd C, Sokoro A, Lix LM, Thorlacius L, Moffatt M, Slater J, Bohm E. Increased rates of 25-hydroxy vitamin D testing: Dissecting a modern epidemic. Clin Biochem 2018; 59:56-61. [DOI: 10.1016/j.clinbiochem.2018.07.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 06/23/2018] [Accepted: 07/12/2018] [Indexed: 11/28/2022]
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13
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Aghajafari F, Pond D, Catzikiris N, Cameron I. Quality assessment of systematic reviews of vitamin D, cognition and dementia. BJPsych Open 2018; 4:238-249. [PMID: 29998819 PMCID: PMC6060489 DOI: 10.1192/bjo.2018.32] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 05/03/2018] [Accepted: 05/19/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND There is conflicting evidence regarding the association of vitamin D with cognition performance and dementia.AimsWe aimed to summarise the evidence on the association of vitamin D with cognitive performance, dementia and Alzheimer disease through a qualitative assessment of available systematic reviews and meta-analyses. METHOD We conducted an overview of the systematic reviews of all study types with or without meta-analyses on vitamin D and either Alzheimer disease, dementia or cognitive performance up to June 2017. RESULTS Eleven systematic reviews were identified, nine of which were meta-analyses with substantial heterogeneity, differing statistical methods, variable methodological quality and quality of data abstraction. A Measurement Tool to Assess Systematic Reviews checklist scores ranged from 4 to 10 out of 11, with seven reviews of 'moderate' and four of 'high' methodological quality. Out of six meta-analyses on the association between low serum concentration of 25-hydroxyvitamin D and risk of dementia, five showed a positive association. Results of meta-analyses on the association between low serum concentration of 25-hydroxyvitamin D and memory function tests showed conflicting results. CONCLUSIONS This systematic evaluation of available systematic reviews provided a clearer understanding of the potential link between low serum vitamin D concentrations and dementia. This evaluation also showed that the quality of the available evidence is not optimal because of both the low methodological quality of the reviews and low quality of the original studies. Interpretation of these systematic reviews should therefore be made with care.Declaration of interestNone.
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Affiliation(s)
- Fariba Aghajafari
- Assistant Professor, Department of Family Medicine, Cumming School of Medicine, University of Calgary Sunridge Family Medicine Teaching Centre, Canada
| | - Dimity Pond
- Professor and Head of Department of Family Medicine, University of Newcastle, Australia
| | - Nigel Catzikiris
- Research Assistant, School of Medicine and Public Health, Faculty of Medicine, The University of Newcastle, Australia
| | - Ian Cameron
- Professor, Northern Clinical School, Rehabilitation Studies Unit, Sydney Medical School, The University of Sydney, Australia
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Galior K, Ketha H, Grebe S, Singh RJ. 10 years of 25-hydroxyvitamin-D testing by LC-MS/MS-trends in vitamin-D deficiency and sufficiency. Bone Rep 2018; 8:268-273. [PMID: 29955644 PMCID: PMC6020395 DOI: 10.1016/j.bonr.2018.05.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/04/2018] [Accepted: 05/17/2018] [Indexed: 01/22/2023] Open
Abstract
In early 2000's vitamin-D deficiency was shown to be prevalent in several countries including the United States (US). Studies exploring the role of vitamin-D metabolism in diverse disease pathways generated an increased demand for vitamin-D supplementation and an immense public interest in measurement of vitamin-D metabolite levels. In this report, we review the role of vitamin-D metabolism in disease processes, clinical utility of measuring vitamin-D metabolites including 25-hydroxyvitamin-D (25(OH)D), 1,25-dihydroxyvitamin-D and 24,25-dihydroxyvitamin-D and discuss vitamin-D assay methodologies including immunoassays and liquid chromatography mass spectrometry (LC-MS/MS) assays. We also provide examples of vitamin-D toxicity and insight into the trends in serum 25(OH)D levels in the US population based on 10 years of data from on serum 25(OH)D values from ~5,000,000 patients who were tested at the Mayo Medical Laboratories between February 2007-February 2017.
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Affiliation(s)
- Kornelia Galior
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Hemamalini Ketha
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, United States
| | - Stefan Grebe
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Ravinder J Singh
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
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15
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Aghajafari F, Letourneau N, Mahinpey N, Cosic N, Giesbrecht G. Vitamin D Deficiency and Antenatal and Postpartum Depression: A Systematic Review. Nutrients 2018; 10:E478. [PMID: 29649128 PMCID: PMC5946263 DOI: 10.3390/nu10040478] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/04/2018] [Accepted: 04/10/2018] [Indexed: 01/10/2023] Open
Abstract
Vitamin D has been implicated in antenatal depression (AD) and postpartum depression (PPD) in many studies; however, results have been inconsistent due to the complexity of this association. We searched the MEDLINE, Embase, PsycINFO, and Maternity and Infant Care databases for literature addressing associations between vitamin D and AD and PPD. Two independent authors reviewed titles and abstracts of the search results and selected studies for full review. Data were extracted, and a quality rating was done using the Newcastle-Ottawa Scale (NOS) on the selected studies. A total of 239 studies were identified; 14 were included in the review. The quality assessment of the included studies ranged from moderate to high. Of the studies on PPD, five of nine (55%) showed a significant association between vitamin D and PPD. Five of seven (71%) studies on AD showed a significant association with vitamin D status. As the included studies used different effect estimates and statistical analyses to report the association, it was not possible to transform the existing data into one single effect measure to employ meta-analytic techniques. While results of this systematic review vary, they indicate a significant association between vitamin D status and AD and PD.
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Affiliation(s)
- Fariba Aghajafari
- Department of Family Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Sunridge Family Medicine Teaching Centre, Calgary, AB T2N 1N4, Canada.
| | - Nicole Letourneau
- Faculty of Nursing and Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
| | - Newsha Mahinpey
- Life Science Program, Queen's University, Kingston, ON K7L 3N6, Canada.
| | - Nela Cosic
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
| | - Gerald Giesbrecht
- Departments of Paediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
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Higashi T, Shimada K. Application of Cookson-type reagents for biomedical HPLC and LC/MS analyses: a brief overview. Biomed Chromatogr 2016; 31. [DOI: 10.1002/bmc.3808] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 08/08/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Tatsuya Higashi
- Faculty of Pharmaceutical Sciences; Tokyo University of Science; Chiba 278-8510 Japan
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17
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Moreau E, Bächer S, Mery S, Le Goff C, Piga N, Vogeser M, Hausmann M, Cavalier E. Performance characteristics of the VIDAS® 25-OH Vitamin D Total assay - comparison with four immunoassays and two liquid chromatography-tandem mass spectrometry methods in a multicentric study. Clin Chem Lab Med 2016; 54:45-53. [PMID: 26124054 DOI: 10.1515/cclm-2014-1249] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 05/22/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND The study was conducted to evaluate the analytical and clinical performance of the VIDAS® 25-OH Vitamin D Total assay. The clinical performance of the assay was compared with four other immunoassays against the results of two different liquid chromatography/mass spectrometry methods (LC-MS/MS) standardized to NIST reference materials. METHODS VIDAS® 25-OH Vitamin D Total assay precision, linearity, detection limits and sample matrix comparison were assessed following CLSI guidelines. For method comparison, a total of 150 serum samples ranging from 7 to 92 ng/mL were analyzed by all the methods. Correlation was studied using Passing-Bablok regression and Bland-Altman analysis. The concordance correlation coefficient (CCC) was calculated to evaluate agreement between immunoassays and the reference LC-MS/MS method. In addition, samples containing endogenous 25(OH)D2 were used to assess each immunoassay's ability to detect this analyte. Pregnancy and hemodialysis samples were used to the study the effect of vitamin D binding protein (DBP) concentration over VIDAS® assay performance. RESULTS The VIDAS® 25-OH Vitamin D Total assay showed excellent correlation to the LC-MS/MS results (y=1.01x+0.22 ng/mL, r=0.93), as obtained from two different sites and distinct LC-MS/MS methods. The limit of quantification was determined at 8.1 ng/mL. Cross-reactivity for 25(OH)D2 was over 80%. At concentrations of 10.5, 26 and 65.1 ng/mL, within-run CVs were 7.9%, 3.6% and 1.7%, while total CVs (between runs, calibrations, lots and instruments) were 16.0%, 4.5% and 2.8%. The VIDAS® performance was not influenced by altered DBP levels, though under-recovery of 25(OH)D as compared to LC-MS/MS was observed for hemodialysis samples. CONCLUSIONS The VIDAS® 25-OH Vitamin D Total assay is therefore considered suitable for assessment of vitamin D status in clinical routine.
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Satoh M, Ishige T, Ogawa S, Nishimura M, Matsushita K, Higashi T, Nomura F. Development and validation of the simultaneous measurement of four vitamin D metabolites in serum by LC–MS/MS for clinical laboratory applications. Anal Bioanal Chem 2016; 408:7617-7627. [DOI: 10.1007/s00216-016-9821-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 07/06/2016] [Accepted: 07/21/2016] [Indexed: 11/30/2022]
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Tabesh M, Garland SM, Gorelik A, Nankervis A, Maclean S, Callegari ET, Chang S, Heffernan K, Wark JD. Improving Vitamin D Status and Related Health in Young Women: The Safe-D study - Part B. JMIR Res Protoc 2016; 5:e80. [PMID: 27166214 PMCID: PMC4879332 DOI: 10.2196/resprot.5465] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/09/2016] [Accepted: 03/18/2016] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Vitamin D deficiency is highly prevalent and associated with increased risk of a number of chronic health conditions including cardiovascular disease, poor bone and muscle health, poor mental health, infection, and diabetes. Vitamin D deficiency affects millions of Australians, potentially causing considerable suffering, economic loss, and mortality. OBJECTIVE To measure the effectiveness of a (1) mobile-based app (behavioral) and (2) pharmacological intervention to increase circulating 25-hydroxyvitamin D (serum 25 OHD) levels and health outcomes over 4 months of intervention compared with usual care in a cohort of young women with suboptimal serum 25 OHD levels (25-75 nmol/L). METHODS Participants with 25 OHD levels 25 to 75 nmol/L are invited to participate in this study. Participants are randomized to one of three groups in 1:1:1 ratio: a mobile phone-based application, vitamin D supplementation (1000 IU/day), and a control group. Data collection points are at baseline, 4, and 12 months post baseline with the major endpoints being at 4 months. A wide-range of information is collected from participants throughout the course of this study. General health, behavioral and demographic information, medications, smoking, alcohol and other substance use, health risk factors, nutrition, eating patterns and disorders, and mental health data are sourced from self-administered, Web-based surveys. Clinical data include anthropometric measurements, a silicone skin cast of the hand, cutaneous melanin density, bone mineral density, and body composition scans obtained through site visits. Main analyses will be conducted in two ways on an intention-to-treat (ITT) basis using the last observation carried forward approach as an imputation for missing data, and on a per protocol basis to compare the intervention arms against the control group at 4 and 12 months. RESULTS Publication of trial results is anticipated in 2017. CONCLUSIONS The study will allow assessment of the effects of a mobile-based app behavioral intervention and vitamin D supplementation on vitamin D status and will evaluate the effects of improving vitamin D levels on several health outcomes.
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Affiliation(s)
- Marjan Tabesh
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, VIC, Australia
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Yu S, Cheng X, Fang H, Zhang R, Han J, Qin X, Cheng Q, Su W, Hou L, Xia L, Qiu L. 25OHD analogues and vacuum blood collection tubes dramatically affect the accuracy of automated immunoassays. Sci Rep 2015; 5:14636. [PMID: 26420221 PMCID: PMC4588576 DOI: 10.1038/srep14636] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 09/02/2015] [Indexed: 02/06/2023] Open
Abstract
Variations in vitamin D quantification methods are large, and influences of vitamin D analogues and blood collection methods have not been systematically examined. We evaluated the effects of vitamin D analogues 25OHD2 and 3-epi 25OHD3 and blood collection methods on vitamin D measurement, using five immunoassay systems and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Serum samples (332) were selected from routine vitamin D assay requests, including samples with or without 25OHD2 or 3-epi 25OHD3, and analysed using various immunoassay systems. In samples with no 25OHD2 or 3-epi 25OHD3, all immunoassays correlated well with LC-MS/MS. However, the Siemens system produced a large positive mean bias of 12.5 ng/mL and a poor Kappa value when using tubes with clot activator and gel separator. When 25OHD2 or 3-epi 25OHD3 was present, correlations and clinical agreement decreased for all immunoassays. Serum 25OHD in VACUETTE tubes with gel and clot activator, as measured by the Siemens system, produced significantly higher values than did samples collected in VACUETTE tubes with no additives. Bias decreased and clinical agreement improved significantly when using tubes with no additives. In conclusion, most automated immunoassays showed acceptable correlation and agreement with LC-MS/MS; however, 25OHD analogues and blood collection tubes dramatically affected accuracy.
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Affiliation(s)
- Songlin Yu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xinqi Cheng
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Huiling Fang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Ruiping Zhang
- Department of Clinical Laboratory, China-Japan Hospital, Beijing 100029, China
| | - Jianhua Han
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xuzhen Qin
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Qian Cheng
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Wei Su
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Li'an Hou
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Liangyu Xia
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Ling Qiu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
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Mena-Bravo A, Priego-Capote F, Luque de Castro MD. Study of blood collection and sample preparation for analysis of vitamin D and its metabolites by liquid chromatography-tandem mass spectrometry. Anal Chim Acta 2015; 879:69-76. [PMID: 26002479 DOI: 10.1016/j.aca.2015.03.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 01/26/2015] [Accepted: 03/06/2015] [Indexed: 11/18/2022]
Abstract
The analysis of vitamin D status, with special emphasis on 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D, is gaining interest in clinical studies due to the classical and non-classical effects attributed to this prohormone. In this research, the influence of the two steps preceding determination (viz. sample collection and preparation) on the quantitative analysis of vitamin D and its more important metabolites has been studied. Two preparation approaches, deproteination and solid-phase extraction (SPE), have been evaluated in terms of sensitivity to delimit their application, thus establishing that detection of 1,25-dihydroxyvitamin D cannot be addressed by protein precipitation. Concerning sample collection, serum and plasma reported high accuracy (above 83.3%) for vitamin D and metabolites, while precision, expressed as relative standard deviation, was below 12.9% for all analytes in both samples. Statistical analysis revealed that serum and plasma provided similar physiological levels for vitamin D3, 24,25-dihydroxyvitamin D3 and 25-hydroxyvitamin D3, while significantly different levels were obtained for 1,25-dihydroxyvitamin D3, always higher in plasma than in serum. Sample collection and treatment have proved to be significant in the analysis of vitamin D and its relevant metabolites.
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Affiliation(s)
- A Mena-Bravo
- Department of Analytical Chemistry, Annex Marie Curie Building, Campus of Rabanales, University of Córdoba, Córdoba, Spain; Agroalimentary Excellence Campus, ceiA3, University of Córdoba, Córdoba, Spain; Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
| | - F Priego-Capote
- Department of Analytical Chemistry, Annex Marie Curie Building, Campus of Rabanales, University of Córdoba, Córdoba, Spain; Agroalimentary Excellence Campus, ceiA3, University of Córdoba, Córdoba, Spain; Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain.
| | - M D Luque de Castro
- Department of Analytical Chemistry, Annex Marie Curie Building, Campus of Rabanales, University of Córdoba, Córdoba, Spain; Agroalimentary Excellence Campus, ceiA3, University of Córdoba, Córdoba, Spain; Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain.
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22
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Yu S, Fang H, Han J, Cheng X, Xia L, Li S, Liu M, Tao Z, Wang L, Hou L, Qin X, Li P, Zhang R, Su W, Qiu L. The high prevalence of hypovitaminosis D in China: a multicenter vitamin D status survey. Medicine (Baltimore) 2015; 94:e585. [PMID: 25715263 PMCID: PMC4554140 DOI: 10.1097/md.0000000000000585] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Vitamin D deficiency, which is usually detected by using immunoassays or the more reliable liquid chromatography tandem mass spectrometry (LC-MS/MS) methods, has recently been considered a public health problem worldwide. However, the vitamin D status in Chinese populations, as measured using the LC-MS/MS method, is not available. The objective of this multicenter study was to determine the vitamin D status and prevalence of vitamin D deficiency by using a reliable method in 5 large cities in China. From May 1 to September 31, 2013, we conducted a multicenter study on 2173 apparently healthy adults who were recruited from 5 Chinese cities. The 25-hydroxyvitamin D 25OHD2 and 25OHD3 levels were measured using the LC-MS/MS method. Intact parathyroid hormone (iPTH), calcium, phosphorus, and alkaline phosphate levels were also measured using an automatic analyzer. The mean 25OHD level of all participants was 19.4 ± 6.4 ng/mL (2.5-97.5%: 7.9-32.6 ng/mL), and only 109 (5.0%) participants had a 25OHD2 level >2.5 ng/mL (maximum, 22.4 ng/mL). In this study, the prevalence of severe vitamin D deficiency (<10 ng/mL), vitamin D deficiency (10-20 ng/mL), vitamin D insufficiency (20-30 ng/mL), and vitamin D sufficiency (>30 ng/mL) was 5.9%, 50.0%, 38.7%, and 5.4%, respectively. Women had a significant higher rate of deficiency than men (66.3% vs 45.3%, P < 0.01). Participants aged 18 to 39 years had a lower 25OHD level than elderly individuals (>59 years). Lifestyle may influence the 25OHD level more than the latitude, with participants in Dalian having the highest 25OHD level and the lowest deficiency rate. The serum iPTH level showed a significant negative correlation with the 25OHD level (r = -0.23, P < 0.01) after correcting for age and sex. In conclusion, the present study evaluated the vitamin D status using a reliable method, and our results indicate that vitamin D deficiency is prevalent among all age groups in China, especially among younger adults. We also observed significant differences in the 25OHD levels according to sex, age, and region among apparently healthy individuals.
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Affiliation(s)
- Songlin Yu
- From the Department of Clinical Laboratory (SY, HF, JH, XC, LX, LH, XQ, PL, WS, LQ), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing; Department of Clinical Laboratory (SL), The First Affiliated Hospital of Dalian Medical University, Dalian; Department of Clinical Laboratory (ML), The First Affiliated Hospital, Sun Yat-sen University, Guangdong; Department of Clinical Laboratory (ZT), The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou; Department of Clinical Laboratory (LW), Xinjiang Medical University, Xinjiang; and Department of Clinical Laboratory (RZ), China-Japan Friendship Hospital, Beijing, China
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23
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Meng QH, Wagar EA. Laboratory approaches for the diagnosis and assessment of hypercalcemia. Crit Rev Clin Lab Sci 2014; 52:107-19. [DOI: 10.3109/10408363.2014.970266] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Su Z, Narla SN, Zhu Y. 25-Hydroxyvitamin D: analysis and clinical application. Clin Chim Acta 2014; 433:200-5. [PMID: 24680864 DOI: 10.1016/j.cca.2014.03.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Revised: 03/18/2014] [Accepted: 03/19/2014] [Indexed: 01/04/2023]
Abstract
25-Hydroxyvitamin D (25-OHD) is one of the most popular tests requested by clinicians nowadays because in addition to bone diseases, many non-skeletal disorders have been suggested to be linked to vitamin D deficiency or insufficiency. Methodologies used in clinical laboratories include competitive vitamin D protein binding assays (CPBA), immunoassays, high performance liquid chromatography (HPLC), and liquid chromatography-tandem mass spectrometry (LC-MS/MS). In this review article, we introduce the basic metabolism and physiology of vitamin D, key issues in the methods for 25-OHD measurement currently used in most clinical laboratories, and clinical applications of 25-OHD testing. We conclude that although the methodologies for 25-OHD testing have improved significantly, considerable bias between different methods and laboratories still exists. Therefore, standardization of the method is critical. The optimal 25-OHD levels should be determined based on the standardized method. Also, more studies are needed to further determine the relationship between vitamin D deficiency or insufficiency and non-skeletal diseases as well as daily vitamin D dose requirement for reducing the risk of non-skeletal diseases.
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Affiliation(s)
- Zengliu Su
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Satya Nandana Narla
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Yusheng Zhu
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA.
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25
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Shin SY, Kwon MJ, Song J, Park H, Woo HY. Measurement of serum total vitamin D (25-OH) using automated immunoassay in comparison [corrected] with liquid chromatography tandem-mass spectrometry. J Clin Lab Anal 2014; 27:284-9. [PMID: 23852785 DOI: 10.1002/jcla.21598] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 02/04/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The associations of vitamin D deficiency with many nonskeletal diseases are still being discovered. We evaluated the use of an automated immunoassay to measure serum total vitamin D (25-OH) and assessed vitamin D status in a Korean adult population. METHODS We compared the Elecsys Vitamin D (25-OH) Total Assay (Roche Diagnostics) with liquid chromatography-tandem mass spectrometry (LC-MS/MS) using 300 serum samples. Total imprecision was calculated using three levels of quality control materials and serum samples. We also investigated the vitamin D status using data for 70,762 cases who had a routine health check-up in our hospitals. RESULTS The regression equation: Elecsys = 0.882 × LC-MS/MS + 6.814 (r = 0.926). Total imprecision was within 10% for all quality control materials and serum samples. The prevalence of vitamin D deficiency using cut-off values of <50 nmol/l (<20 ng/ml) were 70.3% in males and 86.4% in females, respectively. The prevalence of vitamin D deficiency was higher in younger subjects than in older subjects (P for linear-by-linear association was <0.001). Serum vitamin D levels were highest in September and lowest in February. CONCLUSION The Elecsys Vitamin D (25-OH) Total Assay was comparable to LC-MS/MS and appropriate for routine clinical use. Vitamin D deficiency is common in Korean adults.
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Affiliation(s)
- Sang-Yong Shin
- Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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26
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Leung KSY, Fong BMW. LC–MS/MS in the routine clinical laboratory: has its time come? Anal Bioanal Chem 2013; 406:2289-301. [DOI: 10.1007/s00216-013-7542-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 11/18/2013] [Accepted: 11/28/2013] [Indexed: 11/30/2022]
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Abstract
The demand for analysis of 25-hydroxyvitamin D has increased dramatically throughout the world over the past decade. As a consequence, a number of new automated assays have been introduced for 25-hydroxyvitamin D measurement. Automated assays have shown variable ability to meet the technical challenges associated with 25-hydroxyvitamin D measurement. Assays are able to meet performance goals for precision at high concentrations but fail to do so at low concentrations of 25-hydroxyvitamin D. The overall accuracy of automated methods has improved over recent years and generally shows good overall agreement with reference methods; however, discrepancies persist for individual samples. Liquid chromatography-tandem mass spectrometry is used by some routine laboratories for 25-hydroxyvitamin D analysis but its widespread use is hampered by limited sample throughput. 1,25-Dihydroxyvitamin D is an important analyte in specific clinical situations, which remains in the hands of specialised laboratories using manual analytical methods.
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de Koning L, Henne D, Hemmelgarn BR, Woods P, Naugler C. Non-linear relationship between serum 25-hydroxyvitamin D concentration and subsequent hip fracture. Osteoporos Int 2013; 24:2061-5. [PMID: 23250271 DOI: 10.1007/s00198-012-2249-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 11/29/2012] [Indexed: 11/28/2022]
Abstract
UNLABELLED Serum 25-OH vitamin D levels were compared in 254 hip fracture subjects and 2,402 matched control subjects. There was a significant inverse association between 25-OH vitamin D and hip fracture only between 0 and 70 nmol/L. INTRODUCTION Vitamin D is integral to bone metabolism, however the utility of serum 25-OH vitamin D as a risk marker for hip fractures is controversial. METHODS We conducted a case-control study of patients admitted to the hospitals with hip fractures in Calgary, Alberta, (catchment population 1.4 million) between January 1, 2007 and August 31, 2011. We searched the laboratory information system of Calgary Laboratory Services for serum 25-OH vitamin D levels within 6 months prior to admission on patients admitted to hospital with hip fractures. Cases were identified through the Calgary Laboratory Services laboratory information system and were matched to controls for age, sex, and month of testing. The hip fracture-25-OH vitamin D association was examined using multiple linear and spline regression. RESULTS Of 305 subjects initially identified with hip fractures, serum 25-OH vitamin D levels were available for 254 (83 %). These were matched to 2,402 control subjects. We observed a significant (p < 0.01) non-linear relationship such that 25-OH vitamin D was inversely associated with hip fracture only below 70 nmol/L (odds ratio = 0.81 per 10 nmol/L increase; 95 % CI 0.86-0.93). CONCLUSIONS The utility of 25-OH vitamin D level as a risk marker for hip fracture depends on the cut-off level used and was of potential use only for lower levels of 25-OH vitamin D.
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Affiliation(s)
- L de Koning
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
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Bilinski K, Boyages S. Evidence of overtesting for vitamin D in Australia: an analysis of 4.5 years of Medicare Benefits Schedule (MBS) data. BMJ Open 2013; 3:bmjopen-2013-002955. [PMID: 23794593 PMCID: PMC3693422 DOI: 10.1136/bmjopen-2013-002955] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To comprehensively examine pathology test utilisation of 25-hydroxyvitamin D (25(OH)D) testing in each state of Australia to determine the cost impact and value and to add evidence to enable the development of vitamin D testing guidelines. DESIGN Longitudinal analysis of all 25(OH)D pathology tests in Australia. SETTING Primary and Tertiary Care. MEASUREMENTS The frequency of 25(OH)D testing between 1 April 2006 and 30 October 2010 coded for each individual by provider, state and month between 2006 and 2010. Rate of tests per 100 000 individuals and benefit for 25(OH)D, full blood count (FBC) and bone densitometry by state and quarter between 2000 and 2010. RESULTS 4.5 million tests were performed between 1 April 2006 and 30 October 2010. 42.9% of individuals had more than one test with some individuals having up to 79 tests in that period. Of these tests, 80% were ordered by general practitioners and 20% by specialists. The rate of 25(OH)D testing increased 94-fold from 2000 to 2010. Rate varied by state whereby the most southern state represented the highest increase and northern state the lowest increase. In contrast, the rate of a universal pathology test such as FBC remained relatively stable increasing 2.5-fold. Of concern, a 0.5-fold (50%) increase in bone densitometry was seen. CONCLUSIONS The marked variation in the frequency of testing for vitamin D deficiency indicates that large sums of potentially unnecessary funds are being expended. The rate of 25(OH)D testing increased exponentially at an unsustainable rate. Consequences of such findings are widespread in terms of cost and effectiveness. Further research is required to determine the drivers and cost benefit of such expenditure. Our data indicate that adoption of specific guidelines may improve efficiency and effectiveness of 25(OH)D testing.
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Affiliation(s)
- Kellie Bilinski
- Westmead Breast Cancer Institute, Westmead Hospital, Westmead NSW and The University of Sydney, Western Clinical School, Sydney New South Wales, Australia
| | - Steve Boyages
- Department of Endocrinology, Westmead Hospital, The University of Sydney, eHealth NSW Initiative, NSW Health, Westmead, New South Wales, Australia
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Preanalytical evaluation of serum 25-hydroxyvitamin D3 and 25-hydroxyvitamin D2 measurements using LC–MS/MS. Clin Chim Acta 2013; 420:114-20. [DOI: 10.1016/j.cca.2012.10.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 10/10/2012] [Indexed: 11/23/2022]
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31
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Garg U, Munar A, Frazee C, Scott D. A simple, rapid atmospheric pressure chemical ionization liquid chromatography tandem mass spectrometry method for the determination of 25-hydroxyvitamin D2 and D3. J Clin Lab Anal 2013; 26:349-57. [PMID: 23001980 DOI: 10.1002/jcla.21530] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Vitamin D plays a vital role not only in bone health but also in pathophysiology of many other body functions. In recent years, there has been significant increase in testing of 25-hydroxyvitamin D (25-OH vitamin D), a marker of vitamin D deficiency. The most commonly used methods for the measurement of 25-OH vitamin D are immunoassays and liquid chromatography tandem mass spectrometry (LC-MS-MS). Since immunoassays suffer from inaccuracies and interferences, LC-MS-MS is a preferred method. In LC-MS-MS methods, 25-OH vitamin D is extracted from serum or plasma by solid-phase or liquid-phase extraction. Because these extraction methods are time consuming, we developed an easy method that uses simple protein precipitation followed by injection of the supernatant to LC-MS-MS. Several mass-to-charge (m/z) ratio transitions, including commonly used transitions based on water loss, were evaluated and several tube types were tested. The optimal transitions for 25-OH vitamin D2 and D3 were 395.5 > 269.5 and 383.4 > 257.3, respectively. The reportable range of the method was 1-100 ng/mL, and repeatability (within-run) and within-laboratory imprecision were <4% and <6%, respectively. The method agreed well with the solid-phase extraction methods.
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Affiliation(s)
- Uttam Garg
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospitals and Clinics, Kansas City, MO 64108, USA.
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32
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Several approaches for vitamin D determination by surface plasmon resonance and electrochemical affinity biosensors. Biosens Bioelectron 2013; 40:350-5. [DOI: 10.1016/j.bios.2012.07.077] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 07/30/2012] [Accepted: 07/31/2012] [Indexed: 01/22/2023]
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Abstract
There are many different methods to choose for vitamin D analysis. While immunoassays are available commercially and readily automated, specificity for 25-hydroxyvitamin D2 and D3 is variable. Chemical assays such as HPLC and LC-MS/MS have greater specificity and are capable of detecting 25-hydroxyvitamin D2 and D3 separately, but are more complex and require method development. Currently LC-MS/MS is considered the method of choice for 25-hydroxyvitamin D analysis and the methods given here are for LC-MS/MS analysis of serum, plasma and dried whole blood for the separate quantitation of 25-hydroxyvitamin D2 and D3. In addition to highlighting potential interferences, the many non-analytical factors that influence vitamin D measurement are also discussed.
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Affiliation(s)
- Loretta Ford
- Department of Clinical Biochemistry, City Hospital, Birmingham, UK
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Gathungu RM, Flarakos CC, Reddy GS, Vouros P. The role of mass spectrometry in the analysis of vitamin D compounds. MASS SPECTROMETRY REVIEWS 2013; 32:72-86. [PMID: 22996283 DOI: 10.1002/mas.21353] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 04/03/2012] [Accepted: 04/03/2012] [Indexed: 06/01/2023]
Abstract
This review highlights the superseding role of mass spectrometry in the structural characterization and quantitation of vitamin D compounds in comparison to other analytical methods (e.g., UV, bioassays) that lack the sensitivity and specificity of mass spectrometry. After a short introduction to the biochemistry of vitamin D compounds, an overview of the current techniques to characterize and quantitate vitamin D compounds is given with emphasis on the contribution of mass spectrometry.
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Affiliation(s)
- Rose M Gathungu
- Barnett Institute of Chemical and Biological Analysis, Department of Chemistry and Chemical Biology, Northeastern University, Boston, Massachusetts 02115, USA
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Ajuria-Morentin I, Mar-Medina C, Bereciartua-Urbieta E, Izquierdo-Quirce F, Valladares-Gómez C, Crespo-Picot E, Jaume T. Lack of transferability between different immunoassays and LC-MS/MS for total 25-hydroxyvitamin D measurement and disagreement defining deficiency. Scandinavian Journal of Clinical and Laboratory Investigation 2012; 73:82-6. [PMID: 23171427 DOI: 10.3109/00365513.2012.743165] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Over the last few years, it has become much more common to measure concentrations of vitamin D, as its deficiency has been associated with an increasing number of health problems. Recently, a number of new immunoassays for measurement of total 25-hydroxyvitamin D (25OH-D) concentration have been released but their results may not be transferable. METHODS Our main objective was to compare results from the Cobas(®) e411 (Roche Diagnostics), Advia Centaur(®) (Siemens), Architect (Abbott), IDS-iSYS (Vitro S.A.), and Liaison(®) (Diasorin) immunoassay systems with each other and with liquid chromatography-tandem mass spectrometry (LC-MS/MS). We obtained 184 routine serum samples, covering the whole measuring range, for these methods. RESULTS Kappa values above 0.8 were considered to indicate excellent agreement. With a cut-off of 50 nmol/L Architect and Cobas were the only immunoassay methods able to identify patients with deficiencies consistent with the findings of the reference method LC-MS/MS. On the other hand, using a cut-off of 37.5 nmol/L for Liaison and 75 nmol/L for IDS-iSYS, while maintaining the value of 50 nmol/L for the LC-MS/MS method, kappa values of 0.80 and 0.83 respectively were obtained. CONCLUSIONS Choosing the best method for each laboratory is challenging due to methodological differences between them and 50 nmol/L cannot be considered as a general cut-off for defining hypovitaminosis.
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Mula-Abed WA. 25- hydroxyvitamin d: explosion in clinical interest and laboratory requests. Oman Med J 2012; 24:239-41. [PMID: 22216375 DOI: 10.5001/omj.2009.49] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Accepted: 09/10/2009] [Indexed: 01/12/2023] Open
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Coney P, Demers LM, Dodson WC, Kunselman AR, Ladson G, Legro RS. Determination of vitamin D in relation to body mass index and race in a defined population of black and white women. Int J Gynaecol Obstet 2012; 119:21-5. [PMID: 22818533 PMCID: PMC3438362 DOI: 10.1016/j.ijgo.2012.05.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 05/02/2012] [Accepted: 06/24/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To examine the contributions of obesity and race to levels of 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH) in a defined cohort of black and white women. METHODS An interventional study was conducted from October 2004 to March 2008, among 219 healthy female volunteers. Serum 25(OH)D and PTH levels were determined in 117 African American women and 102 white women and the results were compared with body mass index (BMI), percentage body fat, serum lipids, and PTH levels. RESULTS Black women had lower median levels of 25(OH)D compared with white women (27.3 nmol/L vs 52.4 nmol/L; P<0.001). Serum levels of 25(OH)D below 50 nmol/L were found in 98% of black women and 45% of white women (P<0.001). The differences between the racial groups in the levels of 25(OH)D persisted despite adjustments for body weight, percentage body fat, and BMI. Black women had higher median serum levels of PTH than white women (31.9 pg/mL vs 22.3 pg/mL; P<0.01). CONCLUSION African American women are at significant risk for low vitamin D levels. Studies are needed to determine if low vitamin D status in young African American women is associated with a greater risk for vitamin D-related chronic diseases that can be reduced with vitamin D supplementation.
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Affiliation(s)
- PonJola Coney
- Departments of Obstetrics and Gynecology, Meharry Medical College, Nashville, TN, USA
| | - Laurence M. Demers
- MS Hershey Medical Center, Pennsylvania State University, Hershey, PA, USA
| | - William C. Dodson
- MS Hershey Medical Center, Pennsylvania State University, Hershey, PA, USA
| | - Allen R. Kunselman
- MS Hershey Medical Center, Pennsylvania State University, Hershey, PA, USA
| | - Gwinnett Ladson
- Departments of Obstetrics and Gynecology, Meharry Medical College, Nashville, TN, USA
| | - Richard S. Legro
- MS Hershey Medical Center, Pennsylvania State University, Hershey, PA, USA
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Bilinski KL, Boyages SC. The rising cost of vitamin D testing in Australia: time to establish guidelines for testing. Med J Aust 2012; 197:90. [PMID: 22794049 DOI: 10.5694/mja12.10561] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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39
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Current 25-hydroxyvitamin D assays: Do they pass the test? Clin Chim Acta 2012; 413:1127-34. [DOI: 10.1016/j.cca.2012.03.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 03/12/2012] [Accepted: 03/12/2012] [Indexed: 02/06/2023]
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40
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Thibeault D, Caron N, Djiana R, Kremer R, Blank D. Development and optimization of simplified LC–MS/MS quantification of 25-hydroxyvitamin D using protein precipitation combined with on-line solid phase extraction (SPE). J Chromatogr B Analyt Technol Biomed Life Sci 2012; 883-884:120-7. [DOI: 10.1016/j.jchromb.2011.12.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 12/09/2011] [Accepted: 12/20/2011] [Indexed: 10/14/2022]
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Cluse ZN, Fudge AN, Whiting MJ, McWhinney B, Parkinson I, O'Loughlin PD. Evaluation of 25-hydroxy vitamin D assay on the immunodiagnostic systems iSYS analyser. Ann Clin Biochem 2011; 49:159-65. [PMID: 22155920 DOI: 10.1258/acb.2011.011018] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND We evaluated the recently released chemiluminescence assay for 25-hydroxy vitamin D (25-OHD) on the Immunodiagnostic Systems iSYS (IDS-iSYS) automated analyser. METHODS The IDS-iSYS comparison was performed using patient samples previously measured for 25-OHD by a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method (n = 119) and an IDS enzyme immunoassy (IDS-EIA) method (n = 64). Limit of detection and limit of quantification were determined from a precision profile. Imprecision was assessed using quality control material and pooled serum. External QAP material (Vitamin D External Quality Assessment Scheme, UK) was analysed to establish inaccuracy. Linearity was assessed by two dilution studies. Cross-reactivity was determined by three serial dilution studies of patient samples with known 25-OHD(2) concentrations. RESULTS The IDS-iSYS correlated well with both established methods (iSYS = 1.03LC-MS/MS - 6.53, R(2) = 0.82 and iSYS = 1.07IDS-EIA - 1.61, R(2) = 0.86). Imprecision of the iSYS assay for IDS control material was 13.4% at 32 nmol/L, 10% at 78 nmol/L, 9.4% at 161 nmol/L, and for the pooled material 9.3% at 72 nmol/L and 5.6% at 158 nmol/L. The evaluation found the assay to be highly accurate (IDS-iSYS = 0.93ALTM + 3.79, R(2) = 0.94) and linear (obs(1) = 0.93exp(1) - 5.05, R(2) = 0.99 (P = 0.256); and obs(2) = 0.97exp(2) + 6.07, R(2) = 0.97 (P = 0.654); ALTM, all-laboratory trimmed mean). Cross-reactivity studies demonstrated no significant difference to the calculated total 25-OHD as measured by LC-MS/MS. CONCLUSIONS Even though the imprecision of the iSYS was found to be greater than that of the LC-MS/MS and EIA methods, the performance characteristics of the IDS-iSYS 25-OHD assay are suitable for routine diagnostic purposes on a high throughput automated analyser.
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Affiliation(s)
- Zee N Cluse
- Metabolic Laboratory, Chemical Pathology Directorate, SA Pathology, Box 14, Rundle Post Office, Adelaide SA 5000, Australia.
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El-Khoury JM, Reineks EZ, Wang S. Progress of liquid chromatography-mass spectrometry in measurement of vitamin D metabolites and analogues. Clin Biochem 2011; 44:66-76. [DOI: 10.1016/j.clinbiochem.2010.05.007] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 05/05/2010] [Accepted: 05/10/2010] [Indexed: 11/16/2022]
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Vogeser M, Seger C. Pitfalls Associated with the Use of Liquid Chromatography–Tandem Mass Spectrometry in the Clinical Laboratory. Clin Chem 2010; 56:1234-44. [DOI: 10.1373/clinchem.2009.138602] [Citation(s) in RCA: 238] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND
Novel mass spectrometric techniques such as atmospheric pressure ionization and tandem mass spectrometry have substantially extended the spectrum of clinical chemistry methods during the past decade. In particular, liquid chromatography tandem–mass spectrometry (LC-MS/MS) has become a standard tool in research laboratories as well as in many clinical laboratories. Although LC-MS/MS has features that suggest it has a very high analytical accuracy, potential sources of inaccuracy have recently been identified.
CONTENT
The sources of inaccuracy in LC-MS/MS methods used in the routine quantification of small molecules are described and discussed. Inaccuracy of LC-MS/MS methods can be related to the process of ionization through the insource transformation of conjugate metabolites or target analytes and may also be attributable to ionization matrix effects that have a differential impact on target analytes and internal-standard compounds. Inaccuracy can also be associated with the process of ion selection, which mainly occurs when compounds from the sample matrix share mass transitions with a target analyte. In individual assays, most potential sources of inaccuracy can be controlled by sufficient LC separation–based sample workup before MS analysis.
SUMMARY
LC-MS/MS methods should undergo rigorous and systematic validation before introduction into patient care.
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Affiliation(s)
- Michael Vogeser
- Institute of Clinical Chemistry, Hospital of the University of Munich, Munich, Germany
| | - Christoph Seger
- Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital Innsbruck, Innsbruck, Austria
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Hanley DA, Cranney A, Jones G, Whiting SJ, Leslie WD, Cole DEC, Atkinson SA, Josse RG, Feldman S, Kline GA, Rosen C. Vitamin D in adult health and disease: a review and guideline statement from Osteoporosis Canada. CMAJ 2010; 182:E610-8. [PMID: 20624868 DOI: 10.1503/cmaj.080663] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- David A Hanley
- Departments of Medicine, University of Calgary, Calgary, AB, Canada.
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Wallace AM, Gibson S, de la Hunty A, Lamberg-Allardt C, Ashwell M. Measurement of 25-hydroxyvitamin D in the clinical laboratory: current procedures, performance characteristics and limitations. Steroids 2010; 75:477-88. [PMID: 20188118 DOI: 10.1016/j.steroids.2010.02.012] [Citation(s) in RCA: 201] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 02/15/2010] [Accepted: 02/16/2010] [Indexed: 12/19/2022]
Abstract
In this review we describe procedures, performance characteristics and limitations of methods available for the measurement of 25-hydroxyvitamin (25OHD) since the year 2000. The two main types of methods are competitive immunoassay and those based on chromatographic separation followed by non-immunological direct detection (HPLC, LC-MS/MS). Lack of a reference standard for 25OHD has, until recently, been a major issue resulting in poor between-method comparability. Fortunately this should soon improve due to the recent introduction of a standard reference material in human serum (SRM 972) from the National Institute of Standards and Technology (NIST). For immunoassay, specificity can be an issue especially in relation to the proportion of 25OHD2 that is quantified whereas HPLC and LC-MS/MS methods are able to measure the two major vitamin D metabolites 25OHD2 and 25OHD3 independently. HPLC and LC-MS/MS require more expensive equipment and expert staff but this can be offset against lower reagent costs. Increasingly procedures are being developed to semi-automate or automate HPLC and LC-MS/MS but run times remain considerably longer than for immunoassays especially if performed on automated platforms. For most HPLC and LC-MS/MS methods extraction and procedural losses are corrected for by the inclusion of an internal standard which, in part, may account for higher results compared to immunoassay. In general precision of immunoassay, HPLC and LC-MS/MS are comparable and all have the required sensitivity to identify severe vitamin D deficiency. Looking to the future it is hoped that the imminent introduction of a standard reference method (or methods) for 25OHD will further accelerate improvements in between method comparability.
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Affiliation(s)
- A M Wallace
- Department of Clinical Biochemistry, Macewen Building, Royal Infirmary, Glasgow G4 0SF, UK.
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Hoofnagle AN, Laha TJ, Donaldson TF. A rubber transfer gasket to improve the throughput of liquid-liquid extraction in 96-well plates: application to vitamin D testing. J Chromatogr B Analyt Technol Biomed Life Sci 2010; 878:1639-42. [PMID: 20444657 PMCID: PMC2877171 DOI: 10.1016/j.jchromb.2010.04.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Revised: 03/24/2010] [Accepted: 04/11/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND The unmitigated rise in demand for the assessment of vitamin D status has taxed the ability of clinical mass spectrometry laboratories to preserve turn-around times. We aimed to improve the throughput of liquid-liquid extraction of plasma/serum for the assay of 25-hydroxy vitamin D. METHODS We designed and fabricated a flexible rubber gasket that seals two 96-well plates together to quantitatively transfer the contents of one plate to another. Using the transfer gasket and a dry-ice acetone bath to freeze the aqueous infranatant, we developed a novel liquid-liquid extraction workflow in a 96-well plate format. We applied the technology to the mass spectrometric quantification of 25-hydroxy vitamin D. RESULTS Cross-contamination between wells was < or = 0.13%. The interassay imprecision over 132 days of clinical implementation was less than 10%. The method compared favorably to a standard liquid-liquid extraction in glass tubes (Deming slope=1.018, S(x|y)=0.022). The accuracy of the assay was 102-105% as assessed with the recently released control materials from NIST. CONCLUSIONS The development of a plate-sealing gasket permits the liquid-liquid extraction of clinical specimens in a moderate-throughput workflow and the reliable assay of vitamin D status. In the future, the gasket may also prove useful in other sample preparation techniques for HPLC or mass spectrometry.
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Affiliation(s)
- Andrew N Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, WA 98195-7110, USA.
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Singh RJ. Quantitation of 25-OH-vitamin D (25OHD) using liquid tandem mass spectrometry (LC-MS-MS). Methods Mol Biol 2010; 603:509-17. [PMID: 20077103 DOI: 10.1007/978-1-60761-459-3_50] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
25-OH-vitamin D (25OHD) is ordered and interpreted clinically in light of calcium balance and homeostasis. Various methodologies including immunoassay and chromatography are described for the measurement of 25OHD in biological fluids. It is well reported that all existing methods are challenging and require a high level of technical expertise. While this is also true of the methods using liquid chromatography-tandem mass spectrometry (LC-MS-MS), the technique is gaining favor in various laboratories because it offers advantages of greatly improved specificity and sensitivity.
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Affiliation(s)
- Ravinder J Singh
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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25-OH-vitamin D assay variation and subject management in clinical practice. Clin Biochem 2009; 43:531-3. [PMID: 20004185 DOI: 10.1016/j.clinbiochem.2009.11.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Revised: 11/23/2009] [Accepted: 11/23/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To compare two methods for assessing vitamin D status in clinical settings. DESIGN AND METHODS 25-OH-vitamin D status was measured in 120 patients by HPLC and a commercial immunoassay. RESULTS Only 53% of the subjects considered as vitamin D sufficient by immunoassay fell within this category according to HPLC although subjects with concentrations above 75 nmol/L, regardless of the method used, presented normal PTH concentrations. CONCLUSIONS Both methods are not exchangeable to classify subjects based on unique cut-offs but they are comparable when interpreted in relation with PTH concentrations.
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50
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Possible renoprotection by vitamin D in chronic renal disease: beyond mineral metabolism. Nat Rev Nephrol 2009; 5:691-700. [DOI: 10.1038/nrneph.2009.185] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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