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Berg AH, Tavasoli M, Lo AS, Burnett-Bowie SAM, Bhan I, Karumanchi SA, Kalim S, Zhang D, Zhao S, Thadhani RI. Development and analytical validation of a novel bioavailable 25-hydroxyvitamin D assay. PLoS One 2021; 16:e0254158. [PMID: 34242315 PMCID: PMC8270209 DOI: 10.1371/journal.pone.0254158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 06/21/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Bioavailable 25-hydroxyvitamin D (25OHD) may be a better indicator of vitamin D sufficiency than total 25OHD. This report describes a novel assay for measuring serum bioavailable 25OHD. METHODS We developed an assay for 25OHD % bioavailability based on competitive binding of 25OHD tracer between vitamin D-binding protein (DBP)-coated affinity chromatography beads and serum DBP. Bioavailable 25OHD, total 25OHD, albumin, and DBP protein concentrations were measured in 89 samples from hospitalized patients and 42 healthy controls to determine how the DBP binding assay responds to differences in concentrations of DBP and compares to calculated bioavailable 25OHD values. RESULTS DBP binding assay showed a linear relationship between DBP-bound 25OHD tracer recovered from bead supernatant and DBP calibrator concentrations (y = 0.0017x +0.731, R2 = 0.9961, p<0.001). Inversion of this relationship allowed interpolation of DBP binding equivalents based upon 25OHD tracer recovered. The relationship between DBP binding equivalents and % bioavailability fits a non-linear curve, allowing calculation of % bioavailable 25OHD from DBP binding equivalents (y = 10.625x-0.817, R2 = 0.9961, p<0.001). In hospitalized patient samples, there were linear relationships between DBP protein concentrations and DBP binding equivalents (y = 0.7905x + 59.82, R2 = 0.8597, p<0.001), between measured vs. calculated % bioavailability (y = 0.9528 + 0.0357, R2 = 0.7200, p<0.001), and between absolute concentrations of measured vs. calculated bioavailable 25OHD (y = 1.2403 + 0.1221, R2 = 0.8913, p<0.001). CONCLUSIONS The DBP-binding assay for bioavailable 25OHD shows expected changes in 25OHD % bioavailability in response to changes in DBP concentrations and concordance with calculated bioavailable 25OHD concentrations.
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Affiliation(s)
- Anders H. Berg
- Department of Pathology, Cedars Sinai Medical Center, Los Angeles, California, United States of America
| | - Mahtab Tavasoli
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Agnes S. Lo
- Department of Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Division of Nephrology and Center for Vascular Biology Research, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sherri-Ann M. Burnett-Bowie
- Endocrine Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Ishir Bhan
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - S. Ananth Karumanchi
- Department of Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Division of Nephrology and Center for Vascular Biology Research, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sahir Kalim
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Dongsheng Zhang
- Department of Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Division of Nephrology and Center for Vascular Biology Research, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sophia Zhao
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Ravi I. Thadhani
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
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2
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Troja C, Hoofnagle AN, Szpiro A, Stern JE, Lin J, Winer RL. Understanding the Role of Emerging Vitamin D Biomarkers on Short-term Persistence of High-Risk Human Papillomavirus Infection Among Mid-Adult Women. J Infect Dis 2021; 224:123-132. [PMID: 33205195 DOI: 10.1093/infdis/jiaa711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 11/10/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Associations between vitamin D biomarkers and persistent high-risk human papillomavirus (hrHPV) detection have not been evaluated. METHODS 2011-2012 stored sera from 72 women aged 30-50 years with prevalent hrHPV (n = 116 type-specific infections) were tested for 5 vitamin D biomarkers: 25(OH)D and 4 emerging biomarkers, 1,25(OH)2D; 24,25(OH)2D; free vitamin D; and vitamin D binding protein (DBP). The hrHPV detection patterns (persistent vs transient/sporadic) were determined using cervicovaginal swabs collected monthly for 6 months. Associations between vitamin D and short-term type-specific hrHPV persistence were estimated using logistic regression. Our primary exposure was continuous 25(OH)D, with additional biomarkers evaluated as secondary exposures. Primary models were adjusted for age, race, body mass index, education, contraceptives, smoking, season, and calcium/phosphate levels. Sensitivity analyses were restricted from 19 hrHPV types to 14 used in cervical cancer screening. RESULTS In primary analyses, nonsignificant positive associations with hrHPV persistence were observed for measures of 25(OH)D and 24,25(OH)2D. Associations were stronger and significant when restricting to 14 hrHPV types (25(OH)D per 10 ng/mL increase: adjusted odds ratio [aOR], 1.82 [95% confidence interval {CI}, 1.15-2.88] and aOR, 4.19 [95% CI, 1.18-14.88] DBP-adjusted; 25(OH)D ≥30 vs <30 ng/mL: aOR, 8.85 [95% CI, 2.69-29.06]; 24,25(OH)2D: aOR, 1.85 [95% CI, 1.18-2.88]). 1,25(OH)2D was unassociated with persistence. CONCLUSIONS Serum vitamin D measured by multiple biomarkers showed positive associations with short-term hrHPV persistence that were significant only when restricting to 14 clinically relevant hrHPV types.
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Affiliation(s)
- Catherine Troja
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
| | - Adam Szpiro
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Joshua E Stern
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - John Lin
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Rachel L Winer
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
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3
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Ishigami J, Grams ME, Michos ED, Lutsey PL, Matsushita K. 25-hydroxyvitamin D, Fibroblast Growth Factor 23, and Risk of Acute Kidney Injury Over 20 Years of Follow-Up. Kidney Int Rep 2021; 6:1299-1308. [PMID: 34013108 PMCID: PMC8116771 DOI: 10.1016/j.ekir.2021.02.009] [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: 08/07/2020] [Revised: 01/11/2021] [Accepted: 02/01/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Low serum 25-hydroxyvitamin D levels have been identified as a risk factor for acute kidney injury (AKI) among critically ill patients. Whether low 25-hydroxyvitamin D levels are associated with long-term incidence of hospitalization with AKI in the general population is unknown. METHODS Among 12,380 participants (mean age, 57 years; 24% black) in the Atherosclerosis Risk in Communities (ARIC) Study who attended visit 2 (1990-1992), we explored the association of serum 25-hydroxyvitamin D with incident hospitalization with AKI. Multivariable Cox models were used to estimate hazard ratios (HRs). We also examined the association of serum fibroblast growth factor 23 (FGF23) with AKI. RESULTS During a median follow-up of 24.3 years, 2145 participants had incident hospitalization with AKI (crude incidence rate: 8.3; 95% confidence interval [CI]: 8.0-8.7, per 1,000 person-years). In multivariable Cox models (including adjustment for kidney function), lower 25-hydroxyvitamin D and higher FGF23 levels were each significantly associated with an increased risk of AKI (HR: 1.35; 95% CI: 1.17-1.54, for lowest vs. highest quartile for 25-hydroxyvitamin D, and HR: 1.19; 95% CI: 1.05-1.36, for highest vs. lowest quartile for FGF23). The association was consistent across demographic and clinical subgroups, regardless of whether AKI was the primary diagnosis for hospitalization, and when adjusting for incident chronic kidney disease (CKD) or cardiovascular disease (CVD) as a time-varying covariate. CONCLUSION Among middle- to older-age adults in the community, low 25-hydroxyvitamin D and high FGF23 levels were independently associated with an increased risk of AKI. Future studies should explore underlying mechanisms linking these bone mineral metabolism markers with kidney injury.
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Affiliation(s)
- Junichi Ishigami
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Morgan E. Grams
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Erin D. Michos
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Pamela L. Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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4
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Cavalier E, Fraser CG, Bhattoa HP, Heijboer AC, Makris K, Ulmer CZ, Vesper HW, Vasikaran S, Lukas P, Delanaye P, Carobene A. Analytical Performance Specifications for 25-Hydroxyvitamin D Examinations. Nutrients 2021; 13:431. [PMID: 33525653 PMCID: PMC7911223 DOI: 10.3390/nu13020431] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 12/21/2022] Open
Abstract
Currently the 25-hydroxy vitamin D (25(OH)D) concentration is thought to be the best estimate of the vitamin D status of an individual. Unfortunately, its measurement remains complex, despite recent technological advances. We evaluated the biological variation (BV) of 25(OH)D in order to set analytical performance specifications (APS) for measurement uncertainty (MU). Six European laboratories recruited 91 healthy participants. The 25(OH)D concentrations in K3-EDTA plasma were examined weekly for up to 10 weeks in duplicate on a Lumipulse G1200 (Fujirebio, Tokyo, Japan). The linear regression of the mean 25(OH)D concentrations at each blood collection showed that participants were not in a steady state. The dissection of the 10-sample collection into two subsets, namely collections 1-5 and 6-10, did not allow for correction of the lack of homogeneity: estimates of the within-subject BV ranged from 5.8% to 7.1% and the between-subject BV ranged from 25.0% to 39.2%. Methods that would differentiate a difference induced by 25(OH)D supplementation at p < 0.05 should have MU < 13.6%, while at p < 0.01, the MU should be <9.6%. The development of APS using BV assumes a steady state of patients. The findings in this study suggest that patients are not in steady state. Therefore, APS that are based on MU appear to be more appropriate.
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Affiliation(s)
- Etienne Cavalier
- CHU de Liège and Centre de Recherche Intégré sur les Médicaments (CIRM), Department of Clinical Chemistry, University of Liège, Domaine du Sart-Tilman, B-4000 Liège, Belgium;
| | - Callum G. Fraser
- Centre for Research into Cancer Prevention and Screening, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK;
| | - Harjit P. Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary;
| | - Annemieke C. Heijboer
- Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam Gastroenterology & Metabolism, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam UMC, 1081 HVAmsterdam, The Netherlands;
| | - Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, GR-14561 Athens, Greece;
| | - Candice Z. Ulmer
- National Center for Environmental Health, Centers for Disease Control and Prevention, Division of Laboratory Sciences, Atlanta, GA 30329, USA; (C.Z.U.); (H.W.V.)
| | - Hubert W. Vesper
- National Center for Environmental Health, Centers for Disease Control and Prevention, Division of Laboratory Sciences, Atlanta, GA 30329, USA; (C.Z.U.); (H.W.V.)
| | - Samuel Vasikaran
- PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch 6150, Australia;
| | - Pierre Lukas
- CHU de Liège and Centre de Recherche Intégré sur les Médicaments (CIRM), Department of Clinical Chemistry, University of Liège, Domaine du Sart-Tilman, B-4000 Liège, Belgium;
| | - Pierre Delanaye
- Department of Nephrology, Dialysis and Transplantation, University of Liege, CHU de Liege, B-4000 Liège, Belgium;
- Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Caremeau, 30900 Nîmes, France
| | - Anna Carobene
- Laboratory Medicine, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
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5
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Ginsberg C, Hoofnagle AN, Katz R, Becker JO, Kritchevsky SB, Shlipak MG, Sarnak MJ, Ix JH. The Vitamin D Metabolite Ratio Is Independent of Vitamin D Binding Protein Concentration. Clin Chem 2020; 67:385-393. [PMID: 33188595 DOI: 10.1093/clinchem/hvaa238] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/10/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND 25-Hydroxyvitamin D [25(OH)D] may be a poor marker of vitamin D status as it reflects differences in vitamin D binding protein (VDBP) between individuals. The vitamin D metabolite ratio [VMR, ratio of 24,25(OH)2D3 to 25(OH)D3] is a marker of vitamin D status that has been hypothesized to be independent of variability in VDBP. This hypothesis has not been directly evaluated. METHODS We measured 25(OH)D3, 24,25(OH)2D3, 1,25(OH)2D3, and VDBP in 377 community-dwelling older adults that participated in the Health Aging and Body Composition Study. 24,25(OH)2D3 and 25(OH)D3 were used to calculate the VMR. We used linear regression to assess the relationship between VDBP with the VMR, 24,25(OH)2D3, 25(OH)D3, and 1,25(OH)2D3. RESULTS Participants had mean age 75 ± 3 years, 52% were female, 40% were black, and 24% had chronic kidney disease. VDBP concentrations were associated with sex, serum albumin, and VDBP phenotype in multivariable models. In fully adjusted models, each 1% higher VDBP was associated with a 0.92%[95% CI(0.37,1.49%)], 0.76% (0.39, 1.13%), and 0.57% (0.29, 0.85%), higher 24,25(OH)2D3, 25(OH)D3, and 1,25(OH)2D3. The VMR was independent of VDBP concentration, [0.16%(-0.11, 0.44) higher VMR per 1% higher VDBP, P = .25]. CONCLUSIONS The VMR was independent of VDBP concentration, whereas VDBP was strongly directly associated with the individual vitamin D metabolite concentrations. Prior studies evaluating only 25(OH)D3 may have been confounded by absence of data on VDBP status. The VMR may serve as an important biomarker of vitamin D status and clinical outcomes that can be utilized in populations with a large spectrum of VDBP concentrations.
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Affiliation(s)
- Charles Ginsberg
- Division of Nephrology-Hypertension, University of California, San Diego, San Diego, CA
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine and the Kidney Research Institute, University of Washington, Seattle, WA.,Department of Medicine and the Kidney Research Institute, University of Washington, Seattle, WA
| | - Ronit Katz
- Kidney Research Institute, University of Washington, Seattle, WA
| | - Jessica O Becker
- Department of Laboratory Medicine and the Kidney Research Institute, University of Washington, Seattle, WA.,Department of Medicine and the Kidney Research Institute, University of Washington, Seattle, WA
| | - Stephen B Kritchevsky
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Michael G Shlipak
- Kidney Health Research Collaborative, Veterans Affairs Medical Center, San Francisco, CA.,University of California, San Francisco, CA
| | - Mark J Sarnak
- Department of Medicine, Division of Nephrology, Tufts Medical Center, Boston, MA
| | - Joachim H Ix
- Division of Nephrology-Hypertension, University of California, San Diego, San Diego, CA.,Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, CA
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6
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Bottani M, Banfi G, Guerra E, Locatelli M, Aarsand AK, Coşkun A, Díaz-Garzón J, Fernandez-Calle P, Sandberg S, Ceriotti F, González-Lao E, Simon M, Carobene A. European Biological Variation Study (EuBIVAS): within- and between-subject biological variation estimates for serum biointact parathyroid hormone based on weekly samplings from 91 healthy participants. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:855. [PMID: 32793699 DOI: 10.21037/atm-19-4498] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background The European Biological Variation Study (EuBIVAS) was created by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group on Biological Variation to establish high-quality biological variation (BV) estimates for clinically important measurands. In this study, the aim was to deliver reliable BV estimates for the biointact parathyroid hormone (PTH 1-84). Methods Serum samples were obtained from a population of 91 healthy individuals (38 men, 43 pre-menopausal women, and 10 post-menopausal women; 21-69 years) from 5 European countries, with all samples stored at -80 °C prior to analysis. PTH 1-84 analysis was performed at the San Raffaele Hospital (Milan, Italy) on the Roche Cobas e801. All samples from each individual were analysed in duplicate within a single run. CV-ANOVA was applied, after analysis of variance homogeneity and outliers, to obtain BV estimates for PTH 1-84 with 95% CIs. Results The within-subject BV [CVI (95% CI)] estimates were significantly different between men and women [13.0% (12.1-14.2%) and 15.2% (14.3-16.3%), respectively], while the between-subject estimates [CVG (95% CI)] were similar (men: 26.8% (21.4-35.1%), pre-menopausal women: 27.8% (22.7-36.1%)], allowing for delivery of updated analytical performance specifications and reference change values. Conclusions Updated BV estimates for serum PTH 1-84 based on the large-scale EuBIVAS may be beneficial for the diagnosis and management of parathyroid glands and bone turnover pathologies.
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Affiliation(s)
- Michela Bottani
- IRCCS Istituto Ortopedico Galeazzi, Laboratory of Experimental Biochemistry and Molecular Biology, Milan, Italy
| | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, Laboratory of Experimental Biochemistry and Molecular Biology, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Elena Guerra
- Laboratory Medicine, Ospedale San Raffaele, Milan, Italy
| | | | - Aasne K Aarsand
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway.,Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Abdurrahman Coşkun
- Acibadem Mehmet Ali Aydınlar University, School of Medicine, Atasehir, Istanbul, Turkey
| | - Jorge Díaz-Garzón
- Hospital Universitario La Paz, Madrid, Spain, and Quality Analytical Commission of Spanish Society of Clinical Chemistry (SEQC), Barcelona, Spain
| | - Pilar Fernandez-Calle
- Hospital Universitario La Paz, Madrid, Spain, and Quality Analytical Commission of Spanish Society of Clinical Chemistry (SEQC), Barcelona, Spain
| | - Sverre Sandberg
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway.,Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Ferruccio Ceriotti
- Central Laboratory, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Margarita Simon
- Intercomarcal Laboratory Consortiums of Alt Penedès, Anoia and Garraf, Barcelona, Spain
| | - Anna Carobene
- Laboratory Medicine, Ospedale San Raffaele, Milan, Italy
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7
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Troja C, Hoofnagle AN, Szpiro A, Stern JE, Lin J, Winer RL. Serum Concentrations of Emerging Vitamin D Biomarkers and Detection of Prevalent High-Risk HPV Infection in Mid-adult Women. Cancer Epidemiol Biomarkers Prev 2020; 29:1468-1474. [PMID: 32317302 DOI: 10.1158/1055-9965.epi-20-0126] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/23/2020] [Accepted: 04/17/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Vitamin D has potential immunomodulating benefits in infection. One prior population-based cross-sectional study showed a protective association between serum concentrations of 25(OH)D and high-risk human papillomavirus (hrHPV) detection. Additional biomarkers present at different stages along the vitamin D metabolic pathway may more completely characterize vitamin D status but have not yet been evaluated in relation to hrHPV infection. METHODS Stored sera from women aged 30-50 years (N = 404) enrolled in an HPV natural history study from 2011-2012 were tested for 25(OH)D and 4 novel vitamin D biomarkers: 1,25(OH)2D, 24,24(OH)2D3, free vitamin D, and vitamin D-binding protein. Cross-sectional associations between vitamin D serum concentrations and cervicovaginal hrHPV detection were estimated using logistic regression. RESULTS 25(OH)D serum concentrations were not associated with hrHPV. After adjusting for age, race, season, education, oral contraceptive use, smoking status, body mass index, and serum concentrations of calcium and phosphate, each 1 ng/mL increase in 24,25(OH)2D3 was nearly statistically significantly associated with higher likelihood of hrHPV detection [aOR = 1.22; 95% confidence interval (CI), 0.97-1.52]. No significant associations were observed for other biomarkers. CONCLUSIONS 25(OH)D serum concentrations were unassociated with prevalent hrHPV. Higher levels of one novel biomarker, 24,25(OH)2D3, were positively associated with hrHPV, an unexpected finding. IMPACT Inconsistent with previous findings of a protective association between 25(OH)D and prevalent hrHPV infection, these results suggest serum concentrations of 4 vitamin D biomarkers are unassociated with detection of hrHPV in mid-adult women.
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Affiliation(s)
- Catherine Troja
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Adam Szpiro
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Joshua E Stern
- Department of Global Health, University of Washington, Seattle, Washington
| | - John Lin
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Rachel L Winer
- Department of Epidemiology, University of Washington, Seattle, Washington.
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8
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Corte Z, Venta R. Biological variation of metabolic cardiovascular risk factors in haemodialysis patients and healthy individuals. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:281. [PMID: 32355725 PMCID: PMC7186598 DOI: 10.21037/atm.2020.03.26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Maintenance haemodialysis (HD) is associated with a very high cardiovascular risk and the assessment of metabolic cardiovascular risk factors is essential for an adequate diagnosis and management. The aim of the study has been to estimate the biological variation (BV) of serum lipids, calcium, inorganic phosphorus, 25-OH vitamin D, C-reactive protein and plasma intact parathyroid hormone (PTHi) and total homocysteine, to evaluate whether HD alter the homeostatic set-point of these magnitudes. Methods Blood samples were collected from 18 HD patients in steady-state conditions, one per month during 6 months, and from 11 healthy volunteers at weekly intervals over 5 weeks. BV data were derived using CV-ANOVA. Results Within-subject coefficients of variation (CVI) and derived reference change values (RCV) estimated in HD patients were significantly higher than in healthy individuals for calcium (CVI =3.8% vs. 2.3%) (RCV =12.6% vs. 7.6%), inorganic phosphorus (13.1% vs. 8.0%) (RCV =38.7% vs. 30.1%) and PTHi (20.3% vs. 11.3%) (RCV =57.5% vs. 34.0%). Conclusions For calcium, inorganic phosphorus and PTHi, RCV derived from advanced disease-specific BV data is recommended for the management of bone-mineral disturbances in HD patients. For the rest of cardiovascular risk factors, the use of RCV derived from healthy individuals could be appropriate.
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Affiliation(s)
- Zoraida Corte
- Clinical Biochemistry Service, San Agustín University Hospital, Avilés, Asturias, Spain
| | - Rafael Venta
- Clinical Biochemistry Service, San Agustín University Hospital, Avilés, Asturias, Spain.,Biochemistry and Molecular Biology Department, Oviedo University, Asturias, Spain
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9
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Ferrari D, Lombardi G, Banfi G. Concerning the vitamin D reference range: pre-analytical and analytical variability of vitamin D measurement. Biochem Med (Zagreb) 2017; 27:030501. [PMID: 28900363 PMCID: PMC5575654 DOI: 10.11613/bm.2017.030501] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 07/22/2017] [Indexed: 12/17/2022] Open
Abstract
Unlike other vitamins, the vitamin D concentration in blood varies cyclically over the course of the year in relation to genetic (gender, ethnicity, polymorphisms) and environmental factors (sunlight exposure, diet, food-related or direct vitamin D supplementation, skin pigmentation). Although the major diagnostics manufacturers have recently developed improved automated 25-hydroxy vitamin D immunoassays, the intra- and inter-laboratory variability is still high (especially at low vitamin D concentrations) which might lead to incorrect vitamin D deficiency/insufficiency diagnosis. Moreover, despite recent efforts to standardize the assay and minimize its variability, the current bias for measured vitamin D concentrations is often still above the desirable ± 10% criterion. Because the implications of low vitamin D concentrations in non-skeletal diseases are still partially unknown, international guideline recommendations for establishing meaningful ranges, at any time over the course of the year, irrespective not only of environmental and personal factors but also of instrumental variability, are needed. In this review, we discuss the main factors that influence the variability of vitamin D concentrations and whether a centile curve, individually calculated by a theoretical equation considering such factors, might be better suited than a fixed limit to assess abnormal vitamin D concentrations in otherwise healthy subjects. Vitamin D reference ranges during pregnancy, childhood, or diagnosed illnesses, which merit separate discussion, are beyond the scope of this review.
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Affiliation(s)
- Davide Ferrari
- Department of Biosciences, University of Parma, Parma, Italy
| | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | - Giuseppe Banfi
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
- Vita-Salute San Raffaele University, Milano, Italy
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10
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High Levels of Circulating Type II Collagen Degradation Marker (CTx-II) Are Associated with Specific VDR Polymorphisms in Patients with Adult Vertebral Osteochondrosis. Int J Mol Sci 2017; 18:ijms18102073. [PMID: 28961166 PMCID: PMC5666755 DOI: 10.3390/ijms18102073] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/12/2017] [Accepted: 09/25/2017] [Indexed: 01/31/2023] Open
Abstract
Both vitamin D and collagen have roles in osteocartilaginous homeostasis. We evaluated the association between the circulating 25-hydroxyvitamin D (25(OH)D) type I and II collagen degradation products (CTx-I, and CTx-II), and four vitamin D receptor gene (VDR) polymorphisms, in Italian males affected by low back pain (LBP) due to herniation/discopathy and/or vertebral osteochondrosis. FokI, BsmI, ApaI, and TaqI VDR-polymorphisms were detected through PCR-restriction fragment length polymorphism (RFLP), and circulating 25(OH)D, CTx-I and CTx-II were measured by immunoassays in 79 patients (of which 26 had osteochondrosis) and 79 age-, sex- and body mass index (BMI)-matched healthy controls. Among all 158 subjects, carriers of FF and Ff genotypes showed lower 25(OH)D than ff, which suggested a higher depletion of vitamin D in F allele carriers. Higher CTx-I concentrations were observed in TT versus Tt among controls, and Tt versus tt among LBP cases, which suggested a higher bone-cartilaginous catabolism in subjects bearing the T allele. Higher CTx-II concentrations were observed in patients with osteochondrosis bearing FF, bb, TT, or Aa genotypes in comparison with hernia/discopathy patients and healthy controls. Vertebral osteochondrosis shows peculiar genotypic and biochemical features related to vitamin D and the osteocartilaginous metabolism. Vitamin D has roles in the pathophysiology of osteochondrosis.
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Robinson-Cohen C, Zelnick LR, Hoofnagle AN, Lutsey PL, Burke G, Michos ED, Shea SJC, Tracy R, Siscovick DS, Psaty B, Kestenbaum B, de Boer IH. Associations of Vitamin D-Binding Globulin and Bioavailable Vitamin D Concentrations With Coronary Heart Disease Events: The Multi-Ethnic Study of Atherosclerosis (MESA). J Clin Endocrinol Metab 2017; 102:3075-3084. [PMID: 28472285 PMCID: PMC5546864 DOI: 10.1210/jc.2017-00296] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 04/27/2017] [Indexed: 01/14/2023]
Abstract
CONTEXT Low 25-hydroxyvitamin D [25(OH)D] is associated with coronary heart disease (CHD) in people who are white and Chinese but not black or Hispanic. Vitamin D binding globulin (VDBG) avidly binds 25(OH)D, reducing its bioavailability, and differs in isoform and concentration by race. OBJECTIVE Evaluate associations of VDBG with CHD and whether accounting for VDBG or estimating bioavailable 25(OH)D explains the heterogeneity of the association of 25(OH)D with CHD. DESIGN AND SETTING We conducted a case-cohort study within the Multi-Ethnic Study of Atherosclerosis. Participants with an incident CHD event over 12 years of follow-up (n = 538) and a randomly assigned subcohort (n = 999) were included. We measured baseline 25(OH)D, VDBG, and isoforms using mass spectrometry and estimated bioavailable 25(OH)D from published equations. RESULTS VDBG was associated with an increased risk of CHD [hazard ratio, 1.77 (95% confidence interval, 1.46 to 2.14) per standard deviation increment, P < 0.0001], without evidence of heterogeneity by race or isoform (each P for interaction > 0.1). Low total 25(OH)D was differentially associated with CHD events, by race, with or without adjustment for VDBG (P for interaction = 0.04 or 0.05, respectively). Associations of 25(OH)D with CHD were strengthened with adjustment for VDBG among participants who were white or Chinese, and bioavailable 25(OH)D was associated with CHD events only among white participants. CONCLUSIONS High VDBG concentration was associated with CHD events in all racial and ethnic groups. Incorporation of VDBG strengthened existing associations of 25(OH)D with CHD but did not explain racial heterogeneity in associations of 25(OH)D with CHD.
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Affiliation(s)
- Cassianne Robinson-Cohen
- Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington 98195
| | - Leila R. Zelnick
- Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington 98195
| | - Andrew N. Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, Washington 98195
| | - Pamela L. Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55455
| | - Gregory Burke
- School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27109
| | - Erin D. Michos
- Division of Cardiology, Johns Hopkins University, Baltimore, Maryland 21218
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21205
| | - Steven J. C. Shea
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York 10032
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10027
| | - Russell Tracy
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, Vermont 05405
- Department of Biochemistry, University of Vermont, Burlington, Vermont 05405
| | | | - Bruce Psaty
- Cardiovascular Health Research Unit, Departments of Epidemiology and Medicine, University of Washington, Seattle, Washington 98101
- Department of Health Services, University of Washington, Seattle, Washington 98195
- Group Health Research Institute, Seattle, Washington 98101
| | - Bryan Kestenbaum
- Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington 98195
| | - Ian H. de Boer
- Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington 98195
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Berg AH, Bhan I, Powe C, Karumanchi SA, Xu D, Thadhani RI. Acute Homeostatic Changes Following Vitamin D 2 Supplementation. J Endocr Soc 2017; 1:1135-1149. [PMID: 29264568 PMCID: PMC5686571 DOI: 10.1210/js.2017-00244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 07/14/2017] [Indexed: 01/08/2023] Open
Abstract
Context: Changes in vitamin D binding protein (DBP) concentrations and catabolism of 25-hydroxyvitamin D to 24,25-dihydroxyvitamin D (24,25D) after vitamin D2 supplementation may alter concentrations and bioavailability of circulating 25-hydroxyvitamin D (25D). Objective: Examine acute changes in vitamin D metabolism and bioavailability after vitamin D2 supplementation. Methods: Study design was secondary analysis of a single-arm interventional study. Thirty consenting volunteers were treated with five 50,000 IU oral doses of ergocalciferol over 2 weeks. Main outcome measures included concentrations of DBP, vitamin D metabolites, and bioavailable 25-hydroxyvitamin D (25D) in pre- and posttreatment serum samples. Results: After supplementation, 25D2 (mean ± standard deviation) increased from 1.4 ± 0.9 ng/mL to 45.3 ± 16.5 ng/mL (P < 0.0001), and 25D3 levels decreased from 26.8 ± 9.9 ng/mL to 19.7 ± 8.2 ng/mL (P < 0.0001). Total 25D (25D2 plus 25D3) increased from 28.2 ± 10.0 ng/mL to 65.0 ± 21.1 ng/mL (152.2% ± 102.5%; P < 0.0001). DBP and total 24,25D concentrations increased 39.1% ± 39.4% (165.6 ± 53.8 µg/mL to 222.0 ± 61.1 µg/mL; P < 0.0001) and 31.3% ± 48.9% (3.9 ± 2.0 ng/mL to 4.7 ± 2.1 ng/mL; P = 0.0147), respectively. In contrast to total 25D, bioavailable 25D increased by 104.4% ± 99.6% (from 5.0 ± 2.0 ng/mL to 8.7 ± 2.7 ng/mL; P < 0.001), and 1,25D increased by 32.3% ± 38.8% (from 45.5 ± 10.7 pg/mL to 58.1 ± 13.0 pg/mL; P = 0.0006). There were no changes in calcium or parathyroid hormone (P > 0.05 for both). Conclusion: Changes after vitamin D2 supplementation involve acute rise in serum DBP and 24,25D, both of which may attenuate the rise in bioavailable 25D and 1,25D.
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Affiliation(s)
- Anders H Berg
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215
| | - Ishir Bhan
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114
| | - Camille Powe
- Division of Endocrinology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114
| | - S Ananth Karumanchi
- Division of Nephrology and Center for Vascular Biology Research, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215
| | - Dihua Xu
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114
| | - Ravi I Thadhani
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114
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