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Rueter K, Black LJ, Jones A, Bulsara M, Clarke MW, Gamez C, Lim EM, Palmer DJ, Prescott SL, Siafarikas A. Analytical Bias in the Measurement of Plasma 25-Hydroxyvitamin D Concentrations in Infants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020412. [PMID: 31936279 PMCID: PMC7014414 DOI: 10.3390/ijerph17020412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/30/2019] [Accepted: 12/30/2019] [Indexed: 01/16/2023]
Abstract
Hypovitaminosis D is prevalent worldwide; however, analytical bias in the measurement of circulating 25-hydroxyvitamin D (25(OH)D) concentrations may affect clinical treatment decisions and research. We performed parallel plasma 25(OH)D analyses using the Abbott Architect i2000 chemiluminescent immunoassay (CIA) and liquid chromatography–tandem mass spectrometry (LC–MS/MS) for paired samples from the same infants at 3 (n = 69), 6 (n = 79) and 12 months (n = 73) of age. To test agreement, we used Lin’s concordance correlation coefficient and corresponding 95% confidence interval, Bland–Altman’s limits of agreement, and Bradley–Blackwood (BB) test. Agreement was high at 3 months (coefficient between difference and mean −0.076; BB F = 0.825; p = 0.440), good at 12 months (−0.25; BB F = 2.41; p = 0.097) but missing at 6 months of age (−0.39; BB F = 12.30; p < 0.001). Overall, 18 infants had disparate results based on the cut-off point for vitamin D deficiency (25(OH)D < 50 nmol/L), particularly at three months, with seven (10%) infants deficient according to CIA but not LC–MS/MS, and four (6%) deficient by LC–MS/MS but not CIA. To our knowledge, this is the first study to show that the reported 25(OH)D concentration may be influenced by both age and assay type. Physicians and researchers should be aware of these pitfalls when measuring circulating 25(OH)D concentrations in infants and when developing treatment plans based on measured vitamin D status.
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Affiliation(s)
- Kristina Rueter
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth 6009, Australia; (A.J.); (C.G.); (D.J.P.); (S.L.P.); (A.S.)
- Perth Children’s Hospital, Department of Paediatric Immunology, Perth 6009, Australia
- inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN), West New York, NJ 07093, USA
- Correspondence:
| | - Lucinda J. Black
- School of Public Health, Curtin University, Perth 6102, Australia;
| | - Anderson Jones
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth 6009, Australia; (A.J.); (C.G.); (D.J.P.); (S.L.P.); (A.S.)
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
| | - Max Bulsara
- Institute for Health Research, University of Notre Dame, Fremantle 6160, Australia;
| | - Michael W. Clarke
- Metabolomics Australia, Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Perth 6009, Australia;
| | - Cristina Gamez
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth 6009, Australia; (A.J.); (C.G.); (D.J.P.); (S.L.P.); (A.S.)
| | - Ee M. Lim
- Sir Charles Gairdner Hospital, Department of Endocrinology, Perth 6009, Australia;
- PathWest Laboratory Medicine, QEII Medical Centre, Nedlands 6009, Australia
| | - Debra J. Palmer
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth 6009, Australia; (A.J.); (C.G.); (D.J.P.); (S.L.P.); (A.S.)
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
| | - Susan L. Prescott
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth 6009, Australia; (A.J.); (C.G.); (D.J.P.); (S.L.P.); (A.S.)
- Perth Children’s Hospital, Department of Paediatric Immunology, Perth 6009, Australia
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
| | - Aris Siafarikas
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth 6009, Australia; (A.J.); (C.G.); (D.J.P.); (S.L.P.); (A.S.)
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Institute for Health Research, University of Notre Dame, Fremantle 6160, Australia;
- Perth Children’s Hospital, Department of Paediatric Endocrinology and Diabetes, Perth 6009, Australia
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