Servicio de Bioquímica Clínica, Hospital Universitario Puerta de Hierro-Majadahonda, 28222-Madrid, Spain.
Clin Nutr. 2012 Dec;31(6):1011-4. doi: 10.1016/j.clnu.2012.04.009. Epub 2012 Jun 7.
BACKGROUND & AIM: Vitamin D deficiency is an important concern in clinical settings and recently, international agencies have recognised the importance of 25-OHD assays in defining vitamin D status. Thus, our aim was to assess the consistency of different vitamin D assays in clinical practice.
25-OH-vitamin D was measured in 332 patients by ultra-fast liquid chromatography (UHPLC) and two immunoassays (Liaison Total 25(OH) and ADVIA Centaur Vitamin D Total Assay). Samples from the Vitamin D External Quality Survey (DEQAS) and the Standard Reference Material SRM 972 were used for analytical quality control.
All methods displayed an acceptable performance with DEQAS samples but immunoassays showed a significant bias against certified materials. Compared to UHPLC, differences were significant for both immunoassays in the deficiency interval but the systematic bias was higher for the ADVIA assay throughout the whole range of concentrations.
The prevalence of vitamin D deficiency in clinical practice is assay-dependent and physicians should be aware of the uncertainty associated with vitamin D assessment.
维生素 D 缺乏是临床中的一个重要关注点,最近,国际机构已经认识到 25-羟维生素 D 检测在确定维生素 D 状态方面的重要性。因此,我们的目的是评估临床实践中不同维生素 D 检测方法的一致性。
通过超快速液相色谱法(UHPLC)和两种免疫分析法(Liaison Total 25(OH) 和 ADVIA Centaur Vitamin D Total Assay)对 332 例患者的 25-OH-维生素 D 进行了测量。使用维生素 D 外部质量评估(DEQAS)和标准参考物质 SRM 972 样本进行分析质量控制。
所有方法在 DEQAS 样本中均显示出可接受的性能,但免疫分析法对认证材料显示出显著的偏差。与 UHPLC 相比,两种免疫分析法在缺乏区间的差异均有统计学意义,但在整个浓度范围内,ADVIA 分析法的系统偏差更高。
临床实践中维生素 D 缺乏的流行情况依赖于检测方法,医生应该意识到与维生素 D 评估相关的不确定性。