New assessment on vitamin D testing

"The prevalence of vitamin D deficiency and insufficiency is high, and may possibly increase in the future. Therefore, it is desirable to include assessment of vitamin D in routine examination in order to monitor its concentrations and to follow up eventual supplementation regimens. Provided that accurate 25(OH)D value can be measured, the desirable range should be extrapolated, in individual patients, by an equation considering the time of the year, sun exposure, ethnicity, BMI, the type of assay used and possible intake of vitamin D, that can predict the 25(OH)D centile curve for an healthy subject. The discrepancy between the predicted value and the measured 25(OH)D concentration, at any time of the year, will be then safely used to determine an accurate diagnosis on the patient vitamin D status. If such equations have been developed for otherwise healthy individuals, additional parameters or completely different equations will be needed to assess individual situations like pregnancy, childhood, or diagnosed illnesses.

Although the situation has substantially improved through the efforts of the VDSP, what is still lacking is a general standardization, or at least a harmonization, of methods that provide comparable and, more importantly, less biased results. Ideally, all measurements should be performed using LC-MS; however, this scenario being impracticable, we encourage clinical laboratories to adopt an assay traceable to the gold SRMP as proposed by the Vitamin D Standardization Programme in order to calibrate their new and, if available, old measurements (91, 92)."

Sempos CT, Vesper HW, Phinney KW, Thienpont LM, Coates PM, Vitamin D. Standardization Program (VDSP). Vitamin D status as an international issue: national surveys and the problem of standardization. Scand J Clin Lab Invest Suppl. 2012;243:32–40. [PubMed]