Top

Published in:

Open Access 01-09-2019 | Original Contribution

LC–MS/MS based 25(OH)D status in a large Southern European outpatient cohort: gender- and age-specific differences

Authors: Silvia Giuliani, Verena Barbieri, Angela Maria Di Pierro, Fabio Rossi, Thomas Widmann, Manuela Lucchiari, Irene Pusceddu, Stefan Pilz, Barbara Obermayer-Pietsch, Markus Herrmann

Published in: European Journal of Nutrition | Issue 6/2019

Abstract

Background

Developed countries have a high prevalence of vitamin D deficiency. In previous studies, 25(OH)D was predominantly measured by immunoassays. The present study assessed serum 25(OH)D in a very large Southern European outpatient cohort by liquid chromatography tandem mass spectrometry (LC–MS/MS).

Materials and methods

74,235 serum 25(OH)D results generated under routine conditions between 2015 and 2016 were extracted from the laboratory information system of the Department of Clinical Pathology at Bolzano Hospital (Italy). In 3801 cases, parathyroid hormone (PTH) was requested in parallel. Serum 25(OH)D was measured by a NIST-972 aligned commercial LC–MS/MS method. The distribution of serum 25(OH)D concentrations in males and females of different age groups, the prevalence of 25(OH)D₂ and seasonal variability were studied.

Results

The average 25(OH)D concentration in the entire cohort was 68.6 nmol/L (7.5–1880 nmol/L). Females had a 7 nmol/L higher average 25(OH)D concentration than males, which increased significantly with age. 37.9 and 28.3% of males and females, respectively, had a deficient 25(OH)D concentration of < 50 nmol/L. 620 samples (0.84%) had measureable amounts of 25(OH)D₂. In samples with a normal PTH, 25(OH)D was 11 nmol/L higher than in the entire cohort. Seasonal variation ranged between 20 and 30% and was most pronounced in young individuals. 25(OH)D₂ remained constant throughout the year.

Conclusion

Average serum 25(OH)D in South Tyrol is higher than in other parts of Europe. 25(OH)D and PTH show a continuous inverse relationship. Seasonal variation of serum 25(OH)D is an important aspect in young and middle-aged adults, but becomes less relevant in elderly subjects. 25(OH)D₂ is of minor practical importance in South Tyrol.

Available only for authorised users

Giovannucci E, Liu Y, Rimm EB, Hollis BW, Fuchs CS, Stampfer MJ, Willett WC (2006) Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. Natl Cancer Inst 9:451–459. https://doi.org/10.1093/jnci/djj101 CrossRef

Mitri J, Muraru MD, Pittas AG (2011) Vitamin D and type 2 diabetes: a systematic review. Eur J Clin Nutr 65:1005–1015. https://doi.org/10.1038/ejcn.2011.118 CrossRefPubMedPubMedCentral

Pittas AG, Lau J, Hu FB, Dawson-Hughes B (2007) The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab 92:2017–2029. https://doi.org/10.1210/jc.2007-0298 CrossRefPubMed

Visser M, Deeg DJ, Lips P, Longitudinal Aging Study Amsterdam (2003) Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): the Longitudinal Aging Study Amsterdam. J Clin Endocrinol Metab 88:5766–5772. https://doi.org/10.1210/jc.2003-030604 CrossRefPubMed

Herrmann M, Sullivan DR, Veillard AS, McCorquodale T, Straub IR, Scott R, Laakso M, Topliss D, Jenkins AJ, Blankenberg S, Burton A, Keech AC, FIELD Study Investigators (2015) Serum 25-hydroxyvitamin D: a predictor of macrovascular and microvascular complications in patients with type 2 diabetes. Diabetes Care 38:521–528. https://doi.org/10.2337/dc14-0180 CrossRefPubMed

Agmon-Levin N, Theodor E, Segal RM, Shoenfeld Y (2013) Vitamin D in systemic and organ-specific autoimmune diseases. Clin Rev Allergy Immunol 45:256–266. https://doi.org/10.1007/s12016-012-8342-y CrossRefPubMed

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM, Endocrine Society (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930. https://doi.org/10.1210/jc.2011-0385 CrossRefPubMed

Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC et al (2011) The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 96(1):53–58CrossRefPubMed

Aloia JF The (2011) Report on dietary reference intake for vitamin D: where do we go from here? J Clin Endocrinol Metab 96(10):2987–2996. https://doi.org/10.1210/jc.2011-0090 CrossRefPubMed

10.

Ross AC, Taylor CR, Yaktine AL, Del Valle HB (2011) Committee to review dietary reference intakes for vitamin D and calcium and institute of medicine, dietary reference intakes for calcium and vitamin D. The National Academy Press (US), Washington DC

11.

Soares L, Pedrosa W. Elói-Santos SM, Vasconcellos LS (2017) 25-Hydroxyvitamin D threshold values should be age-specific. Clin Chem Lab Med 55(7):e140–e142. https://doi.org/10.1515/cclm-2016-0798 CrossRefPubMed

12.

Yetley EA (2008) Assessing the vitamin D status of the US population. Am J Clin Nutr 88:558S–564S. https://doi.org/10.1093/ajcn/88.2.558S CrossRefPubMed

13.

Powe CE, Karumanchi SA, Thadhani (2014) Vitamin D-binding protein and vitamin D in blacks and whites. N Engl J Med 370:880–881. https://doi.org/10.1056/NEJMc1315850 CrossRefPubMed

14.

Berg AH, Powe CE, Evans MK, Wenger J, Ortiz G, Zonderman AB, Suntharalingam P, Lucchesi K, Powe NR, Karumanchi SA, Thadhani RI (2015) 24,25-Dihydroxyvitamin d3 and vitamin D status of community-dwelling black and white Americans. Clin Chem 61:877–884. https://doi.org/10.1373/clinchem.2015.240051 CrossRefPubMedPubMedCentral

15.

Valcour A, Blocki F, Hawkins DM, Rao SD (2012) Effects of age and serum 25-OH-vitamin D on serum parathyroid hormone levels. J Clin Endocrinol Metab 97:3989–3995. https://doi.org/10.1210/jc.2012-2276 CrossRefPubMed

16.

Farrell CJ, Martin S, McWhinney B, Straub I, Williams P, Herrmann M (2012) State-of-the-art vitamin D assays: a comparison of automated immunoassays with liquid chromatography-tandem mass spectrometry methods. Clin Chem 58:531–542. https://doi.org/10.1373/clinchem.2011.172155 CrossRefPubMed

17.

Farrell C, Soldo J, Williams P, Herrmann M (2012) 25-Hydroxyvitamin D testing: challenging the performance of current automated immunoassays. Clin Chem Lab Med 50:1953–1963. https://doi.org/10.1515/cclm-2012-0522 CrossRefPubMed

18.

Cavalier E, Wallace AM, Carlisi A, Chapelle JP, Delanaye P, Souberbielle JC (2011) Cross-reactivity of 25-hydroxy vitamin D2 from different commercial immunoassays for 25-hydroxy vitamin D: an evaluation without spiked samples. Clin Chem Lab Med 49:555–558. https://doi.org/10.1515/CCLM.2011.072 CrossRefPubMed

19.

Woitge HW, Knothe A, Witte K, Schmidt-Gayk H, Ziegler R, Lemmer B, Seibel MJ (2000) Circannual rhythms and interactions of vitamin D metabolites, parathyroid hormone, and biochemical markers of skeletal homeostasis: a prospective study. J Bone Miner Res 15:2443–2450. https://doi.org/10.1359/jbmr.2000.15.12.2443 CrossRefPubMed

20.

Cashman KD, Dowling KG, Škrabáková Z, Gonzalez-Gross M, Valtueña J, De Henauw S, Moreno L, Damsgaard CT et al (2016) Vitamin D deficiency in Europe: pandemic? Am J Clin Nutr 103(4):1033–1044. https://doi.org/10.3945/ajcn.115.120873 CrossRefPubMedPubMedCentral

21.

Tai SS, Bedner M, Phinney KW (2010) Development of a candidate reference measurement procedure for the determination of 25-hydroxyvitamin D3 and 25-hydroxyvitamin D2 in human serum using isotope-dilution liquid chromatography-tandem mass spectrometry. Anal Chem 82:1942–1948. https://doi.org/10.1021/ac9026862 CrossRefPubMedPubMedCentral

22.

Binkley N, Sempos CT (2014) Vitamin D standardization program (VDSP). standardizing vitamin D assays: the way forward. J Bone Miner Res 29:1709–1714. https://doi.org/10.1002/jbmr.2252 CrossRefPubMed

23.

Zhao S, Gardner K, Taylor W, Marks E, Goodson N (2015) Vitamin D assessment in primary care: changing patterns of testing. Lond J Prim Care (Abingdon) 7:15–22 (PMC4494470)CrossRef

24.

Carnevale V, Modoni S, Pileri M, Di Giorgio A, Chiodini I, Minisola S, Vieth R, Scillitani A (2001) Longitudinal evaluation of vitamin D status in healthy subjects from southern Italy: seasonal and gender differences. Osteoporos Int 12:1026–1030. https://doi.org/10.1007/s001980170012 CrossRefPubMed

25.

Adami S, Romagnoli E, Carnevale V, Scillitani A, Giusti A, Rossini M, Gatti D, Nuti R, Minisola S, Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS) (2011) Guidelines on prevention and treatment of vitamin D deficiency. Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS). Reumatismo 63:129–147. https://doi.org/10.4081/reumatismo.2011.129 CrossRefPubMed

26.

Hilger J, Friedel A, Herr R, Rausch T, Roos F, Wahl DA, Pierroz DD, Weber P, Hoffmann K (2014) A systematic review of vitamin D status in populations worldwide. Br J Nutr 111:23–45. https://doi.org/10.1017/S0007114513001840 CrossRefPubMed

27.

Spiro A, Buttriss JL (2014) Vitamin D: an overview of vitamin D status and intake in Europe. Nutr Bull 39:322–350. https://doi.org/10.1111/nbu.12108 CrossRefPubMedPubMedCentral

28.

Rabenberg M, Scheidt-Nave C, Busch MA, Rieckmann N, Hintzpeter B, Mensink GB (2015) Vitamin D status among adults in Germany–results from the German Health Interview and Examination Survey for Adults (DEGS1). BMC Public Health 15:641. https://doi.org/10.1186/s12889-015-2016-7 CrossRefPubMedPubMedCentral

29.

http://dati.retecivica.bz.it/it/dataset/irraggiamento-solare-annuale-medio-sulle-principali-aree-urbanedellalto-adige-in-wh-m-progetto

30.

Holick MF, Chen TC, Lu Z, Sauter E (2007) Vitamin D and skin physiology: a D-lightful story. J Bone Miner Res 22(Suppl 2):V28–V33. https://doi.org/10.1359/jbmr.07s211 CrossRefPubMed

31.

Schleicher RL, Sternberg MR, Looker AC, Yetley EA, Lacher DA, Sempos CT, Taylor CL, Durazo-Arvizu RA, Maw KL, Chaudhary-Webb M, Johnson CL, Pfeiffer CM (2016) National estimates of serum total 25-hydroxyvitamin D and metabolite concentrations measured by liquid chromatography-tandem mass spectrometry in the US population during 2007–2010. J Nutr 146:1051–1061. https://doi.org/10.3945/jn.115.227728 CrossRefPubMedPubMedCentral

32.

Hintzpeter B, Mensink GB, Thierfelder W, Müller MJ, Scheidt-Nave C (2008) Vitamin D status and health correlates among German adults. Eur J Clin Nutr 62:1079–1089. https://doi.org/10.1038/sj.ejcn.1602825 CrossRefPubMed

33.

Armas LA, Hollis BW, Heaney RP (2004) Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab 89(11):5387–5391. https://doi.org/10.1210/jc.2004-0360 CrossRefPubMed

34.

Gennari C (2001) Calcium and vitamin D nutrition and bone disease of the elderly. Public Health Nutrb 4(2B):547–559CrossRef

35.

Jablonski NG, Chaplin G (2018) The roles of vitamin D and cutaneous production in human evolution and health. Int J Paleopathol S1879–9817(17):30133. https://doi.org/10.1016/j.ijpp.2018.01.005 CrossRef

36.

Khoo AL, Koenen HJ, Chai LY, Sweep FC, Netea MG, van der Ven AJ, Joosten I (2012) Seasonal variation in vitamin D3 levels is paralleled by changes in the peripheral blood human T Cell compartment. PLoS One 7:e29250. https://doi.org/10.1371/journal.pone.0029250 CrossRefPubMedPubMedCentral

37.

Bose S, Breysse PN, McCormack MC, Hansel NN, Rusher RR, Matsui E, Peng R, Curtin-Brosnan R, Diette GB, Center for Childhood Asthma in the Urban (2013) Outdoor exposure and vitamin D levels in urban children with asthma. Nutr J 12:81. https://doi.org/10.1186/1475-2891-12-81 CrossRefPubMedPubMedCentral

Title: LC–MS/MS based 25(OH)D status in a large Southern European outpatient cohort: gender- and age-specific differences
Authors: Silvia Giuliani
Verena Barbieri
Angela Maria Di Pierro
Fabio Rossi
Thomas Widmann
Manuela Lucchiari
Irene Pusceddu
Stefan Pilz
Barbara Obermayer-Pietsch
Markus Herrmann
Publication date: 01-09-2019
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nutrition / Issue 6/2019
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI: https://doi.org/10.1007/s00394-018-1803-1

ACC 2024 Congress Coverage

Heart Failure Video

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

LC–MS/MS based 25(OH)D status in a large Southern European outpatient cohort: gender- and age-specific differences

Abstract

Background

Materials and methods

Results

Conclusion

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2019

Chronic refined low-fat diet consumption reduces cholecystokinin satiation in rats

Vitamin D deficiency is an independent predictor of mortality in patients with chronic heart failure

Effect of macronutrient composition on meal-induced thermogenesis in adolescents with obesity

Metabolic targets of watercress and PEITC in MCF-7 and MCF-10A cells explain differential sensitisation responses to ionising radiation

A cross-sectional study of fatty acids and brain-derived neurotrophic factor (BDNF) in human milk from lactating women following vegan, vegetarian, and omnivore diets

Differences in the dietary requirement for vitamin D among Caucasian and East African women at Northern latitude

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page