Concerning the vitamin D reference range: Pre-analytical and analytical variability of vitamin D measurement

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish
Article number030501
JournalBiochemia Medica
Volume27
Issue number3
DOIs
Publication statusPublished - Oct 1 2017

Keywords

  • Analytical variability
  • Biological variability
  • DEQAS
  • Standardization
  • Vitamin D

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

Fingerprint Dive into the research topics of 'Concerning the vitamin D reference range: Pre-analytical and analytical variability of vitamin D measurement'. Together they form a unique fingerprint.

Cite this