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Vitamin D testing: advantages and limits of the current assays

European Journal of Clinical Nutrition volume 74, pages 231–247 (2020)Cite this article

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Abstract

Vitamin D deficiency and insufficiency has become a pandemic health problem with a consequent increase of requests for determining circulating levels of 25-hydroxyvitamin D [25(OH)D]. However, the analytical performance of these immunoassays, including radioimmunoassay and ELISA, is highly variable, and even mass spectrometric methods, which nowadays serves as the gold standard for the quantitatively determination of 25(OH)D, do not necessarily produce comparable results, creating limitations for the definition of normal vitamin D status ranges. To solve this problem, great efforts have been made to promote standardization of laboratory assays, which is important to achieve comparable results across different methods and manufacturers. In this review, we performed a systematic analysis evaluating critically the advantages and limits of the current assays available for the measure of vitamin D status, i.e., circulating 25(OH)D and its metabolites, making suggestions that could be used in the clinical practice. Moreover, we also suggest the use of alternatives to blood test, including standardized surveys that may be of value in alerting health-care professionals about the vitamin D status of their patients.

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Authors and Affiliations

  1. Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

    Barbara Altieri

  2. Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy

    Barbara Altieri & Annamaria Colao

  3. Department of Clinical Chemistry, University of Liège, CHU de Liège, Liège, Belgium

    Etienne Cavalier

  4. Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

    Harjit Pal Bhattoa

  5. Instituto de Investigaciones Sanitarias de Aragón, Zaragoza, Spain

    Faustino R. Pérez-López, María T. López-Baena & Gonzalo R. Pérez-Roncero

  6. Faculty of Medicine, University of Zaragoza, Zaragoza, Spain

    Faustino R. Pérez-López

  7. Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador

    Peter Chedraui

  8. Facultad de Ciencias de la Salud, Universidad Católica “Nuestra Señora de la Asunción”, Asunción, Paraguay

    Peter Chedraui

  9. Department of Geriatric Medicine, Angers University Hospital; Angers University Memory Clinic; Research Center on Autonomy and Longevity; UPRES EA 4638, University of Angers, Angers, France

    Cedric Annweiler

  10. Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada

    Cedric Annweiler

  11. Department of Endocrinology, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy

    Silvia Della Casa

  12. Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria

    Sieglinde Zelzer & Markus Herrmann

  13. Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy

    Antongiulio Faggiano

  14. Department of Medicine, Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA

    Michael F Holick

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  1. Barbara Altieri
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  2. Etienne Cavalier
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  3. Harjit Pal Bhattoa
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  13. Annamaria Colao
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  14. Michael F Holick
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Contributions

BA and AC designed the study. BA, EC, HPB, FRP-L, MTL-B, GRP-R, PC, CA, SDC, SZ, MH and AF performed the literature search, screening potentially eligible studies, extracting and analyzing data, interpreting results, and contributed to the writing of the article. BA, FRP-L, MTL-B, GRP-R, PC, CA, SZ and MH prepared the tables. MFH contributed to the abstract and wrote the conclusion. BA, AC and MFH critically revised the article for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Barbara Altieri.

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Conflict of interest

EC has consulted for DiaSorin, IDS, Fujirebio, and bioMérieux. MFH is a consultant for Quest Diagnostics Inc. MH collaborated in research projects of DiaSorin, Fujirebio, and Roche and received honoraria for scientific presentations from DiaSorin, SIEMENS, and Roche. The other co-authors declare no potential conflict of interest.

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Altieri, B., Cavalier, E., Bhattoa, H.P. et al. Vitamin D testing: advantages and limits of the current assays. Eur J Clin Nutr 74, 231–247 (2020). https://doi.org/10.1038/s41430-019-0553-3

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