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Comparison of total, free and bioavailable 25-OH vitamin D determinations to evaluate its biological activity in healthy adults: the LabOscat study

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Abstract

Summary

Determination of different forms of 25-OHD (total, free and bioavailable) in healthy young women does not offer additional advantages over standard 25-OHDT for evaluating vitamin D deficiency. In these subjects 25-OHDT values <15 ng/ml would be more appropriate for defining this deficiency.

Introduction

Determination of 25-OH vitamin D serum levels (25-OHD) constitutes the method of choice for evaluating vitamin D deficiency. However, vitamin D-binding protein (DBP) may modulate its bioavailability thereby affecting correct evaluation of 25-OHD status. We analysed the impact of the determination of 25-OHD (total, free and bioavailable) on the evaluation its biologic activity (estimated by serum PTH determination) in healthy young women.

Methods

173 premenopausal women (aged 35–45 yrs.) were included. We analysed serum values of total 25-OHD (25-OHDT), DBP, albumin, PTH and bone formation (PINP,OC) and resorption (NTx,CTx) markers. Free(25-OHDF) and bioavailable (25-OHDB) serum 25-OHD levels were estimated by DBP and albumin determinations and also directly by ELISA (25-OHDF-2). We analysed threshold PTH values for the different forms of 25-OHD and the correlations and differences according to 25-OHDT levels <20 ng/ml.

Results

62% of subjects had 25-OHD values <20 ng/ml and also had significantly lower 25-OHDF and 25-OHDB values, with no significant differences in bone markers and PTH values. The PTH threshold value was similar for all forms of 25-OHD (∼70 pg/ml). Women with PTH values >70 had lower 25-OHDT (15.4 ± 1.4 vs. 18.3 ± 2.7, p < 0.05) and 25OHDB values (1.7 ± 0.2 vs. 2.2 ± 0.09, p < 0.05). The different forms of 25OHD were significantly intercorrelated, with marginal correlations between PTH and 25-OHDT (r = −0.136, p = 0.082).

Conclusions

Determination of different forms of 25-OHD in healthy young women does not offer additional advantages over standard 25-OHDT for evaluating vitamin D deficiency. In these subjects 25-OHDT values <15 ng/ml would be more appropriate for defining this deficiency.

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Abbreviations

BMI:

Body mass index

25-OHDT :

Total 25 OH vitamin D

PTH:

Parathyroid hormone

DBP:

Vitamin D-binding protein

25-OHDF :

Free 25-OH vitamin D

25-OHDB :

Bioavailable 25-OH vitamin D

25-OHDF-2 :

Free 25-OH vitamin D by ELISA

Bone ALP:

Bone alkaline phosphatase

PINP:

Total serum procollagen type I amino-terminal propeptide

OC:

Osteocalcin

NTx:

Urinary cross-linked N-terminal telopeptide of type I collagen

CTx:

Serum cross-linked C-terminal telopeptide of type I collagen

References

  1. Lips P, Hosking D, Lippuner K, Norquist JM, Wehren L, Maalouf G et al (2006) The prevalence of vitamin D inadequacy amongst women with osteoporosis: an international epidemiological investigation. J Intern Med 260:245–254

    Article  CAS  PubMed  Google Scholar 

  2. Spiro A, Buttriss JL (2014) Vitamin D: an overview of vitamin D status and intake in Europe. Nutr Bull 39:322–350

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Fuleihan G-H, Bouillon R, Clarke B, Chakhtoura M, Cooper C, McClung M et al (2015) Serum 25-Hydroxyvitamin D levels: variability, knowledge gaps, and the concept of a desirable range. J Bone Miner Res 30:1119–1133

    Article  Google Scholar 

  4. Holick MF, Siris ES, Binkley N, Beard MK, Khan A, Katzer JT et al (2005) Prevalence of vitamin D inadequacy among postmenopausal north American women receiving osteoporosis therapy. J Clin Endocrinol Metab 90:3215–3224

    Article  CAS  PubMed  Google Scholar 

  5. Harris SS, Soteriades E, Dawson-Hughes B (2001) Secondary hyperparathyroidism and bone turnover in elderly blacks and whites. J Clin Endocrinol Metab 86:3801–3804

    Article  CAS  PubMed  Google Scholar 

  6. Powe CE, Ricciardi C, Berg AH, Erdenesanaa D, Collerone G, Ankers E et al (2011) Vitamin D-binding protein modifies the vitamin D-bone mineral density relationship. J Bone Miner Res 26:1609–1616

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Powe CE, Evans MK, Wenger J, Zonderman AB, Berg AH, Nalls M et al (2013) Vitamin D-binding protein and vitamin D status of black Americans and white Americans. N Engl J Med 369:1991–2000

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Bikle D, Bouillon R, Thadhani R, Schoenmakers I (2017) Vitamin D metabolites in captivity? Should we measure free or total 25(OH)D to assess vitamin D status?. J Steroid Biochem Mol Biol. (in press)

  9. Holick MF (2013) Bioavailability of vitamin D and its metabolites in black and white adults. N Engl J Med 369:2047–2048

    Article  CAS  PubMed  Google Scholar 

  10. Guañabens N, Filella X, Monegal A, Gómez-Vaquero C, Bonet M, Buquet D et al (2016) Reference intervals for bone turnover markers in Spanish premenopausal women. Clin Chem Lab Med 54:293–303

    Article  PubMed  Google Scholar 

  11. Dawson-Hughes BN, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R (2005) Estimates of optimal vitamin D status. Osteoporos Int 16:713–716

    Article  CAS  PubMed  Google Scholar 

  12. Muggeo VMR (2003) Estimating regression models with unknown break-points. Stat Med 22:3055–3071

    Article  PubMed  Google Scholar 

  13. R Core Team. R: A language and environment for statistical computing. R. Foundation for Statistical Computing, Vienna, Austria. 2016. URL https://www.R-project.org/.

  14. Ponda MP, McGee D, Breslow JL (2014) Vitamin D-binding protein levels do not influence the effect of vitamin D repletion on serum PTH and calcium: data from a randomized, controlled trial. J Clin Endocrinol Metab 99:2494–2499

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Dastani Z, Berger C, Langsetmo L, Fu L, Wong BY, Malik S et al (2014) In healthy adults, biological activity of vitamin D, as assessed by serum PTH, is largely independent of DBP concentrations. J Bone Miner Res 29:494–499

    Article  CAS  PubMed  Google Scholar 

  16. Schwartz JB, Lai J, Lizaola B, Kane L, Markova S, Weyland P et al (2014) A comparison of measured and calculated free 25(OH) vitamin D levels in clinical populations. J Clin Endocrinol Metab 99:1631–1637

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Denburg MR, Hoofnagle AN, Sayed S, Gupta J, de Boer IH, Appel LJ et al (2016) Chronic renal insufficiency cohort study investigators. Comparison of two ELISA methods and mass spectrometry for measurement of vitamin D-binding protein: implications for the assessment of bioavailable vitamin D concentrations across genotypes. J Bone Miner Res 31:1128–1136

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Abrams SA, Griffin IJ, Hawthorne KM, Gunn SK, Gundberg CM, Carpenter TO (2005) Relationships among vitamin D levels, parathyroid hormone, and calcium absorption in young adolescents J Clin Endocrinol Metab 90:5576–5581

  19. Saadi HF, Nagelkerke N, Benedict S, Qazaq HS, Zilahi E, Mohamadiyeh MK et al (2006) Predictors and relationships of serum 25 hydroxyvitamin D concentration with bone turnover markers, bone mineral density, and vitamin D receptor genotype in Emirati women. Bone 39:1136–1143

  20. Larijani B, Hossein-Nezhad A, Feizabad E, Maghbooli Z, Adibi H, Ramezani M et al (2016) Vitamin D deficiency, bone turnover markers and causative factors among adolescents: a cross-sectional study. J Diabetes Metab Disord 15:46

  21. Li M, Lv F, Zhang Z, Deng W, Li Y, Deng Z et al (2016) Establishment of a normal reference value of parathyroid hormone in a large healthy Chinese population and evaluation of its relation to bone turnover and bone mineral density. Osteoporos Int 27:1907–1916

    Article  CAS  PubMed  Google Scholar 

  22. Sahota O, Mundey MK, San P, Godber IM, Lawson N, Hosking DJ (2004) The relationship between vitamin D and parathyroid hormone: calcium homeostasis, bone turnover, and bone mineral density in postmenopausal women with established osteoporosis. Bone 35:312–319

    Article  CAS  PubMed  Google Scholar 

  23. Sai AJ, Walters RW, Fang X, Gallagher JC (2011) Relationship between vitamin D, parathyroid hormone, and bone health. J Clin Endocrinol Metab 96:E436–E446

    Article  CAS  PubMed  Google Scholar 

  24. 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

    Article  CAS  PubMed  Google Scholar 

  25. Chapuy MC, Menier PP (1997) Vitamin D insufficiency in adults and the elderly. In: Feldman D (ed) Vitamin D. Academic Press, San Diego, pp p679–p693

    Google Scholar 

  26. Tangpricha V, Pearce EN, Chen TC, Holick MF (2002) Vitamin D insufficiency among free-living healthy young adults. Am J Med 112:659–662

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Lamberg-Allardt CJ, Outila TA, Kärkkainen MU, Rita HJ, Valsta LM (2001) Vitamin D deficiency and bone health in healthy adults in Finland: could this be a concern in other parts of Europe? J Bone Miner Res 16:2066–2073

    Article  CAS  PubMed  Google Scholar 

  28. LeBlanc ES, Zakher B, Daeges M, Pappas M, Chou R (2015) Screening for vitamin D deficiency: a systematic review for the U.S. preventive services task force. Ann Intern Med 162:109–122

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This work was supported in part by a grant from Societat Catalana de Reumatología.

LabOscat study group

Marta Larrosa, Rheumatology Department, University Institute Parc Taulí, Sabadell; Joan Miquel Nolla, Rheumatologý Department, IDIBELL, Hospital Universitari de Bellvitge, L’Hospitalet, Barcelona; Daniel Roig-Vilaseca, Rheumatology Department, Hospital Moisés Broggi, Barcelona.

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Authors and Affiliations

  1. Hospital Clínic de Barcelona, IDIBAPS. CIBERehd, Barcelona, Spain

    P. Peris, A. Monegal & N. Guañabens

  2. Servicio de Bioquímica Clínica, Hospital Clinic, Barcelona, Spain

    X. Filella & L. Foj

  3. Hospital de l’Alt Penedés, Barcelona, Spain

    M. Bonet

  4. Hospital Arnau de Vilanova, Lleida, Spain

    D. Boquet

  5. Instituto Universitario Parc Taulí, Barcelona, Spain

    E. Casado

  6. Hospital Moisés Broggi, Barcelona, Spain

    D. Cerdá

  7. Hospital Universitari de Bellvitge, Barcelona, Spain

    A. Erra

  8. Hospital San Rafael, Madrid, Spain

    C. Gómez-Vaquero

  9. Hospital Mútua de Terrassa, Madrid, Spain

    S. Martínez

  10. Hospital Sta María, Barcelona, Spain

    N. Montalá

  11. Hospital Esperit Sant, Barcelona, Spain

    C. Pittarch

  12. Hospital de Vic, Barcelona, Spain

    E. Kanterewicz

  13. Hospital de Figueres, Barcelona, Spain

    M. Sala

  14. Hospital de Ganollers, Catalonia, Spain

    X. Suris

  15. Departament de Fonaments Clínics, Universitat de Barcelona, Barcelona, Spain

    J. L. Carrasco

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Consortia

LabOscat Study Group

  • M. Larrosa
  • , J. M. Nolla
  •  & D. Roig-Vilaseca

Corresponding authors

Correspondence to P. Peris or A. Erra.

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Conflicts of interest

Pilar Peris, Xavier Filella, Ana Monegal, Nuria Guañabens, Laura Foj, María Bonet, Dolors Boquet, Enrique Casado, Dacia Cerdá, Alba Erra, Carmen Gómez-Vaquero, Silvia Martínez, Nuria Montalá, Concepción Pittarch, Eduardo Kanterewicz, Miquel Sala, Xavier Suris and Josep L Carrasco declare that they have no conflict of interest.

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Peris, P., Filella, X., Monegal, A. et al. Comparison of total, free and bioavailable 25-OH vitamin D determinations to evaluate its biological activity in healthy adults: the LabOscat study. Osteoporos Int 28, 2457–2464 (2017). https://doi.org/10.1007/s00198-017-4062-8

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