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J Clin Endocrinol Metab. 2008 May;93(5):1804-8. doi: 10.1210/jc.2007-2340. Epub 2008 Mar 4.

Correlation among 25-hydroxy-vitamin D assays.

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1
Osteoporosis Clinical Center and Research Program, University of Wisconsin, 2870 University Avenue, Madison, WI 53705, USA. nbinkley@wisc.edu

Abstract

CONTEXT:

Measurement of circulating 25-hydroxy-vitamin D [25(OH)D]) is the accepted clinical indicator of vitamin D status. However, between-laboratory differences in measurement of this analyte exist, which may confound clinical care.

OBJECTIVES:

We investigated the current agreement of 25(OH)D measurement in clinical laboratories and explored the possibility that simple calibration would improve between-laboratory agreement.

DESIGN AND PARTICIPANTS:

Serum obtained from healthy volunteers (age 20-60 yr) and one "calibrator," selected to have a 25(OH)D value near 30 ng/ml, were sent for 25(OH)D measurement in four clinical laboratories (laboratories A-D) using HPLC, liquid chromatography tandem mass spectroscopy, and RIA methodologies.

MAIN OUTCOME MEASURES:

Serum 25(OH)D. Based upon self-report, the laboratory with the lowest interassay percent coefficient of variation was assigned as the reference to which the others were compared using linear regression and Bland-Altman analyses (Analyse-it; Analyse-it Software, Ltd., Leeds, UK).

RESULTS:

Good correlation was observed for 25(OH)D measurement between laboratory A and laboratories B-D (R(2) = 0.99, 0.81, and 0.95, respectively). Modest between-laboratory variation was noted; the mean bias ranged from 2.9-5.2 ng/ml. Consistent with a systematic offset, each value in laboratory B was higher than in laboratory A, and 89% of values from laboratories B-D were higher than laboratory A. The use of a single calibrator and correction factor reduced mean between-laboratory bias for laboratories B and D.

CONCLUSIONS:

Measurement of 25(OH)D by clinical laboratories yields similar results. The use of even a single calibrator will improve, but not resolve, between-laboratory variability. Based upon these data, in combination with reported within-individual variability, we recommend that clinicians aim for values greater than 30 ng/ml in their patients.

PMID:
18319318
DOI:
10.1210/jc.2007-2340
[Indexed for MEDLINE]
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