Clinical Utility of Measurement of Vitamin D-Binding Protein and Calculation of Bioavailable Vitamin D in Assessment of Vitamin D Status.
BACKGROUND
The associations of vitamin D deficiency with various clinical conditions highlighted the importance of vitamin D testing. Currently, clinicians measure only the total 25-hydroxyvitamin D [25(OH)D] concentration, regardless of its bioavailability. We aimed to determine the effect of vitamin D-binding protein (VDBP) on 25(OH)D bioavailability.


METHODS
Serum samples were collected from 60 healthy controls, 50 pregnant women, and 50 patients in intensive care units (ICUs). Total 25(OH)D was quantified by liquid chromatography with tandem mass spectrometry, and VDBP levels were determined by using an ELISA kit (R&D Systems, USA). The bioavailable 25(OH)D levels were calculated by using total 25(OH)D, VDBP, and albumin concentrations.


RESULTS
In comparison with healthy controls, the total 25(OH)D concentration was significantly lower in ICU patients (median, 11.65 vs 18.25 ng/mL; P<0.00001), but no significant difference was noted between pregnant women (18.25 ng/mL) and healthy controls. The VDBP level was significantly lower in ICU patients (95.58 vs 167.18 μg/mL, P=0.0002) and higher in pregnant women (225.01 vs 167.18 μg/mL, P=0.008) compared with healthy controls. Nonetheless, the calculated bioavailable 25(OH)D levels of ICU patients and pregnant women were significantly lower than those of healthy controls (1.97 and 1.93 ng/mL vs 2.56 ng/mL; P=0.0073 and 0.0027).


CONCLUSIONS
A single marker of the total 25(OH)D level is not sufficient to accurately evaluate vitamin D status, especially in pregnant women. In cases where VDBP concentrations may be altered, VDBP measurements and bioavailable 25(OH)D calculations may help to determine vitamin D status accurately.
Department of Laboratory Medicine, Korean Association of Health Promotion, Seoul, Korea.
Hyun Jeong
HJ
Kim
Department of Laboratory Medicine, Veterans Health Service Medical Center, Seoul, Korea.
Misuk
M
Ji
Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Junghan
J
Song
Department of Laboratory Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea.
Hee Won
HW
Moon
Department of Laboratory Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea.
Mina
M
Hur
Department of Laboratory Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea. ymyun@kuh.ac.kr.
Yeo Min
YM
Yun
D000328:Adult; D000368:Aged; D002851:Chromatography, High Pressure Liquid; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D037841:Pregnant People; D012709:Serum Albumin / Q000032:analysis; D053719:Tandem Mass Spectrometry; D014807:Vitamin D / Q000097:blood*; D014809:Vitamin D-Binding Protein / Q000097:blood*
D012709:Serum Albumin; D014809:Vitamin D-Binding Protein; D014807:Vitamin D
25-Hydroxyvitamin D; Bioavailability; Vitamin D-binding protein