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Criteria of adequacy for vitamin D testing and prevalence of deficiency in clinical practice

  • Fernando Granado-Lorencio EMAIL logo , Inmaculada Blanco-Navarro and Belén Pérez-Sacristán
Published/Copyright: October 14, 2015
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 54 Issue 5

Abstract

Background:

Vitamin D deficiency is an important concern in clinical settings although there is no consensus on who should undergo 25-OH-vitamin D testing. We studied the prevalence of vitamin D deficiency before and after introducing adequacy (clinical and biochemical) criteria for testing.

Methods:

A total of 32,363 tests for 25-OH-vitamin D were retrospectively evaluated. Requests were unrestricted until December 2010 and justification criteria were applied from January 2011. During 6 years, 25,656 samples were analyzed (UHPLC) of which 12,315 were considered the first visit. The prevalence of deficiency was assessed for all the samples and according to the year, sex, season, age, origin of the requests, inclusion of adequacy criteria and consecutive visits.

Results:

A significant proportion of the requests (25%) were unjustified and less than half of the clinically or biochemically-justified tests displayed serum concentrations indicative of deficiency. Application of adequacy criteria resulted in a non-significant increase in the prevalence of deficiency, both at the first visit (36.5 vs. 41.7, p=0.17) and for all the samples analyzed (32.0 vs. 35.5, p=0.14). The percentage of deficiency decreased in consecutive visits although 2/3 and 41% of the patients remained deficient on the second and third visit, respectively. Moreover, at least 1/5 of sufficient patients at the first test became deficient in subsequent evaluations.

Conclusions:

A significant proportion of the requests was unjustified by clinical or biochemical criteria. Our data also indicate that clinical and biochemical criteria may be necessary (to be present) to justify vitamin D testing but not sufficient (predictive) to indicate the presence of vitamin D deficiency.

Keywords: clinical practice; evidence-based medicine; HPLC; vitamin D deficiency; vitamin D status; vitamin D testing
Corresponding author: Fernando Granado-Lorencio, Unidad de Vitaminas, Servicio de Bioquímica Clínica, Hospital Universitario Puerta de Hierro-Majadahonda, 28222-Madrid, Spain, Phone: +34-911917578/7756, E-mail: ; ; and Grupo Metabolismo y Nutrición, IDIPHIM, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain

Acknowledgments

The present work was performed as part of the laboratory assistance offered to the covered population. No additional funding sources were used.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2015-8-12
Accepted: 2015-9-14
Published Online: 2015-10-14
Published in Print: 2016-5-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2015-0781
Keywords for this article
clinical practice; evidence-based medicine; HPLC; vitamin D deficiency; vitamin D status; vitamin D testing

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Protein S100B: from cancer diagnostics to the evaluation of mild traumatic brain injury
  4. Reviews
  5. Capillary electrophoresis based on nucleic acid detection for diagnosing human infectious disease
  6. Oxidative damage and the pathogenesis of menopause related disturbances and diseases
  7. Opinion Paper
  8. EFLM WG-Preanalytical phase opinion paper: local validation of blood collection tubes in clinical laboratories
  9. Genetics and Molecular Diagnostics
  10. Effective quality management practices in routine clinical next-generation sequencing
  11. Analysis of PMP22 duplication and deletion using a panel of six dinucleotide tandem repeats
  12. A novel exonuclease (TaqMan) assay for rapid haptoglobin genotyping
  13. General Clinical Chemistry and Laboratory Medicine
  14. Heparinate but not serum tubes are susceptible to hemolysis by pneumatic tube transportation
  15. Criteria of adequacy for vitamin D testing and prevalence of deficiency in clinical practice
  16. A simple clot based assay for detection of procoagulant cell-derived microparticles
  17. Measurement of factor XIII (FXIII) activity by an automatic ammonia release assay using iodoacetamide blank-procedure: no more overestimation in the low activity range and better detection of severe FXIII deficiencies
  18. Immunoassay or LC-MS/MS for the measurement of salivary cortisol in children?
  19. Head to head evaluation of the analytical performance of two commercial methotrexate immunoassays and comparison with liquid chromatography-mass spectrometry and the former fluorescence polarization immunoassay
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  22. Establishment of reference intervals of clinical chemistry analytes for the adult population in Saudi Arabia: a study conducted as a part of the IFCC global study on reference values
  23. First data on the biological variation and quality specifications for plasma ammonia concentrations in healthy subjects
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  26. Cardiovascular Diseases
  27. Galectin-3, osteopontin and successful aging
  28. Platelet volume is associated with the Framingham risk score for cardiovascular disease in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
  29. Infectious Diseases
  30. Diagnostic values of CD64, C-reactive protein and procalcitonin in ventilator-associated pneumonia in adult trauma patients: a pilot study
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  32. Corrigendum to: Accuracy of GFR estimating equations combining standardized cystatin C and creatinine assays: a cross-sectional study in Sweden
  33. Letters to the Editor
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