Current 25-hydroxyvitamin D assays: Do they pass the test?

Vitamin D testing is becoming increasingly important with recent research demonstrating a correlation between vitamin D insufficiency and metabolic diseases, immunodeficiencies and other diseases. However, existing 25-hydroxyvitamin D (25OHD) assays lack comparability to the candidate reference meth...

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Published inClinica chimica acta Vol. 413; no. 13-14; pp. 1127 - 1134
Main Authors Ong, Lizhen, Saw, Sharon, Sahabdeen, Noorulhijjah Bte, Tey, Kiat Teng, Ho, Chung Shun, Sethi, Sunil Kumar
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier B.V 11.07.2012
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Abstract Vitamin D testing is becoming increasingly important with recent research demonstrating a correlation between vitamin D insufficiency and metabolic diseases, immunodeficiencies and other diseases. However, existing 25-hydroxyvitamin D (25OHD) assays lack comparability to the candidate reference method, causing difficulties in diagnosis and monitoring of vitamin D deficiency. We looked at the accuracy of 3 automated assays (Roche Diagnostics Elecsys® Total 25OHD assay, Abbott Architect® Total vitamin D assay, Advia Centaur® vitamin D Total assay) and Diasorin® Radioimmunoassay (RIA) compared to a routine laboratory Liquid Chromatography–Tandem Mass Spectrometry (LC–MS/MS). The correlation based on Passing Bablok regression was good with the slopes between 0.95 and 1.31 and the intercepts between −3.24 and 3.68. However, a significant positive bias was observed using the Abbott Architect and the Diasorin RIA. Using published analytical goals of coefficient of variation (CV) <10% and bias <5%, most methods did not meet these criteria. Using measurement of uncertainty of 9%, most methods were able to meet criteria using quality control materials but not patient samples. Inadequacies of these assay performances are contributed by differences in method of extraction of vitamin D from vitamin D binding protein, cross-reactivities to 25OHD2, 25OHD3 and other vitamin D metabolites, matrix interferences and a lack of standardization. ► Five 25-hydroxyvitamin D (25OHD) assays were compared. ► Four 25OHD assays were evaluated using accuracy and precision data. ► The imprecision of quality control samples for the immunoassays was all below 10%. ► The imprecision of pooled serum samples for immunoassays was between 2.7% and 22.8%. ► Based on stringent analytical goals, most 25OHD assays did not meet the standards.
AbstractList Vitamin D testing is becoming increasingly important with recent research demonstrating a correlation between vitamin D insufficiency and metabolic diseases, immunodeficiencies and other diseases. However, existing 25-hydroxyvitamin D (25OHD) assays lack comparability to the candidate reference method, causing difficulties in diagnosis and monitoring of vitamin D deficiency. We looked at the accuracy of 3 automated assays (Roche Diagnostics Elecsys® Total 25OHD assay, Abbott Architect® Total vitamin D assay, Advia Centaur® vitamin D Total assay) and Diasorin® Radioimmunoassay (RIA) compared to a routine laboratory Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS). The correlation based on Passing Bablok regression was good with the slopes between 0.95 and 1.31 and the intercepts between -3.24 and 3.68. However, a significant positive bias was observed using the Abbott Architect and the Diasorin RIA. Using published analytical goals of coefficient of variation (CV) <10% and bias <5%, most methods did not meet these criteria. Using measurement of uncertainty of 9%, most methods were able to meet criteria using quality control materials but not patient samples. Inadequacies of these assay performances are contributed by differences in method of extraction of vitamin D from vitamin D binding protein, cross-reactivities to 25OHD(2), 25OHD(3) and other vitamin D metabolites, matrix interferences and a lack of standardization.
BACKGROUNDVitamin D testing is becoming increasingly important with recent research demonstrating a correlation between vitamin D insufficiency and metabolic diseases, immunodeficiencies and other diseases. However, existing 25-hydroxyvitamin D (25OHD) assays lack comparability to the candidate reference method, causing difficulties in diagnosis and monitoring of vitamin D deficiency.METHODSWe looked at the accuracy of 3 automated assays (Roche Diagnostics Elecsys® Total 25OHD assay, Abbott Architect® Total vitamin D assay, Advia Centaur® vitamin D Total assay) and Diasorin® Radioimmunoassay (RIA) compared to a routine laboratory Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS).RESULTSThe correlation based on Passing Bablok regression was good with the slopes between 0.95 and 1.31 and the intercepts between -3.24 and 3.68. However, a significant positive bias was observed using the Abbott Architect and the Diasorin RIA. Using published analytical goals of coefficient of variation (CV) <10% and bias <5%, most methods did not meet these criteria. Using measurement of uncertainty of 9%, most methods were able to meet criteria using quality control materials but not patient samples.CONCLUSIONInadequacies of these assay performances are contributed by differences in method of extraction of vitamin D from vitamin D binding protein, cross-reactivities to 25OHD(2), 25OHD(3) and other vitamin D metabolites, matrix interferences and a lack of standardization.
Vitamin D testing is becoming increasingly important with recent research demonstrating a correlation between vitamin D insufficiency and metabolic diseases, immunodeficiencies and other diseases. However, existing 25-hydroxyvitamin D (25OHD) assays lack comparability to the candidate reference method, causing difficulties in diagnosis and monitoring of vitamin D deficiency. We looked at the accuracy of 3 automated assays (Roche Diagnostics Elecsys® Total 25OHD assay, Abbott Architect® Total vitamin D assay, Advia Centaur® vitamin D Total assay) and Diasorin® Radioimmunoassay (RIA) compared to a routine laboratory Liquid Chromatography–Tandem Mass Spectrometry (LC–MS/MS). The correlation based on Passing Bablok regression was good with the slopes between 0.95 and 1.31 and the intercepts between −3.24 and 3.68. However, a significant positive bias was observed using the Abbott Architect and the Diasorin RIA. Using published analytical goals of coefficient of variation (CV) <10% and bias <5%, most methods did not meet these criteria. Using measurement of uncertainty of 9%, most methods were able to meet criteria using quality control materials but not patient samples. Inadequacies of these assay performances are contributed by differences in method of extraction of vitamin D from vitamin D binding protein, cross-reactivities to 25OHD2, 25OHD3 and other vitamin D metabolites, matrix interferences and a lack of standardization. ► Five 25-hydroxyvitamin D (25OHD) assays were compared. ► Four 25OHD assays were evaluated using accuracy and precision data. ► The imprecision of quality control samples for the immunoassays was all below 10%. ► The imprecision of pooled serum samples for immunoassays was between 2.7% and 22.8%. ► Based on stringent analytical goals, most 25OHD assays did not meet the standards.
Author Tey, Kiat Teng
Ho, Chung Shun
Saw, Sharon
Sahabdeen, Noorulhijjah Bte
Ong, Lizhen
Sethi, Sunil Kumar
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Issue 13-14
Keywords Correlation
Accuracy
25OHD testing
Vitamin D
Precision
Language English
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Snippet Vitamin D testing is becoming increasingly important with recent research demonstrating a correlation between vitamin D insufficiency and metabolic diseases,...
BACKGROUNDVitamin D testing is becoming increasingly important with recent research demonstrating a correlation between vitamin D insufficiency and metabolic...
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pubmed
elsevier
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StartPage 1127
SubjectTerms 25OHD testing
Accuracy
Chromatography, Liquid
Correlation
Humans
Immunoassay
Luminescent Measurements - standards
Precision
Quality Control
Radioimmunoassay
Reproducibility of Results
Sensitivity and Specificity
Tandem Mass Spectrometry
Uncertainty
Vitamin D
Vitamin D - analogs & derivatives
Vitamin D - blood
Vitamin D Deficiency - blood
Vitamin D Deficiency - diagnosis
Title Current 25-hydroxyvitamin D assays: Do they pass the test?
URI https://dx.doi.org/10.1016/j.cca.2012.03.009
https://www.ncbi.nlm.nih.gov/pubmed/22465235
https://search.proquest.com/docview/1011174436
Volume 413
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