Vitamin D Deficiency by LC-MS/MS in Indian Population

• Published in: Indian journal of clinical biochemistry Vol. 30; no. S1; p. S80
• Main Authors: Saxena, Rohit, Rout, Ranjita, Kaur, Manjit
• Format: Journal Article
• Language: English
• Published: Springer 24.05.2022
• Subjects: Alfacalcidol; Calcifediol; Hypertension; Protein binding; Vitamin D; Vitamin D deficiency
• ISSN: 0970-1915

Vitamin D can influence 300 genes of our body. Vitamin D receptors are present in various organs and tissue. Several studies have demonstrated low serum Vitamin 25 (OH) D levels in population across India. In North India, 96% of neonates, 91% of healthy school girls, 78% of healthy hospital staff and 84% of pregnant women are found to be deficient in Vitamin D. The criteria used for defining hypovitaminosis D in most of studies was a serum 25(OH)D level below 50 nmol/L. Vitamin D deficiency has strong association with flu, anemia, cancer, diabetes, hypertension, cardiovascular risks, brain damage, paralysis, TB, asthma, infertility, chronic Kidney disease, autoImuune disorders, numbness, convulsions, weak bones, back pain, unexplained muscle pain, fatigue. Maternal deficiency of Vitamin D is linked with abnormal fetal growth and gestational diabetes. Study of Khadgawat et al (JAPI Sept 2010 vol 58; p539-542) shows very high prevalence (96.7%) of vitamin D deficiency in Asian Indian patients with fragility hip fracture. Psychitric patients presenting with their first episode of psychosis are more likely to have vitamin D deficiency than their healthy peers (Schizophr res 2013;150:533-537. To get a true reading of Vitamin D level, technique should be used that can detect both 25 (OH) D2 & D3 equally. Vitamin D is produced in two forms-Vitamin D2 & Vitamin D3, which differ by the presence of a double bond and methyl group on the aliphatic side chain. Total 25 (OH) D should represent the total amount of Vitamin 25 (OH) D (Both D2 &D3) that is circulating. Present common immunoassay method of measuring 25 (OH) D, has drawbacks for these assays can measure only VitaminD3, as binding protein shows a higher affinity for Vitamin D3 than Vitamin D2. LC-MS/MS is currently the best technique for the correct quantification of 25OHD3 &25OHD2 and has also the capability to overcome most of problems associated with protein binding assays. We studied Vitamin D levels in 3520 subjects by LC-MS/MS technique by chromatographically separating interferences due to epimers. Epimers are non-super imposable (or non mirror image) that differ only in the configuration of one carbon atom. Epimers are compounds with the same molecular weight as Vitamin D metabolites and from the same mass to charge parent and product ion pairs upon ionization. Separation of epimers is essential to avoid false estimate of Vitamin D. Results will be presented.