Vitamin D assays and the definition of hypovitaminosis D: results from the First International Conference on Controversies in Vitamin D
Open accessAbstract
The First International Conference on Controversies in Vitamin D was held in Pisa, Italy, 14–16 June 2017. The meeting's purpose was to address controversies in vitamin D research, review the data available, to help resolve them, and suggest a research agenda to clarify areas of uncertainty. The serum 25‐hydroxyvitamin D [25(OH)D] concentration [i.e. the sum of 25(OH)D 3 and 25(OH)D 2 ] remains the critical measurement for defining vitamin D status. Assay variation for 25(OH)D has contributed to the current chaos surrounding efforts to define hypovitaminosis D. An essential requirement to develop a consensus on vitamin D status is that measurement of 25(OH)D and, in the future, other potential vitamin D biomarkers [e.g. 1α,25(OH) 2 D 3 , 3‐epi‐25(OH)D, 24,25(OH) 2 D 3, vitamin D‐binding protein, free/bioavailable 25(OH)D and parathyroid hormone] be standardized/harmonized, to allow pooling of research data. Vitamin D Standardization Program tools are described and recommended for standardizing 25(OH)D measurement in research. In the future, similar methodology, based on National Institute for Standards and Technology standard reference materials, must be developed for other candidate markers of vitamin D status. Failure to standardize/harmonize vitamin D metabolite measurements is destined to promulgate continued chaos. At this time, 25(OH)D values below 12 ng ml –1 (30 nmol l –1 ) should be considered to be associated with an increased risk of rickets/osteomalacia, whereas 25(OH)D concentrations between 20 ng ml –1 and 50 ng ml –1 (50–125 nmol l –1 ) appear to be safe and sufficient in the general population for skeletal health. In an effort to bridge knowledge gaps in defining hypovitaminosis D, an international study on rickets as a multifactorial disease is proposed.
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We a priori decided to repeat analyses after excluding patients with baseline values indicating pre-study disturbance of bone metabolism (vitamin D < 30 nmol/L and/or PTH >7.63 pmol/L).
“We a priori decided to repeat analyses after excluding patients with baseline values, which could indicate pre-study disturbance of bone metabolism (vitamin D < 30 nmol/L and/or parathyroid hormone (PTH) >7.63 pmol/L) (24).”
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Vitamin D testing and treatment: a narrative review of current evidence
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- Authors
- Sempos, C. T., Heijboer, A. C., Bikle, D. D., Bollerslev, J., Bouillon, R., Brannon, P. M., DeLuca, H. F., Jones, G., Munns, C. F., Bilezikian, J. P., Giustina, A., & Binkley, N.
- Affiliations
- Vitamin D Standardization Program Havre de Grace MD USA
- Amsterdam UMC Location University of Amsterdam (NL)
- San Francisco VA Medical Center (US)
- Oslo University Hospital (NO)
- KU Leuven (BE)
- Cornell University (US)
- University of Wisconsin–Madison (US)
- Queen's University (CA)
- Children's Hospital at Westmead (AU)
- Columbia University Irving Medical Center (US)
- IRCCS Ospedale San Raffaele (IT)
- Corresponding author
- Sempos, Christopher T.
- ORCID
- Venue
- British Journal of Clinical Pharmacology
- Publisher
- Wiley
- Published
- 2018-07-17
- Volume
- 84
- Issue
- 10
- Pages
- 2194-2207
- ISSN
- 0306-5251 (ISSN-L)
- 1365-2125
- PMC
- PMC6138489
- OpenAlex
- W2807662366
- Cited by
- 331
- References
- 117
- Citations by year
- 2026: 11 · 2025: 23 · 2024: 37 · 2023: 75 · 2022: 46 · 2021: 53 · 2020: 40 · 2019: 34 · 2018: 11
- FWCI
- 5.10
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- British Journal of Clinical Pharmacology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Lirias (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs (I01 BX001066, I01 BX003814)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Keywords
- vitamin D status, vitamin D deficiency, 25-hydroxyvitamin D, vitamin D assay, assay standardization, 1α,25-dihydroxyvitamin D, 24,25-dihydroxyvitamin D, vitamin D binding protein, parathyroid hormone, rickets, osteomalacia, standard reference materials
- MeSH terms
- Fibroblast Growth Factor-23, Consensus Statements as Topic, Humans, Reference Standards, Vitamin D, Vitamin D Deficiency, Practice Guidelines as Topic
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