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Vitamin D assay and supplementation: still debatable issues.

Mario Plebani1,2, Martina Zaninotto2, Sandro Giannini3

  • 1University of Padova, Padova, Italy.

Diagnosis (Berlin, Germany)
|September 19, 2024
PubMed
Summary

Accurate vitamin D measurement is crucial for effective supplementation. This review clarifies analytical methods, recommended levels, and the interplay between vitamin D, parathyroid hormone (PTH), and fibroblast growth factor-23 (FGF23).

Keywords:
decision limitsfibroblast growth factor-23 (FGF23)parathyroid hormone (PTH)standardizationsupplementationvitamin D

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Area of Science:

  • Clinical Chemistry
  • Endocrinology
  • Nutritional Science

Background:

  • Vitamin D research has advanced, with improved understanding of its role and measurement technologies.
  • Numerous studies highlight vitamin D's importance and the need for supplementation in deficient populations.
  • Standardization in vitamin D measurement and analysis has progressed significantly.

Purpose of the Study:

  • To clarify fundamental aspects of vitamin D measurement, including analytical and post-analytical considerations.
  • To critically evaluate the scientific evidence regarding the efficacy and safety of vitamin D supplementation.
  • To discuss current recommended vitamin D levels for deficiency, insufficiency, and toxicity, informed by standardization data.

Main Methods:

  • Review of scientific literature, meta-analyses, and clinical guidelines on vitamin D.
  • Analysis of advancements in analytical technologies for vitamin D measurement.
  • Discussion of interrelations between vitamin D, parathyroid hormone (PTH), and fibroblast growth factor-23 (FGF23).

Main Results:

  • Progress in understanding vitamin D's pathophysiology and measurement technologies.
  • Need for clarification on analytical methods and evidence for supplementation efficacy/safety.
  • Importance of discussing recommended levels in light of standardization projects.

Conclusions:

  • Accurate vitamin D measurement is essential for clinical decision-making and supplementation.
  • Further clarification is needed on recommended levels and the clinical utility of vitamin D, PTH, and FGF23.
  • Standardization efforts are vital for reliable interpretation of vitamin D biomarker data.