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Role of Skin in Vitamin D Synthesis01:23

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The skin plays a crucial role in the synthesis of vitamin D, a vital nutrient for various physiological processes in the body. Vitamin D is unique because it can be synthesized in the skin through a series of chemical reactions triggered by exposure to ultraviolet B (UVB) radiation from sunlight.
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Redefining vitamin D status: Establishing population-based indirect reference intervals through big data analysis.

Aleix B Fabregat-Bolufer1, Alba Escolà-Rodríguez2, José Luís Bedini-Chesa1

  • 1Biochemistry and Molecular Genetics Department, CDB, Hospital Clínic of Barcelona, Barcelona, Spain.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|February 1, 2025
PubMed
Summary
This summary is machine-generated.

Accurate vitamin D (25-hydroxyvitamin D) reference intervals were established using real-world data, revealing significant variations by sex, season, and assay method. Tailoring these intervals can optimize screening and supplementation, reducing risks associated with vitamin D assessment.

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Area of Science:

  • Clinical Chemistry
  • Endocrinology
  • Public Health

Background:

  • Accurate reference intervals (RIs) for serum 25-hydroxyvitamin D [25(OH)D] are crucial for diagnosing vitamin D deficiency and guiding supplementation.
  • Existing RIs may not adequately reflect diverse populations or account for variations introduced by different measurement methods, demographics, and seasonal factors.
  • The refineR algorithm offers a method for establishing indirect RIs using real-world data (RWD).

Purpose of the Study:

  • To establish accurate, population-based RIs for serum 25(OH)D in Barcelona using the refineR indirect method and RWD.
  • To investigate the influence of demographic (sex, age), methodological (assay), and seasonal factors on serum 25(OH)D levels.
  • To assess the prevalence of vitamin D deficiency and severe deficiency within the studied population.

Main Methods:

  • Retrospective analysis of 130,030 serum 25(OH)D samples collected between 2018 and 2022.
  • Samples were measured using VDSP-certified Liaison and Atellica immunoassays.
  • The refineR algorithm with Box-Cox transformations was used to establish RIs, analyzing demographic, assay, department, and seasonal variations.

Main Results:

  • Median serum 25(OH)D was 25 ng/mL; 34.2% of samples showed deficiency (≤20 ng/mL) and 12.6% severe deficiency (≤12 ng/mL).
  • Modified Box-Cox transformation yielded RIs of 14.2-65.9 ng/mL, with variations observed between sexes, assays (Liaison: 10.2-58.6 ng/mL, Atellica: 9.9-59.3 ng/mL), and patient groups.
  • Significant seasonal variation was noted, with higher 25(OH)D levels in summer; RIs were lowest in outpatients and endocrinology patients.

Conclusions:

  • The refineR algorithm successfully established population-specific RIs for serum 25(OH)D, highlighting significant demographic and seasonal influences.
  • Redefining 25(OH)D thresholds based on population-specific data can potentially reduce unnecessary screening and supplementation, thereby minimizing associated risks.
  • The study underscores the necessity of implementing population-, seasonal-, and method-specific RIs for improved vitamin D assessment and clinical management.