Serum 25-Hydroxyvitamin D Concentrations from Patient Groups at High Risk for Deficiency.

Abstract

Deficiency of 25-hydroxyvitamin D in serum is endemic in the general population, and testing for this hormone is useful in accessing a patient's overall health and well-being. We obtained blood from 216 hospitalized patients and outpatients divided into 4 groups thought to be at high risk of 25-hydroxyvitamin D deficiency: homeless, recreational drug abusers, psychiatric patients with limited access to the outdoors, and those infected with HIV. The 25-hydroxyvitamin D concentrations from these patients were determined with 2 different methodologies (immunoassay and mass spectrometry) and compared against 25-hydroxyvitamin D concentrations in apparently healthy controls. We hypothesized that these groups may be at higher risk for vitamin D deficiency because of poor nutrition, inadequate housing, restricted access to outdoors, or the presence of chronic disease. For each of the patient groups including healthy controls, the median concentration of 25-hydroxyvitamin D was below 30 ng/mL, indicating deficiency. Comparisons between the healthy controls and the other groups were not statistically significant with either methodology, except for the homeless patients in whom a higher number of individuals had 25-hydroxyvitamin D concentrations below 20 ng/mL. Results between the 2 testing platforms demonstrated that only 52% of the specimens analyzed by immunoassay agreed within ±10% of the LC-MS/MS results, with an overall correlation coefficient to 0.920. The degree of concordance for deficiency with 2 published cutoffs of 20 and 30 ng/mL was 91% and 91%, respectively. Vitamin D deficiency is a common finding in all the populations studied. The Lumipulse® G vitamin D immunoassay is an alternative for detecting vitamin D deficiency.