Free 25-hydroxyvitamin D: impact of vitamin D binding protein assays on racial-genotypic associations

CM Nielson, KS Jones, RF Chun… - The Journal of …, 2016 - academic.oup.com
CM Nielson, KS Jones, RF Chun, JM Jacobs, Y Wang, M Hewison, JS Adams, CM Swanson
The Journal of Clinical Endocrinology & Metabolism, 2016academic.oup.com
Abstract Context: Total 25-hydroxyvitamin D (25OHD) is a marker of vitamin D status and is
lower in African Americans than in whites. Whether this difference holds for free 25OHOD
(f25OHD) is unclear, considering reported genetic-racial differences in vitamin D binding
protein (DBP) used to calculate f25OHD. Objectives: Our objective was to assess racial-
geographic differences in f25OHD and to understand inconsistencies in racial associations
with DBP and calculated f25OHD. Design: This study used a cross-sectional design. Setting …
Context
Total 25-hydroxyvitamin D (25OHD) is a marker of vitamin D status and is lower in African Americans than in whites. Whether this difference holds for free 25OHOD (f25OHD) is unclear, considering reported genetic-racial differences in vitamin D binding protein (DBP) used to calculate f25OHD.
Objectives
Our objective was to assess racial-geographic differences in f25OHD and to understand inconsistencies in racial associations with DBP and calculated f25OHD.
Design
This study used a cross-sectional design.
Setting
The general community in the United States, United Kingdom, and The Gambia were included in this study.
Participants
Men in Osteoporotic Fractures in Men and Medical Research Council studies (N = 1057) were included.
Exposures
Total 25OHD concentration, race, and DBP (GC) genotype exposures were included.
Outcome Measures
Directly measured f25OHD, DBP assessed by proteomics, monoclonal and polyclonal immunoassays, and calculated f25OHD were the outcome measures.
Results
Total 25OHD correlated strongly with directly measured f25OHD (Spearman r = 0.84). Measured by monoclonal assay, mean DBP in African-ancestry subjects was approximately 50% lower than in whites, whereas DBP measured by polyclonal DBP antibodies or proteomic methods was not lower in African-ancestry. Calculated f25OHD (using polyclonal DBP assays) correlated strongly with directly measured f25OHD (r = 0.80–0.83). Free 25OHD, measured or calculated from polyclonal DBP assays, reflected total 25OHD concentration irrespective of race and was lower in African Americans than in US whites.
Conclusions
Previously reported racial differences in DBP concentration are likely from monoclonal assay bias, as there was no racial difference in DBP concentration by other methods. This confirms the poor vitamin D status of many African-Americans and the utility of total 25OHD in assessing vitamin D in the general population.
Oxford University Press