Am J Clin Nutr. 2015 Sep 30. pii: ajcn103689. Epub ahead of print
Sarafin K1, Durazo-Arvizu R2, Tian L3, Phinney KW4, Tai S5, Camara JE5, Merkel J6, Green E7, Sempos CT6, Brooks SP8.
1Bureau of Nutritional Sciences, Health Canada, Ottawa, Canada;
2Department of Public Health Sciences, Loyola University of Chicago Stritch School of Medicine, Chicago, IL;
3Department of Health Research and Policy, Stanford University School of Medicine, Palo Alto, CA;
4Biomolecular Measurement Division and.
5Chemical Sciences Division, National Institute of Standards and Technology, Gaithersburg, MD;
6NIH, Office of Dietary Supplements, Bethesda, MD; and.
7Statistics Canada, Ottawa, Canada.
8Bureau of Nutritional Sciences, Health Canada, Ottawa, Canada; steve.brooks at hc-sc.gc.ca.
BACKGROUND: The Canadian Health Measures Survey (CHMS) is an ongoing cross-sectional national survey that includes a measure of 25-hydroxyvitamin D [25(OH)D] by immunoassay. For cycles 1 and 2, the collection period occurred approximately every 2 y, with a new sample of ∼5600 individuals.
OBJECTIVE: The goal was to standardize the original 25(OH)D CHMS values in cycles 1 and 2 to the internationally recognized reference measurement procedures (RMPs) developed by the US National Institute for Standards and Technology (NIST) and Ghent University, Belgium.
DESIGN: Standardization was accomplished by using a 2-step procedure. First, serum samples corresponding to the original plasma samples were remeasured by using the currently available immunoassay method. Second, 50 serum samples with known 25(OH)D values assigned by the NIST and Ghent reference method laboratories were measured by using the currently available immunoassay method. The mathematical models for each step-i.e., 1) YCurrent = XOriginal and 2) YNIST-Ghent = XCurrent -were estimated by using Deming regression, and the 2 models were solved to obtain a single equation for converting the "original" values to NIST-Ghent RMP values.
RESULTS: After standardization (cycles 1 and 2 combined), the percentage of Canadians with 25(OH)D values <40 nmol/L increased from 16.4% (original) to 19.4% (standardized), and values <50 nmol/L increased from 29.0% (original) to 36.8% (standardized). The 25(OH)D standardized distributions (cycles 1 and 2 analyzed separately) were similar across age and sex groups; slightly higher values were associated with cycle 2 in the young and old. This finding contrasts with the original data, which indicated that cycle 2 values were lower for all age groups.
CONCLUSION: The shifts in 25(OH)D distribution brought about by standardization indicate its importance in drawing correct conclusions about potential population deficiencies and insufficiencies and in permitting the comparison of distributions between national surveys.
- 90 percent of Canadians do not have optimal levels of vitamin D – Nov 2013
- Vitamin D levels continue to fall: Canada 6 percent drop from 2009 to 2011 – Feb 2013
- Big differences (~10 ng) in vitamin D test results, even when using the same type of tester – Aug 2015
- Percent who are Vitamin D Deficient: 6, 9, or 22 – depends on testing system – Oct 2014
- which did not compare test results to standards
- Vitamin D differences of 5 ng are meaningless - Aug 2015 especially when not adjusted to standards