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Abstract：
The demand for vitamin D testing is increasing in China. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) immunoassay is specific and accurate but requires expensive equipment, experienced operators, and complicated pretreatment of serum. Automated immunoassays are simple and convenient but only determine total 25-hydroxyvitamin D (25OHD). The objective of this study was to quantify 25OHD2 and 25OHD3 in patients to assist clinical physicians and laboratory directors in choosing the most appropriate method to determine 25OHD.
Vitamin D testing was conducted for 23,695 patients in Peking Union Medical College Hospital from May 2015 to January 2017. Using this large data set, the prevalence and levels of 25OHD2 were analyzed. LC-MS/MS was used to separately determine 25OHD2 and 25OHD3.
25OHD2 (≥2.5 ng/mL) was detected in 16.4% (3877/23,695) of patients. Males had a significantly lower incidence of detectable 25OHD2 (p<0.01); 1077 (13.9%) samples contained detectable 25OHD2 (median: 3.7 ng/mL; 2.5%-97.5%: 2.5-17.2 ng/mL). For females, 2800 (17.5%) samples contained detectable 25OHD2 (median: 4.0 ng/mL; range: 2.5-20.6 ng/mL). Of the 3877 patients with detectable 25OHD2, males had a significantly higher level of 25OHD3 (p<0.01). There was no significant difference in total 25OHD. The proportion of 25OHD2 in total 25OHD was 1.3%-100%; 87.5% (3391/3877) of the samples contained <10 ng/mL 25OHD2. 25OHD2 negatively correlated with 25OHD3 (r=-0.197, p<0.01) and positively correlated with total 25OHD (r=0.217, p<0.01).
Prevalence of 25OHD2 in patients tested for vitamin D is relatively high in China. 25OHD2 is significantly negatively correlated with 25OHD3.
Vitamin D testing was conducted for 23,695 patients in Peking Union Medical College Hospital from May 2015 to January 2017. Using this large data set, the prevalence and levels of 25OHD2 were analyzed. LC-MS/MS was used to separately determine 25OHD2 and 25OHD3.
25OHD2 (≥2.5 ng/mL) was detected in 16.4% (3877/23,695) of patients. Males had a significantly lower incidence of detectable 25OHD2 (p<0.01); 1077 (13.9%) samples contained detectable 25OHD2 (median: 3.7 ng/mL; 2.5%-97.5%: 2.5-17.2 ng/mL). For females, 2800 (17.5%) samples contained detectable 25OHD2 (median: 4.0 ng/mL; range: 2.5-20.6 ng/mL). Of the 3877 patients with detectable 25OHD2, males had a significantly higher level of 25OHD3 (p<0.01). There was no significant difference in total 25OHD. The proportion of 25OHD2 in total 25OHD was 1.3%-100%; 87.5% (3391/3877) of the samples contained <10 ng/mL 25OHD2. 25OHD2 negatively correlated with 25OHD3 (r=-0.197, p<0.01) and positively correlated with total 25OHD (r=0.217, p<0.01).
Prevalence of 25OHD2 in patients tested for vitamin D is relatively high in China. 25OHD2 is significantly negatively correlated with 25OHD3.
摘要：
中国对维生素D检测的需求正在增加。液相色谱-串联质谱（LC-MS/MS）免疫测定具有特异性和准确性，但需要昂贵的设备，经验丰富的操作员，和复杂的血清预处理。自动化免疫测定简单方便，但仅测定总25-羟基维生素D（25OHD）。这项研究的目的是量化患者的25OHD2和25OHD3，以帮助临床医师和实验室主任选择最合适的方法来确定25OHD。
2015年5月至2017年1月，北京协和医院对23695名患者进行了维生素D检测。使用这个大数据集，分析25OHD2的患病率和水平。使用LC-MS/MS分别测定25OHD2和25OHD3。
在16.4%(3877/23,695)的患者中检测到25OHD2(≥2.5ng/mL)。男性的可检测25OHD2的发生率显着降低（p<0.01）；1077（13.9％）样品含有可检测的25OHD2（中位数：3.7ng/mL；2.5％-97.5％：2.5-17.2ng/mL）。对于女性来说,2800（17.5％）样品含有可检测的25OHD2（中位数：4.0ng/mL；范围：2.5-20.6ng/mL）。在检测到25OHD2的3877名患者中，男性的25OHD3水平明显较高（p<0.01）。25OHD总量差别无统计学意义。25OHD2在总25OHD中的比例为1.3%-100%;87.5%(3391/3877)的样品含有<10ng/mL25OHD2。25OHD2与25OHD3呈负相关（r=-0.197，p<0.01），与总25OHD呈正相关（r=0.217，p<0.01）。
在中国，维生素D检测患者中25OHD2的患病率相对较高。25OHD2与25OHD3呈显著负相关。
2015年5月至2017年1月，北京协和医院对23695名患者进行了维生素D检测。使用这个大数据集，分析25OHD2的患病率和水平。使用LC-MS/MS分别测定25OHD2和25OHD3。
在16.4%(3877/23,695)的患者中检测到25OHD2(≥2.5ng/mL)。男性的可检测25OHD2的发生率显着降低（p<0.01）；1077（13.9％）样品含有可检测的25OHD2（中位数：3.7ng/mL；2.5％-97.5％：2.5-17.2ng/mL）。对于女性来说,2800（17.5％）样品含有可检测的25OHD2（中位数：4.0ng/mL；范围：2.5-20.6ng/mL）。在检测到25OHD2的3877名患者中，男性的25OHD3水平明显较高（p<0.01）。25OHD总量差别无统计学意义。25OHD2在总25OHD中的比例为1.3%-100%;87.5%(3391/3877)的样品含有<10ng/mL25OHD2。25OHD2与25OHD3呈负相关（r=-0.197，p<0.01），与总25OHD呈正相关（r=0.217，p<0.01）。
在中国，维生素D检测患者中25OHD2的患病率相对较高。25OHD2与25OHD3呈显著负相关。
