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See detailAssessment of vitamin D status - a changing landscape.
Herrmann, Markus; Farrell, Christopher-John L.; Pusceddu, Irene et al

in Clinical Chemistry & Laboratory Medicine (in press)

In recent years it has been shown that vitamin D deficiency is associated with an increased incidence as well as the progression of a broad range of diseases including osteoporosis, rickets ... [more ▼]

In recent years it has been shown that vitamin D deficiency is associated with an increased incidence as well as the progression of a broad range of diseases including osteoporosis, rickets, cardiovascular disease, autoimmune disease, multiple sclerosis and cancer. Consequently, requests for the assessment of vitamin D status have increased dramatically. Despite significant progress in the analysis of vitamin D metabolites and an expansion of our pathophysiological knowledge of vitamin D, the assessment of vitamin D status remains a challenging and partially unresolved issue. Current guidelines from scientific bodies recommend the measurement of 25-hydroxy vitamin D (25-OHD) in blood as the preferred test. However, growing evidence indicates significant limitations of this test, including analytical aspects and interpretation of results. In addition, the relationships between 25-OHD and various clinical indices, such as bone mineral density and fracture risk, are rather weak and not consistent across races. Recent studies have systematically investigated new markers of vitamin D status including the vitamin D metabolite ratio (VMR) (ratio between 25-OHD and 24,25-dihydroxy vitamin D), bioavailable 25-OHD [25-OHD not bound to vitamin D binding protein (DBP)], and free 25-OHD [circulating 25-OHD bound to neither DBP nor albumin (ALB)]. These parameters may potentially change how we will assess vitamin D status in the future. Although these new biomarkers have expanded our knowledge about vitamin D metabolism, a range of unresolved issues regarding their measurement and the interpretation of results prevent their use in daily practice. It can be expected that some of these issues will be overcome in the near future so that they may be considered for routine use (at least in specialized centers). In addition, genetic studies have revealed several polymorphisms in key proteins of vitamin D metabolism that affect the circulating concentrations of vitamin D metabolites. The affected proteins include DBP, 7-dehydrocholesterol synthase and the vitamin D receptor (VDR). Here we aim to review existing knowledge regarding the biochemistry, physiology and measurement of vitamin D. We will also provide an overview of current and emerging biomarkers for the assessment of vitamin D status, with particular attention methodological aspects and their usefulness in clinical practice. [less ▲]

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See detailClinical usefulness of bone turnover marker concentrations in osteoporosis.
Morris, H. A.; Eastell, R.; Jorgesen, N. R. et al

in Clinica Chimica Acta (in press)

Current evidence continues to support the potential for bone turnover markers (BTM) to provide clinically useful information particularly for monitoring the efficacy of osteoporosis treatment. Many of the ... [more ▼]

Current evidence continues to support the potential for bone turnover markers (BTM) to provide clinically useful information particularly for monitoring the efficacy of osteoporosis treatment. Many of the limitations identified earlier remain, principally in regard to the relationship between BTM and incident fractures. Important data are now available on reference interval values for CTX and PINP across a range of geographic regions and for individual clinical assays. An apparent lack of comparability between current clinical assays for CTX has become evident indicating the possible limitations of combining such data for meta-analyses. Harmonization of units for reporting serum/plasma CTX (ng/L) and PINP (mug/L) is recommended. The development of international collaborations continues with an important initiative to combine BTM results from clinical trials in osteoporosis in a meta-analysis and an assay harmonization program are likely to be beneficial. It is possible that knowledge derived from clinical studies can further enhance fracture risk estimation tools with inclusion of BTM together with other independent risk factors. Further data of the relationships between the clinical assays for CTX and PINP as well as physiological and pre-analytical factors contributing to variability in BTM concentrations are required. [less ▲]

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See detailWhen obtaining a blood sample from the right arm was not the right thing to do: a case of elevated parathyroid hormone levels 27 years after thyroidectomy.
Wolff, Fleur; Gervy, Christine; Cavalier, Etienne ULg et al

in Clinical Chemistry & Laboratory Medicine (in press)

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See detailFibroblast growth factor 23 in acute burn patients: Novel insights from an intact-form assay.
ROUSSEAU, Anne-Françoise ULg; Souberbielle; DELANAYE, Pierre ULg et al

in Burns : Journal of the International Society for Burn Injuries (in press)

INTRODUCTION: Fibroblast growth factor 23 (FGF23) is a key regulator in phosphate and vitamin D metabolism When measured with c-terminal assay, it has been shown to be increased following burn. Progress ... [more ▼]

INTRODUCTION: Fibroblast growth factor 23 (FGF23) is a key regulator in phosphate and vitamin D metabolism When measured with c-terminal assay, it has been shown to be increased following burn. Progress in understanding FGF23 physiology has emphasized the importance of assessing the intact form of FGF23. METHODS: The present cohort study is a complementary analysis of a previously published work. Patients >18 years, admitted within 24h after injury with burn surface area (BSA) >10% were included. C-terminal (c-term) and intact (i) FGF23 assay were performed at admission and every week during 4 weeks of follow-up. Inflammation and iron status were assessed at the same time points. RESULTS: Twenty patients were initially included and 12 were followed until day 28. The c-term FGF23 tended to gradually increase during the 4 weeks of follow-up while iFGF23 was quite stable into normal ranges. Iron status showed a typical inflammatory profile. C-term FGF23 was significantly positively correlated with c-reactive protein (CRP) and negatively correlated with iron levels. iFGF23 was not correlated with CRP or iron. CONCLUSION: FGF23 status following burn is characterized by a dissociation between c-term FGF23 and iFGF23. The hypothesis of an increased cleavage may be raised. Respective role of inflammation and iron levels in such deregulation need to be specified. Both c-term and intact assays should be performed in further studies aiming to increase knowledge on FGF23 regulation and effects in burn patients. [less ▲]

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See detailDetermination of iohexol and iothalamate in serum and urine by capillary electrophoresis.
Van Houcke, Sofie K.; Seaux, Liesbeth; Cavalier, Etienne ULg et al

in Electrophoresis (in press)

Estimation of glomerular filtration rate (eGFR) is essential to assess kidney function. Iodine containing contrast agents detection by HPLC has been proposed as a safe alternative for inulin or ... [more ▼]

Estimation of glomerular filtration rate (eGFR) is essential to assess kidney function. Iodine containing contrast agents detection by HPLC has been proposed as a safe alternative for inulin or radioactive compounds. However, HPLC is a time-consuming and labour-intensive method. The aim of this study was to develop an assay for iohexol and iothalamate using capillary electrophoresis (CE). Iohexol and iothalamate were directly analysed by CE in serum and urine, using photometric detection (246 nm). Serum peak height was proportional to iohexol and iothalamate concentrations. Detection limits for iohexol and iothalamate were 10 mg/L and 5 mg/L. Limits of quantification were 13.0 mg/L and 15.0 mg/L. Within-run CVs were 4.9% and 6.5%; between-run CVs 3.1-9.9% and 3.8-13.7%. A good correlation was observed between CE and HPLC: y = 1.1703 x + 5.017 (iohexol) and y = 0.7807 x + 11.01 (iothalamate) [y = concentration obtained by CE (mg/L), x = concentration obtained by HPLC (mg/L)]. In addition, CE allowed to determine urinary iohexol concentration. Although the detection limit for CE was higher than for HPLC, CE can still be used for eGFR determination. Advantages of this high throughput method are the absence of sample pretreatment and a minimal sample volume requirement. This article is protected by copyright. All rights reserved. [less ▲]

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See detailThe cardiovascular impact of intense eccentric isokinetic exercise versus aerobic treadmill running
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; LAURENT, Terry ULg et al

in Isokinetics & Exercise Science (2016), 24(3), 201-208

BACKGROUND: Regular physical activity is an important health factor, but intense physical stress can increase the risk of heart disease. OBJECTIVE: Our aim was to determine the potential cardiac ... [more ▼]

BACKGROUND: Regular physical activity is an important health factor, but intense physical stress can increase the risk of heart disease. OBJECTIVE: Our aim was to determine the potential cardiac repercussions of, and the oxidative stress resulting from a maximal eccentric isokinetic exercise and a 1-hour treadmill run at 75% ˙V O2 max (maximal exercise done 6 weeks before). METHODS: Twelve young sedentary healthy subjects randomly performed two tests separated by 6 weeks: 1) 3 sets of 30 maximal eccentric isokinetic contractions of the quadriceps; 2) a 1-hour running on treadmill at 75% ˙V O2 max. We drew blood samples just before each exercise (T1), and just after (T2), 3 hours after (T3), and 24 hours after (T4) the end of each exercise to measure cardiac and oxidative stress biomarkers. RESULTS: In the running group, we observed significant differences for myoglobin (T3: 145 ± 80 μg/L), creatinine kinase (T4: 593 ± 350 mg/L), oxidized glutathione (T2: 22 ± 15.6 μmol/L), and highly sensitive cardiac troponin T, (T3: 0.051 ± 0.038 ng/mL). In the isokinetic group, we observed significant differences for myoglobin (T3:1419 ± 2533 mg/L), creatine kinase (3303 ± 7159 mg/L), and oxidized glutathione (T4:24 ± 14 μmol/L). Between isokinetic exercise and running, we observed significant differences for uric acid (p < 0.05, running > eccentric), myoglobin (p < 0.05, ditto), NT-proBNP (p < 0.05, ditto), hsTnT (p < 0.01, ditto), and oxidized glutathione (p < 0.05). CONCLUSIONS: As cardiac biomarkers appear practically unmodified after the isokinetic exercise, despite the considerable oxidative stress, we suggest that the application of intense maximal eccentric isokinetic exercise, when indicated, should be safe for most patients including those whose cardiac status is unknown. On the other hand, the increase in cardiac biomarkers observed after running, could reflect leakage of these biomarkers from the cytosolic pool of cardiac cells, linked to membrane damage, rather than the result of a major injury and hence running is supposed to be a safe practice. However, since sudden death during running has been previously described, assesment of the cardiac biomarkers and a follow-up by a sport doctor is important especially if there is a cardiac family history. [less ▲]

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See detailRelease of cardiac biomarkers during a cycling race
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; D'OTREPPE DE BOUVETTE, Stéphanie ULg et al

in World Journal of Cardiovascular Diseases (2016), 6(8), 285-294

Objectives: Over the past two decades, a large interest in cardiac marker elevations has developed in endurance sports events. The intense effort is not without risk. We aim to see if the relatively ... [more ▼]

Objectives: Over the past two decades, a large interest in cardiac marker elevations has developed in endurance sports events. The intense effort is not without risk. We aim to see if the relatively cardiospecific biomarkers could show the damage on cardiac muscle cells. Methods: Fourteen cyclists were recruited for an international race (177km). We studied the release of injury related cardiac markers, risk related cardiac markers, renal function markers and blood cytology. The subjects were submitted to three blood test: one before (T0), one just after (T1) and the last one 3 hours after the race (T3). Results: Blood cytology markers, namely erythrocytes, hemoglobin, hematocrit, and average hemoglobin concentration, were found to evolve in a similar way. Renal function markers, such as creatinin, cystatin C and uric acid, showed a post effort increase that might be related to renal blood flow depletion during exercise. Cardiac and muscular markers were all increased at T1. Conclusions: Physiological stress induced by an international cycling race certainly has consequences on cardiac muscle cells. Fortunately, those blood concentration variations are more representative of a transitional state, due to an imbalance created by an intense aerobic effort maintained during several hours, rather than an irreversible injury. [less ▲]

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See detailThe role of biochemical of bone turnover markers in osteoporosis and metabolic bone disease: a consensus paper of the Belgian Bone Club.
Cavalier, Etienne ULg; Bergmann, P.; Bruyère, Olivier ULg et al

in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (2016)

The exact role of biochemical markers of bone turnover in the management of metabolic bone diseases remains a topic of controversy. In this consensus paper, the Belgian Bone Club aimed to provide a state ... [more ▼]

The exact role of biochemical markers of bone turnover in the management of metabolic bone diseases remains a topic of controversy. In this consensus paper, the Belgian Bone Club aimed to provide a state of the art on the use of these biomarkers in different clinical or physiological situations like in postmenopausal women, osteoporosis in men, in elderly patients, in patients suffering from bone metastasis, in patients with chronic renal failure, in pregnant or lactating women, in intensive care patients, and in diabetics. We also gave our considerations on the analytical issues linked to the use of these biomarkers, on potential new emerging biomarkers, and on the use of bone turnover biomarkers in the follow-up of patients treated with new drugs for osteoporosis. [less ▲]

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See detailImpact of a mountain ultra-marathon on cardiac biomarkers
Le Goff, Caroline ULg; Gergelé, Laurent; Kaux, Jean-François ULg et al

in Crossing borders through sport science (2016, July)

Objectives. While moderate exercise has beneficial effects on the cardiovascular system, consequences of a supra-physiological effort are not clear yet. In particular, the physiological consequences of ... [more ▼]

Objectives. While moderate exercise has beneficial effects on the cardiovascular system, consequences of a supra-physiological effort are not clear yet. In particular, the physiological consequences of ultramarathons need to be further documented. The aim of the study was to assess the changes of various cardiac biomarkers after a mountain ultra-marathon. Material and methods. Blood and urine samples were collected on 28 runners (17 men) participating to the Ultra-Trail du Mont Blanc (105km, total positive elevation: 5600 m) at 3 different times: before the race (Pre), within 1 h after the finish (Post) and 7 days after the finish (D+7). Several biomarkers involved in heart disease (coronary syndrome, heart failure and fibrosis) and in inflammation were assayed on different analyzers such a COBAS® (for CKMB,TnThs, NT-proBNP, H-FABP and CRPs) and KRYPTOR® (for Copeptin). ST2 was measured manually with the Presage kit from CRITICAL DIAGNOSTIC®. Results. Plasma levels of cardiac markers (CKMB, TnThs, NT-proBNP, copeptin, H FABP, ST2) and inflammation (CRPs) increased significantly at Post. Means values increased from Pre to Post as follows: 2.3 to 91.9 UI/L for CKMB (p<0.0001); 7.6 to 31.7 ng/L for TnThs (p<0.0001); 41.7 to 1190.5 ng/L for NT-proBNP, 4.2 to 22.9 pmol/L for copeptin (p=0.001); 3.6 to 107.8 ng/mL for H-FABP (p<0.0001), 29.7 to 126.2 ng/mL for ST2 (p<0.0001); 0.5 to 29.1 mg/L for CRPs (p<0.0001). With the exception of a few (H-FABP, ST2, CRPs) biomarkers in some subjects, all values were back to Pre values at D+7. Discussion-conclusion. Prolonged strenuous running exercise caused an elevation in cardiac biomarkers. Elevation in CK-MB levels lacks specificity for cardiac damage as runners have increased CKMB from skeletal muscles as well. Previous studies suggested that exercise induced TnThs elevation is a benign reversible physiologic phenomenon but this parameter, as well as H-FABP, could be a sign of ischemia. Different phenomena occurred such as stretch of myocytes causing an increase in pressure or volume and neurohormonal activation which can explain the Copeptine and NT-proBNP increase, while ST2 is a biomarker of cardiac remodeling and fibrosis. CRP is an acute phase compound that tends to increase following a strenuous and prolonged bout of exercise and/or muscular injury. As the values tended to return within the normal reference range values within 7 days after the race, our study suggests that there is no permanent structural damage at the myocardium level. [less ▲]

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See detailA Randomised, Cross-Over Study to Estimate the Influence of Food on the 25-Hydroxyvitamin D(3) Serum Level after Vitamin D(3) Supplementation.
Cavalier, Etienne ULg; Jandrain, Bernard; Coffiner, Monte et al

in Nutrients (2016), 8(5),

Vitamin D(3) is known to be liposoluble and its release could be a factor limiting the rate of absorption. It was presumed that the presence of fat could favor absorption of vitamin D(3). However, as ... [more ▼]

Vitamin D(3) is known to be liposoluble and its release could be a factor limiting the rate of absorption. It was presumed that the presence of fat could favor absorption of vitamin D(3). However, as bioavailability is related not only to the active molecules but also to the formulations and excipients used, the optimization of the pharmaceutical form of vitamin D(3) is also important. The objective of this study was to evaluate if there is a food effect on absorption when a high dose of vitamin D(3) is completely solubilized in an oily solution. In the present cross-over study, 88 subjects were randomized and received a single dose of 50,000 IU of vitamin D(3) in fasting state or with a standardized high-fat breakfast. Assessment of serum concentrations of 25 hydroxyvitamin D(3) (25(OH)D(3)) was performed three, five, seven, 14, 30 and 60 days after supplementation. In fed and fast conditions, the 25(OH)D(3) serum concentrations were significantly higher than the baseline value three days after administration and remained significantly higher during the first month. No significant difference between fasting vs. fed conditions was observed. It is therefore concluded that the vitamin D(3) absorption from an oily solution was not influenced by the presence or absence of a meal. [less ▲]

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See detailCystatin C standardization decreases assay variation and improves assessment of glomerular filtration rate
Ebert, N; DELANAYE, Pierre ULg; Shlipak, M et al

in Clinica Chimica Acta (2016), 456

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See detailPrevalence and determinants of vitamin D deficiency in healthy French adults: the VARIETE study
Souberbielle; Massart, Catherine; Brailly-Tabard, Sylvie et al

in Endocrine (2016)

The U.S. Institute of Medicine considers that a serum 25-hydroxyvitamin D (25OHD) concentration >20 ng/mL corresponds to optimal vitamin D status in the general population. Old studies of vitamin D status ... [more ▼]

The U.S. Institute of Medicine considers that a serum 25-hydroxyvitamin D (25OHD) concentration >20 ng/mL corresponds to optimal vitamin D status in the general population. Old studies of vitamin D status in the French general population have demonstrated high prevalence of insufficiency. We measured serum 25OHD, 1,25(OH)2D, PTH, calcium, phosphorus, and creatinine levels in 892 French Caucasian healthy subjects (463 men, 429 women) aged from 18 to 89 years. The 25OHD concentration was similar in men (24.1 ± 8.2 ng/mL) and women (23.4 ± 8.0 ng/mL). 25OHD concentrations of <10, <12, <20, and <30 ng/mL were found in respectively 6.3, 9.9, 34.6, and 80.3 % of subjects. Residence in northern France (odds ratio [OR] 1.91), blood sampling between January and March (OR 7.74), BMI ≥24 kg/m2 (OR 1.81), and age 60 years or more (OR 1.99) were significant determinants of hypovitaminosis D (25OHD <20 ng/mL). The serum 25OHD level correlated positively with 1,25(OH)2D and negatively with PTH. 25OHD values below 20 ng/mL were associated with lower 1,25(OH)2D levels, and 25OHD values below 27 ng/mL were associated with higher PTH levels. Many French healthy adults have a 25OHD concentration <20 ng/mL, especially during winter months. Actions to improve the vitamin D status of the French general population are urgently needed. [less ▲]

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See detailIs isokinetic exercise dangerous for the heart?
Le Goff, Caroline ULg; Kaux, Jean-François ULg; Cavalier, Etienne ULg et al

in European Journal of Physical and Rehabilitation Medicine (2016, April), 52(suppl. 1 No. 2), 457

INTRODUCTION: Very strenuous exercises can be performed on an isokinetic dynamometer in order to evaluate the resistance to fatigue of different muscular groups. Good cardiac function is necessary in ... [more ▼]

INTRODUCTION: Very strenuous exercises can be performed on an isokinetic dynamometer in order to evaluate the resistance to fatigue of different muscular groups. Good cardiac function is necessary in order to perform these very intensive exercises; otherwise an acute myocardial dysfunction could theoretically appear in predisposed patients. PURPOSE: Our study aimed to observe the cardiovascular impact (by biological point of view) of maximal intense isokinetic eccentric and concentric protocols performed by a population of sedentary young men. METHOD: Resting (T0) and post-exercise (just after (T1), 3 hours (T2) and 24 hours after the exercise (T3)) blood samples were taken in 2 populations of young sedentary men: 12 subjects (22.5±1.15 yo) for the eccentric protocol and 18 subjects (22.4±2.6 yo) for the concentric protocol. These subjects performed an intense maximal isokinetic exercise of the quadriceps muscles involving 30 knee flexions–extensions for each leg. We evaluated markers of cardiovascular risk (highly sensitive troponin T (hs-TnT), N-Terminal Brain natriuretic peptide (NT-proBNP), myoglobin (MYO)), of inflammation (highly sensitive C-reactive protein (hsCRP)), muscle damage (creatine kinase (CK)) and of oxidative stress (myeloperoxidase (MPO), lipidic peroxides (POXL), reduced (GSH) and oxidised glutathione (GSSG)). Haemodynamic parameters were measured continuously using a Portapres, and respiratory parameters were measured using a Sensormedics Vmax 29C. RESULTS: All the physiological parameters measured presented statistically significant changes. For the eccentric exercise, no significant modification in cardiac (NT-proBNP, hs-TNT) and inflammation (hsCRP) biomarkers was observed. However, a significant increase for CK (T3), MYO (T2), MPO (T1), POXL (T1), GSSG (T3) and ratio GSH/GSSG (T2-T3) was shown. For the concentric exercise, the results showed significant increases for the CK (T1-T2-T3), MYO (T1-T2), GSH/GSSG (T1). Evolutionary trends were also observed for the following biomarkers: NT-proBNP (T1-T2-T3), MPO (T2), and GSSG (T4). DISCUSSION and CONCLUSIONS: No modification in cardiac biomarkers was observed after the maximal eccentric isokinetic exercise but some variations can be observed for these biomarkers after the concentric exercise. However, these changes do not exceed the reference values in healthy subjects. We were thus able to prove that the exercise could be performed without any risk to cardiac function in young sedentary subjects. Nevertheless, a significant level of oxidative stress was induced by both exercises. [less ▲]

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See detailBrain-derived neurotrophic factor (BDNF) in normal healthy and hemodialyzed populations.
CAVALIER, Etienne ULg; CARLISI, Ignazia ULg; KOVACS, Stéphanie ULg et al

in Osteoporosis International (2016, April), 27(Supplement 1), 512

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See detailConcordance between Iothalamate and Iohexol Plasma Clearance
DELANAYE, Pierre ULg; LE GOFF, Caroline ULg; JOURET, François ULg et al

in American Journal of Kidney Diseases (2016), 68(2), 329-330

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See detailPerformance characteristics of the VIDAS 25-OH Vitamin D total assay - comparison with four immunoassays and two liquid chromatography-tandem mass spectrometry methods in a multicentric study
Moreau, E; Bächer, S; Mery, S et al

in Clinical Chemistry & Laboratory Medicine (2016)

Background: The study was conducted to evaluate the analytical and clinical performance of the VIDAS® 25-OH Vitamin D Total assay. The clinical performance of the assay was compared with four other ... [more ▼]

Background: The study was conducted to evaluate the analytical and clinical performance of the VIDAS® 25-OH Vitamin D Total assay. The clinical performance of the assay was compared with four other immunoassays against the results of two different liquid chromatography/ mass spectrometry methods (LC-MS/MS) standardized to NIST reference materials. Methods: VIDAS® 25-OH Vitamin D Total assay precision, linearity, detection limits and sample matrix comparison were assessed following CLSI guidelines. For method comparison, a total of 150 serum samples ranging from 7 to 92 ng/mL were analyzed by all the methods. Correlation was studied using Passing-Bablok regression and Bland- Altman analysis. The concordance correlation coefficient (CCC) was calculated to evaluate agreement between immunoassays and the reference LC-MS/MS method. In addition, samples containing endogenous 25(OH)D2 were used to assess each immunoassay’s ability to detect this analyte. Pregnancy and hemodialysis samples were used to the study the effect of vitamin D binding protein (DBP) concentration over VIDAS® assay performance. Results: The VIDAS® 25-OH Vitamin D Total assay showed excellent correlation to the LC-MS/MS results (y = 1.01x+0.22 ng/mL, r = 0.93), as obtained from two different sites and distinct LC-MS/MS methods. The limit of quantification was determined at 8.1 ng/mL. Cross-reactivity for 25(OH)D2 was over 80%. At concentrations of 10.5, 26 and 65.1 ng/mL, within-run CVs were 7.9%, 3.6% and 1.7%, while total CVs (between runs, calibrations, lots and instruments) were 16.0%, 4.5% and 2.8%. The VIDAS® performance was not influenced by altered DBP levels, though under-recovery of 25(OH)D as compared to LC-MS/ MS was observed for hemodialysis samples. Conclusions: The VIDAS® 25-OH Vitamin D Total assay is therefore considered suitable for assessment of vitamin D status in clinical routine. Keywords: assay performance; liquid chromatography/ [less ▲]

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See detailDeterminants of vitamin D supplementation prescription in nursing homes: a survey among general practitioners
Buckinx, Fanny ULg; Reginster, Jean-Yves ULg; Cavalier, Etienne ULg et al

in Osteoporosis International (2016), 27

Abstract Summary A total of 119 GPs participated to a survey aimed to assess the profile and determinants of vitamin D supplementation prescription in nursing homes. Among the respondent GPs, 65 (54.6 ... [more ▼]

Abstract Summary A total of 119 GPs participated to a survey aimed to assess the profile and determinants of vitamin D supplementation prescription in nursing homes. Among the respondent GPs, 65 (54.6 %) systematically prescribe vitamin D to their institutionalized patients and the 54 (45.4 %) others prescribe only sometimes. Introduction The aim of this study is to assess the profile and determinants of vitamin D supplementation prescription in nursing homes. Methods General practitioners (GPs) having at least one patient in a nursing home in Liège, Belgium, were asked to complete the survey. Results A total of 119 GPs participated in the survey. Among the respondent GPs, 65 (54.6 %) systematically prescribe vitamin D to their institutionalized patients and the 54 (45.4 %) others prescribe only sometimes. The main reasons for prescribing vitamin D cited by GPs who do so systematically are as follows: because they believe nursing home residents are mostly deficient in vitamin D status (92.1 %), because they believe that vitamin D supplementation prevents osteoporotic fractures (77.8 %), and because vitamin D supplementation is recommended by various scientific societies (38.1 %). GPs who only prescribe vitamin D supplementation in some patients mainly do so following a diagnosis of osteoporosis (82.4 %), on the basis the 25(OH)D level (78.4 %), in the case of history of fracture (54.9 %) or after a recent fracture (43.4 %). Surprisingly, 16 physicians (31.4 %) only prescribe vitamin D when they think of it. Interestingly, while 40.7% of GPs always prescribe the same dose of vitamin D, the remaining 59.3 % prescribe a dose that will mainly depend on the results of the 25(OH)D level (94.0 %), the patient’s bone health (49.3 %), or history of fracture (43.3 %). Conclusions More than half of GPs systematically prescribe vitamin D to their patients living in nursing homes. The other GPs usually prescribe vitamin D following the result of the vitamin D status or after a diagnosis of osteoporosis. [less ▲]

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See detailCystatin C standardization decreases assay variation and improves assessment of GFR
Ebert, N; DELANAYE, Pierre ULg; Shlipak, M et al

Poster (2016)

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