Implications of standardization of serum 25-hydroxyvitamin D data for the evaluation of vitamin D status in Germany, including a temporal analysis

dc.contributor.authorRabenberg, Martina
dc.contributor.authorScheidt-Nave, Christa
dc.contributor.authorBusch, Markus A.
dc.contributor.authorThamm, Michael
dc.contributor.authorRieckmann, Nina
dc.contributor.authorDurazo-Arvizu, Ramón A.
dc.contributor.authorDowling, Kirsten G.
dc.contributor.authorSkrabakova, Zuzana
dc.contributor.authorCashman, Kevin D.
dc.contributor.authorSempos, Christopher T.
dc.contributor.authorMensink, Gert B. M.
dc.contributor.funderBundesministerium für Ernährung, Landwirtschaft und Verbraucherschutz
dc.contributor.funderBundesministerium für Bildung und Forschung
dc.contributor.funderBundesministerium für Gesundheit
dc.description.abstractBackground: Comparability of 25-hydroxyvitamin D (25(OH)D) measurements is hampered by method-related differences in measurement values. International standardization of laboratory assays has been suggested to solve this problem. Methods: As part of the European Commission-funded project ` Food-based solutions for optimal vitamin D nutrition and health through the life cycle' (ODIN), original measurements of serum 25(OH)D of three German national health surveys conducted between 1998 and 2011 have been standardized retrospectively. In these representative population-based samples including persons aged between 1 and 79 years, the original 25(OH)D values were compared with those after standardization. Mean values and prevalences of vitamin D deficiency, insufficiency, and sufficiency (25(OH)D levels <30, 30-<50, and > =50 nmol/l, respectively) were calculated by sex and age groups based on original and standardized 25(OH)D data. Results: In comparison to the original 25(OH)D levels, the standardized levels showed higher means overall and in age-and sex-specific analyses. After standardization, the prevalence of vitamin D deficiency was lower in all surveys while the prevalence of vitamin D sufficiency was higher. Nevertheless, even after standardization similar to 15% of adults and 12.5% of children had serum 25(OH)D levels <30 nmol/l. Thus, the proportion of deficient vitamin D levels in the German population is still considerable. Conclusions: The use of standardization of 25(OH)D levels has a substantial impact on estimates of the vitamin D status in Germany. Since clinical diagnostic, therapeutic and public health decision-making require valid and comparable data, standardization and calibration of commercial, clinical and research laboratory assays for 25(OH)D measurement should become common practice. Until then, researchers, health practitioners and policy makers should be aware of the peculiarities of the measurement methods when comparing and interpreting 25(OH)D levels.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.identifier.citationRabenberg, M., Scheidt-Nave, C., Busch, M. A., Thamm, M., Rieckmann, N., Durazo-Arvizu, R. A., Dowling, K. G., Škrabáková, Z., Cashman, K. D., Sempos, C. T. and Mensink, G. B. M. (2018) 'Implications of standardization of serum 25-hydroxyvitamin D data for the evaluation of vitamin D status in Germany, including a temporal analysis', BMC Public Health, 18(1), 845 (14pp). doi: 10.1186/s12889-018-5769-yen
dc.identifier.journaltitleBMC Public Healthen
dc.publisherBioMed Centralen
dc.rights© 2018, the Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.en
dc.subjectVitamin Den
dc.subjectVitamin D deficiencyen
dc.subjectPopulation surveyen
dc.titleImplications of standardization of serum 25-hydroxyvitamin D data for the evaluation of vitamin D status in Germany, including a temporal analysisen
dc.typeArticle (peer-reviewed)en
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