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Lee JH, Seo JD, Lee K, Roh EY, Yun YM, Lee YW, Cho SE, Song J. Multicenter comparison of analytical interferences of 25-OH vitamin D immunoassay and mass spectrometry methods by endogenous interferents and cross-reactivity with 3-epi-25-OH-vitamin D 3. Pract Lab Med 2024; 38:e00347. [PMID: 38188654 PMCID: PMC10770599 DOI: 10.1016/j.plabm.2023.e00347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
Background Vitamin D (vit-D) deficiency is highly prevalent in the Korean population, highlighting the need for accurate measurements. In this study, the interferences by endogenous and cross-reactive substances were compared between routine vit-D immunoassays and mass spectrometry (MS) methods. Methods Two MS methods and 4 immunoassays from different manufacturers (Abbott, Beckman Coulter, Roche, Siemens) were compared. Residual samples that were icteric, lipemic, hemolyzed, high in rheumatoid factor, from myeloma patients, or patients undergoing hemodialysis were collected. Also, 4 levels of National Institute of Standards and Technology (NIST) Standard Reference Material 972a, and 12 samples serially spiked with 3-epi-25-OH-D3 were prepared. Results Significant interferences were observed in hemolytic (Roche), icteric (Beckman and Siemens) and lipemic samples (all 4 immunoassays). Level 4 NIST material and 3-epi-25-OH-D3-spiked samples induced significant cross-reactivity, yielding higher total vit-D measurements in non-epimer-separating MS methods, and both the Beckman and Roche immunoassays. Conclusion Most observed interferences were consistent with manufacturers' claims, but overall improvement of immunoassay bias limits is required. Awareness of potential interference is important to increase the accuracy of vit-D measurements. Moreover, care is due when interpreting vit-D results of newborns, infants and less commonly, pregnant women, who are known to have physiologically high levels of the highly cross-reactive 3-epi-25-OH-D3.
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Affiliation(s)
- Joon Hee Lee
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jong Do Seo
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, South Korea
| | - Kyunghoon Lee
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Eun Youn Roh
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Department of Laboratory Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Yeo-Min Yun
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, South Korea
| | - Yong-Wha Lee
- Department of Laboratory Medicine & Genetics, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Sung-Eun Cho
- Department of Endocrine Substance Analysis Center (ESAC), Green Cross Laboratories (GC Labs), Yongin, South Korea
| | - Junghan Song
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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2
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Sirajudeen S, Shah I, Karam SM, Al Menhali A. Seven-Month Vitamin D Deficiency Inhibits Gastric Epithelial Cell Proliferation, Stimulates Acid Secretion, and Differentially Alters Cell Lineages in the Gastric Glands. Nutrients 2023; 15:4648. [PMID: 37960302 PMCID: PMC10649607 DOI: 10.3390/nu15214648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
Vitamin D (VD) deficiency can result from insufficiency of either light exposure or VD intake. We investigated the biological effects of VD deficiency for 7 months on the mouse gastric glands. Varying degrees of VD deficiency were induced in C57BL/6 mice by keeping them on standard diet with constant-dark conditions (SDD) or VD deficient diet with constant-dark conditions (VDD). Samples of serum, glandular stomach, and gastric contents were collected for LCMS/MS, RT-PCR, immunohistochemistry, and acid content measurements. Both SDD and VDD mice had a significant decline in 25OHVD metabolite, gastric epithelial cell proliferation, and mucin 6 gene expression. These effects were enhanced with the severity of VD deficiency from SDD to VDD. Besides and compared to the control group, SDD mice only displayed a significant increase in the number of zymogenic cells (p ≤ 0.0001) and high expression of the adiponectin (p ≤ 0.05), gastrin (p ≤ 0.0001), mucin 5AC (*** p ≤ 0.001) and the Cyclin-dependent kinase inhibitor 1A (**** p ≤ 0.0001). These phenotypes were unique to SDD gastric samples and not seen in the VDD or control groups. This study suggests that the body reacts differently to diverse VD deficiency sources, light or diet.
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Affiliation(s)
- Shaima Sirajudeen
- Department of Biology, College of Science, United Arab Emirates University (UAEU), Al Ain 15551, United Arab Emirates;
| | - Iltaf Shah
- Zayed bin Sultan Al Nahyan Center for Health Sciences, United Arab Emirates University (UAEU), Al Ain 15551, United Arab Emirates; (I.S.); (S.M.K.)
- Department of Chemistry, College of Science, United Arab Emirates University (UAEU), Al Ain 15551, United Arab Emirates
| | - Sherif M. Karam
- Zayed bin Sultan Al Nahyan Center for Health Sciences, United Arab Emirates University (UAEU), Al Ain 15551, United Arab Emirates; (I.S.); (S.M.K.)
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University (UAEU), Al Ain 15551, United Arab Emirates
| | - Asma Al Menhali
- Department of Biology, College of Science, United Arab Emirates University (UAEU), Al Ain 15551, United Arab Emirates;
- Zayed bin Sultan Al Nahyan Center for Health Sciences, United Arab Emirates University (UAEU), Al Ain 15551, United Arab Emirates; (I.S.); (S.M.K.)
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3
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Vergara-Maldonado C, Urdaneta-Machado JR. The Effects of Latitude and Temperate Weather on Vitamin D Deficiency and Women's Reproductive Health: A Scoping Review. J Midwifery Womens Health 2023; 68:340-352. [PMID: 37255079 DOI: 10.1111/jmwh.13516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION We conducted a scoping review to analyze the effects and implications of vitamin D deficiency on female reproductive health during the last decade, considering temperate planetary zones and climate change impacts. METHODS We used a qualitative methodology for a panoramic database review of PubMed, Web of Science, and Scopus covering articles from the last decade focused on populations living at latitudes higher than 40° N and 40° S. As descriptors, we used the phrases climate change, cholecalciferol or vitamin d3, pregnancy, and woman health and the Boolean operators AND and OR. We excluded letters to the editor, reviews, protocols, and clinical trials without human participants, as well as duplicate articles. RESULTS We included 35 studies in English, the majority of which were from North America or Europe. No studies were found from the Southern Hemisphere or having any direct relation with climate change, although studies demonstrated that latitude and environmental factors affected vitamin D deficiency, which had an impact on pregnant women and their children. Supplementation guidelines were not well developed, and there was a lack of studies among at-risk groups of women (eg, darker skin, higher latitudes, immigrants) across the life span. DISCUSSION Vitamin D deficiency is a global environmental problem that affects female reproductive health and depends on multiple environmental factors and human behavior. Therefore, we recommend consideration of environmental and sociocultural factors in public policy and clinical research and more research on the effectiveness of supplementation and fortification strategies. Health care professionals working in reproductive health need to generate actions for detection of, education on, and prevention of vitamin D deficiency among women across their life spans, considering the multicausality of the phenomenon, which includes environmental and climate factors in population health.
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4
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Herrmann M. Assessing vitamin D metabolism - four decades of experience. Clin Chem Lab Med 2023; 61:880-894. [PMID: 36639845 DOI: 10.1515/cclm-2022-1267] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023]
Abstract
One hundred years ago, the role of vitamin D for bone mineralization and the prevention of rickets was discovered. Vitamin D comprises a group of over 50 metabolites with multiple functions that go far beyond calcium homeostasis and bone mineralization. Approximately 50 years ago, first methods for the measurement of 25-hydroxyvitamin D (25(OH)D) in human blood were developed. Over the years, different analytical principals were employed including competitive protein binding assays, high-performance liquid chromatography, various immunoassay and mass spectrometric formats. Until the recent standardization of serum 25(OH)D measurement, agreement between methods was unsatisfactory. Since then, comparability has improved, but substantial variability between methods remains. With the advent of liquid chromatography tandem mass spectrometry (LC-MS/MS), the accurate determination of 25(OH)D and other metabolites, such as 24,25(OH)2D, becomes increasingly accessible for clinical laboratories. Easy access to 25(OH)D testing has triggered extensive clinical research showing that large parts of the population are vitamin D deficient. The variable response of vitamin D deficient individuals to supplementation indicates that assessing patients' vitamin D stores by measuring 25(OH)D provides limited insight into the metabolic situation. Meanwhile, first evidence has emerged suggesting that the simultaneous measurement of 25(OH)D, 24,25(OH)2D and other metabolites allows a dynamic evaluation of patients' vitamin D status on metabolic principals. This may help to identify patients with functional vitamin D deficiency from those without. It can be expected that research into the assessment vitamin D status will continue for another 50 years and that this will help rationalizing our approach in clinical practice.
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Affiliation(s)
- Markus Herrmann
- Clinical Institute of Medical and Chemical Diagnostics, Medical University of Graz, Graz, Austria
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5
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Janoušek J, Pilařová V, Macáková K, Nomura A, Veiga-Matos J, Silva DDD, Remião F, Saso L, Malá-Ládová K, Malý J, Nováková L, Mladěnka P. Vitamin D: sources, physiological role, biokinetics, deficiency, therapeutic use, toxicity, and overview of analytical methods for detection of vitamin D and its metabolites. Crit Rev Clin Lab Sci 2022; 59:517-554. [PMID: 35575431 DOI: 10.1080/10408363.2022.2070595] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Vitamin D has a well-known role in the calcium homeostasis associated with the maintenance of healthy bones. It increases the efficiency of the intestinal absorption of dietary calcium, reduces calcium losses in urine, and mobilizes calcium stored in the skeleton. However, vitamin D receptors are present ubiquitously in the human body and indeed, vitamin D has a plethora of non-calcemic functions. In contrast to most vitamins, sufficient vitamin D can be synthesized in human skin. However, its production can be markedly decreased due to factors such as clothing, sunscreens, intentional avoidance of the direct sunlight, or the high latitude of the residence. Indeed, more than one billion people worldwide are vitamin D deficient, and the deficiency is frequently undiagnosed. The chronic deficiency is not only associated with rickets/osteomalacia/osteoporosis but it is also linked to a higher risk of hypertension, type 1 diabetes, multiple sclerosis, or cancer. Supplementation of vitamin D may be hence beneficial, but the intake of vitamin D should be under the supervision of health professionals because overdosing leads to intoxication with severe health consequences. For monitoring vitamin D, several analytical methods are employed, and their advantages and disadvantages are discussed in detail in this review.
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Affiliation(s)
- Jiří Janoušek
- Department of Pharmacognosy, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Veronika Pilařová
- Department of Analytical Chemistry, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Kateřina Macáková
- Department of Pharmacognosy, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Anderson Nomura
- UCIBIO - Applied Molecular Biosciences Unit, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Jéssica Veiga-Matos
- UCIBIO - Applied Molecular Biosciences Unit, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Diana Dias da Silva
- UCIBIO - Applied Molecular Biosciences Unit, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal.,TOXRUN - Toxicology Research Unit, University Institute of Health Sciences, CESPU CRL, Gandra, Portugal
| | - Fernando Remião
- UCIBIO - Applied Molecular Biosciences Unit, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.,Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Luciano Saso
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Kateřina Malá-Ládová
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Josef Malý
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Lucie Nováková
- Department of Analytical Chemistry, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
| | - Přemysl Mladěnka
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic
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6
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Zhang L, Long Q, Zhang J, Zeng Q, Zhao H, Chen W, Zhang T, Zhang C. A candidate reference method and multiple commutable control materials for serum 25-hydroxyvitamin D measurement. J Clin Lab Anal 2022; 36:e24756. [PMID: 36371780 PMCID: PMC9756985 DOI: 10.1002/jcla.24756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/13/2022] [Accepted: 10/21/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The aim of the current study was to establish a reliable candidate reference method for serum 25-hydroxyvitamin D [25(OH)D] measurement and to assess the commutability of multiple control materials among liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods. METHODS Serum 25-hydroxyvitamin D2 [25(OH)D2] and 25-hydroxyvitamin D3 [25(OH)D3] together with spiked internal standards were extracted with a one-step approach and then analyzed by LC-MS/MS. The commutability assessment for 25(OH)D was conducted according to the Clinical and Laboratory Standards Institute (CLSI) EP14-A3 protocol. 25(OH)D concentrations in 5 levels of unprocessed serum pools, 7 levels of serum pools spiked with 25(OH)D3 or 25(OH)D2, 3 levels of commercial control materials, 2 levels of spiked bovine serum, and 4 levels of external quality assessment (EQA) materials were measured along with 30 single-donor samples using the candidate reference method and two routine LC-MS/MS methods. RESULTS The candidate reference method could separate 25(OH)D2 and 25(OH)D3 from 14 potential interfering compounds completely within a 9-min analysis time. Good method precision was obtained, and measurement results on certified reference material NIST SRM 972a were within the uncertainty of the certified values. All candidate materials were assessed commutable for LC-MS/MS methods. CONCLUSIONS The candidate reference method for serum 25(OH)D measurement is precise, accurate, and robust against interferences and can provide an accuracy base for routine methods. The multiple alternative control materials with commutability among LC-MS/MS methods will facilitate the further standardization for serum 25(OH)D measurement.
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Affiliation(s)
- Li Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory MedicineChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Qichen Long
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory MedicineChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jiangtao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of GerontologyBeijing Engineering Research Center of Laboratory MedicineBeijingChina
| | - Qingzhang Zeng
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory MedicineChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Haijian Zhao
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of GerontologyBeijing Engineering Research Center of Laboratory MedicineBeijingChina
| | - Wenxiang Chen
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of GerontologyBeijing Engineering Research Center of Laboratory MedicineBeijingChina
| | - Tianjiao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of GerontologyBeijing Engineering Research Center of Laboratory MedicineBeijingChina
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of GerontologyBeijing Engineering Research Center of Laboratory MedicineBeijingChina
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7
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Zhang M, Huang X, Song M, Mi L, Yin Y, Wang F, Chen M, Zhang T, Yang J, Cui X. A novel LC-MS/MS method for the simultaneous analysis of selected fat-soluble vitamins in serum obtained from pediatric patients with pneumonia. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2022; 14:2511-2521. [PMID: 35703250 DOI: 10.1039/d2ay00491g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Several observational studies have reported associations between low levels of fat-soluble vitamins (A, D and E) and the incidence of pneumonia. Whether infection affects or negatively regulates serum vitamin levels remains controversial. Our aims were to develop and validate a simple-pretreatment and fast method to determine the serum levels of selected fat-soluble vitamins, namely vitamin A (retinol), vitamin D (25-OH-D3, 25-OH-D2, and 3-epi-25-OH-D3), and vitamin E (α-tocopherol), in children suffering from pneumonia during the acute phase and after inflammatory marker recovery. The sample preparation procedure involving protein precipitation and filtration was finished in one step, and separation took 8 min per sample. The calibrations were linear, with R2 > 0.99. Both the intra-run (n = 6) and inter-run (n = 3) precision (relative standard deviation, RSD%) values were below 14.61%. The spiked recoveries at 3 concentrations ranged from 80.97 to 111.91%. Accuracies were calibrated using both National Institute of Standards and Technology serum (NIST 968f) and external quality assurance (EQA) samples offered by the National Center of Clinical Laboratories of China, and the relative error (RE%) values ranged from -13.17% to 12.53%. Clinical sample analysis revealed that infection did alter the serum retinol concentration and it did not alter the 25-OH-D and α-tocopherol levels in young children with pneumonia.
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Affiliation(s)
- Min Zhang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, China
- Department of Biochemistry and Immunology, Capital Institute of Pediatrics, Beijing 100020, China
| | - XiaoLan Huang
- Clinical Central Laboratory, Capital Institute of Pediatrics, Beijing 100020, China.
| | - MeiYan Song
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Shanxi Medical University, Taiyuan 030001, China
| | - Lala Mi
- Department of Biochemistry and Molecular Biology, Shanxi Key Laboratory of Birth Defect and Cell Regeneration, Shanxi Medical University, Taiyuan 030001, China
| | - Yan Yin
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing 100020, China
| | - Fang Wang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, China
- Department of Biochemistry and Immunology, Capital Institute of Pediatrics, Beijing 100020, China
| | - Min Chen
- Clinical Central Laboratory, Capital Institute of Pediatrics, Beijing 100020, China.
| | - Ting Zhang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, China
- Department of Biochemistry and Immunology, Capital Institute of Pediatrics, Beijing 100020, China
| | - Jian Yang
- Department of Neurology, Capital Institute of Pediatrics, Beijing 100020, China.
| | - XiaoDai Cui
- Clinical Central Laboratory, Capital Institute of Pediatrics, Beijing 100020, China.
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8
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C3-Epimer of 25-Hydroxyvitamin D3 as a Superior Marker for Predicting the Severity of Chronic Kidney Disease in Rheumatoid Arthritis Patients. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:5268706. [PMID: 35498132 PMCID: PMC9054460 DOI: 10.1155/2022/5268706] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/31/2022] [Indexed: 02/05/2023]
Abstract
Objective. 25-hydroxyvitamin D3 (25[OH]D3) is involved in oxidative stress regulation by upregulating the expression of antioxidant genes except for mineral homeostasis physiological role. C3-epimer of 25(OH)D3 (C3-epi-25[OH]D3) is a form of vitamin D metabolite with low bioaffinity in vivo, but little is known about the relationship between C3-epi-25(OH)D3 and diseases. This study was aimed at investigating the relationship between C3-epi-25(OH)D3 and the severity of chronic kidney disease (CKD) in patients with rheumatoid arthritis (RA). Method. A total of 318 RA inpatients were enrolled and divided into mild (
), moderate (
), and severe (
) CKD groups according to the CKD prognosis criterion of the Kidney Disease Improving Global Outcomes guidelines. Serum levels of 25(OH)D2, 25(OH)D3, C3-epi-25(OH)D3, and free 25(OH)D (F25[OH]D) were measured, and the value of 25(OH)D was calculated. The relationship and changing trend of the indexes based on CKD severity were analyzed. Results. The serum levels of 25(OH)D, 25(OH)D3, and F25(OH)D showed a decreasing trend (
,
) in RA patients with CKD progression from mild to severe, while C3-epi-25(OH)D3 showed an increasing trend (
,
) and 25(OH)D2 showed no significant difference among the groups (
,
). Only levels of C3-epi-25(OH)D3 presented significant differences between adjacent CKD severity groups in RA patients (mild to moderate:
,
; moderate to severe:
,
). Multiple logistic regression analysis showed that 25(OH)D3 and C3-epi-25(OH)D3 were significant predictors for CKD progression in RA patients, and C3-epi-25(OH)D3 had a better predictive advantage (moderate vs. mild:
,
; severe vs. mild:
,
). Conclusions. To the best of our knowledge, this is the first study to reveal that C3-epi-25(OH)D3 is a dominant predictor of CKD severity in RA patients. Further studies are needed to explore the relationship between C3-epi-25(OH)D3 and other diseases.
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9
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Xu S, Ni R, Lv L, Chen R, Chen Y, Huang F, Xu Z. Simultaneous determination of vitamin D metabolites 25(OH)D3 and 1α,25(OH)2D3 in human plasma using liquid chromatography tandem mass spectrometry. J Mass Spectrom Adv Clin Lab 2022; 24:65-79. [PMID: 35572785 PMCID: PMC9093011 DOI: 10.1016/j.jmsacl.2022.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/30/2022] [Accepted: 04/21/2022] [Indexed: 12/14/2022] Open
Abstract
LC-MS/MS method development and optimization for simultaneous determination of 25(OH)D3 and 1α,25(OH)2D3 in human plasma. Lowest concentration of 25(OH)D3 and 1α,25(OH)2D3 was 1000 and 20 pg/mL, respectively. The validated method was applied to a pharmacokinetic study in humans.
Background Although measurement of 25(OH)D3 is a routine analytical method to determine plasma vitamin D status, 1α,25(OH)2D3 is the biologically active form. Hence, simultaneous measurement of 25(OH)D3 and 1α,25(OH)2D3 could provide better insight into vitamin D status and pharmacokinetics. However, 1α,25(OH)2D3 has a low plasma concentration, making its quantification challenging for most analytical techniques. Here, we demonstrate use of liquid chromatography tandem mass spectrometry (LC-MSMS) for the development of a simple and rapid method for the simultaneous quantification of 25(OH)D3 and 1α,25(OH)2D3. Methods Samples were purified from 250 µL human plasma. Chromatography was performed on an analytical column, under gradient conditions using a mobile phase consisting of methanol-lithium acetate. The mass detector was operated in positive multiple reaction monitoring mode. The established method was validated according to the guidance issued by ICH and FDA. Furthermore, a clinical study was performed using this method to detect the plasma concentrations of 1α,25(OH)2D3 after oral administration of calcitriol. Results and conclusion The method was acceptably linear over the concentration ranges of 20–1200 pg/mL for 1α,25(OH)2D3 and 1–60 ng/mL for 25(OH)D3, respectively, with correlation coefficients of r2 > 0.993. Both the inter-assay and intra-assay precision was < 15%, and the analytical recoveries were within 100% ± 10%, with no significant matrix effect or carryover. Thereby, we, provide a facile method for the simultaneous detection of vitamin D metabolites in plasma.
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10
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Letourneau N, Aghajafari F, Bell RC, Deane AJ, Dewey D, Field C, Giesbrecht G, Kaplan B, Leung B, Ntanda H. The Alberta Pregnancy Outcomes and Nutrition (APrON) longitudinal study: cohort profile and key findings from the first three years. BMJ Open 2022; 12:e047503. [PMID: 35131812 PMCID: PMC8823238 DOI: 10.1136/bmjopen-2020-047503] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
PURPOSE The objectives of the ongoing Canadian longitudinal cohort called the Alberta Pregnancy Outcomes and Nutrition (APrON) study are to: (1) determine the relationship between maternal nutrient intake and status before, during, after pregnancy, and (a) maternal mental health, (b) pregnancy and birth outcomes, and (c) infant/child neurodevelopment and behavior; (2) identify maternal mental health and nutrient predictors of child behaviour; and (3) establish a DNA biobank to explore genomic predictors of children's neurodevelopment and behavior. The purpose of this paper is to describe the participants, measures, and key findings on maternal and paternal mental health, maternal nutrition, and child outcomes to when children are 3 years of age. PARTICIPANTS Participants included mothers and their children (n=2189) and mothers' partners (usually fathers; n=1325) from whom data were collected during the period from pregnancy to when children were 3 years of age, in Alberta, Canada. More than 88% of families have been retained to take part in completed data collection at 8 years of age. FINDINGS TO DATE Data comprise: questionnaires completed by pregnant women/mothers and their partners on mothers', fathers' and children's health; dietary interviews; clinical assessments; linkage to hospital obstetrical records; and biological samples such as DNA. Key findings on mental health, nutrition and child outcomes are presented. APrON women who consumed more selenium and omega-3 were less likely to develop symptoms of perinatal depression. Higher prenatal consumption of choline rich foods such as eggs and milk were recommended as was vitamin D supplementation for both mothers and children to meet guidelines. Couples in which both mothers and fathers were affected by perinatal depression reported lower incomes and higher maternal prenatal depressive symptoms and lower support from fathers postnatally and their children presented with the most behavioural problems. Maternal experiences of early adversity predicted increased likelihood of perinatal depression and anxiety and children's behavioural problems. FUTURE PLANS The APrON cohort offers a unique opportunity to advance understanding of the developmental origins of health and disease. There is a planned follow-up to collect data at 12 years of age.
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Affiliation(s)
- Nicole Letourneau
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine (Departments of Paediatrics, Psychiatry & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Fariba Aghajafari
- Cumming School of Medicine (Family Medicine & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Rhonda C Bell
- Faculty of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Andrea J Deane
- Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta, Canada
| | - Deborah Dewey
- Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta, Canada
| | - Catherine Field
- Faculty of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Gerald Giesbrecht
- Cumming School of Medicine (Pediatrics & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Bonnie Kaplan
- Cumming School of Medicine (Pediatrics & Community Health Sciences), University of Calgary, Calgary, Alberta, Canada
| | - Brenda Leung
- Health Science - Public Health Program, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Henry Ntanda
- Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta, Canada
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11
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Mao D, Yuen LY, Ho CS, Wang CC, Tam CHT, Chan MHM, Lowe WL, Ma RCW, Tam WH. Maternal and Neonatal 3-epi-25-hydroxyvitamin D Concentration and Factors Influencing Their Concentrations. J Endocr Soc 2022; 6:bvab170. [PMID: 34909515 PMCID: PMC8664761 DOI: 10.1210/jendso/bvab170] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Little is known about the presence of 3-epi-25 hydroxyvitamin D in maternal and neonatal circulation, the extent of its contribution to total 25 hydroxyvitamin D, or factors influencing its levels. METHODS A total of 1502 and 1321 archived maternal and umbilical cord serum samples from the Hyperglycemia and Adverse Pregnancy Outcome Study cohort from Hong Kong were assayed for 25(OH)D2, 25(OH)D3, and isomeric form of 25(OH)D3 (3-epi-25(OH)D3) by a liquid chromatography-tandem mass spectrometry method. RESULTS Vitamin D deficiency (total serum 25(OH)D level < 50 nmol/L) and severe vitamin D deficiency (total serum 25(OH)D level < 25 nmol/L) occurred in 590 (39.3%) and 25 (1.7%) mothers, respectively. 3-epi-25(OH)D3 could be detected in 94.5% of maternal and 92.1% of neonatal umbilical sera, with the highest 3-epi-25(OH)D3 levels contributing to 19.9% and 15.3% of the maternal and umbilical cord sera 25(OH)D3 levels, respectively. Pregnancy with a male fetus, ambient solar radiation, and maternal glycemia and 25(OH)D3 levels were independent factors associated with maternal 3-epi-25(OH)D3 level. Advanced maternal age, multiparity, maternal gestational weight gain below the Institute of Medicine recommendation, maternal glycemic status, and earlier gestational age at delivery were significantly associated with higher umbilical cord serum 3-epi-25(OH)D3. CONCLUSIONS 3-epi-25(OH)D3 accounted for a significant portion of total 25(OH)D in maternal and neonatal circulations. Further study is needed to determine the possible mechanism underlying this observation.
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Affiliation(s)
- Di Mao
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lai-Yuk Yuen
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chung-Shun Ho
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi-Chiu Wang
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Claudia Ha-Ting Tam
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Michael Ho-Ming Chan
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - William L Lowe
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ronald Ching-Wan Ma
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wing-Hung Tam
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China
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12
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Vierucci F, Fusani L, Saba A, Minucciani T, Belluomini MP, Domenici R, Bracco GL, Vaccaro A, Federico G. Gestational vitamin D 3 supplementation and sun exposure significantly influence cord blood vitamin D status and 3-epi-25-hydroxyvitamin D 3 levels in term newborns. Clin Chim Acta 2022; 524:59-68. [PMID: 34838794 DOI: 10.1016/j.cca.2021.11.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS High prevalence of hypovitaminosis D is worldwide reported among pregnant women and newborns. We assessed cord blood 25-hydroxyvitamin D3 [25(OH)D3] and 3-epi-25-hydroxyvitamin D3 (C3-epimer) levels in relation to assumed maternal risk factors for hypovitaminosis D. METHODS We enrolled 246 term newborns during summer. 175/246 mothers were supplemented with a daily variable dosage (200-1,000 IU) of vitamin D3 during pregnancy. Cord blood 25(OH)D3 and C3-epimer concentrations were analyzed by high performance liquid chromatography tandem mass spectrometry. RESULTS Median cord blood 25(OH)D3 levels were 23.4 ng/mL (16.9-28.8). The prevalences of vitamin D sufficiency (≥ 30.0 ng/mL), insufficiency (20.0-29.9 ng/mL), and deficiency (< 20.0 ng/mL) were 19.9%, 45.9%, and 34.2%, respectively. Non-Caucasian ethnicity, housewife life, weight excess, negligible sun exposure and absent gestational vitamin D supplementation were associated with both reduced cord blood 25(OH)D3 and C3-epimer levels. C3-epimer/25(OH)D3 ratio was 15.1% (13.6%-18.4%) and it was not related to any of the assumed risk factors for hypovitaminosis D. CONCLUSIONS Cord blood vitamin D deficiency was common, particularly in newborns from mother not receiving vitamin D supplementation and with poor sun exposure. C3-epimer levels were high in cord blood, causing possible misclassification of vitamin D status if they were not distinguished from 25(OH)D3 concentrations.
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Affiliation(s)
| | - Lara Fusani
- Pediatric Unit, University-Hospital of Pisa, Pisa, Italy.
| | - Alessandro Saba
- Laboratory of Endocrinology, University of Pisa, Pisa, Italy.
| | | | | | | | - Gian Luca Bracco
- Obstetrics and Gynecology Unit, San Luca Hospital, Lucca, Italy.
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13
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Absolute quantification of eleven A, D, E and K vitamers in human plasma using automated extraction and UHPLC-Orbitrap MS. Anal Chim Acta 2021; 1181:338877. [PMID: 34556212 DOI: 10.1016/j.aca.2021.338877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/08/2021] [Accepted: 07/22/2021] [Indexed: 11/22/2022]
Abstract
Fat-Soluble Vitamers [FSV] deficiencies and hypervitaminosis are associated with lifestyle diseases such as cardiovascular disease, diabetes, and cancer. Quantification of FSV and their metabolites in plasma has proved to be one of the most demanding analytical chemistry challenges. Current FSV quantification methods are compromises between breadth of coverage and sensitivity across the physiological range. Here, we developed and validated a sensitive, robust, semi-automated method using liquid-liquid extraction coupled with LC-ESI-MS/MS to quantify 11 FSV across their physiological concentrations in plasma. The addition of Phree® phospholipid removal plates as the last step in the extraction process reduced matrix effects, improving precision, recoveries, and the method's final sensitivity. This method can detect and quantify: retinol, retinoic acid, retinyl palmitate, 25 hydroxyvitamin D3 [25-OH-D3], 1-α-25-dihydroxy-D3, α-tocopherol, γ-tocopherol, α-tocotrienol, phylloquinone [K1], Menatetrenone [MK-4], and menaquinone-7 [MK-7].The Instrument Quantitation Limit [IQL]s for retinol (64.1 ng/mL), 25-OH-D3 (10.2 ng/mL), and α-tocopherol (3000 ng/mL) can detect clinical deficiencies. Our automated method will assist in the understanding of the complex interaction between these compounds and their possible role in health and disease.
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14
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Weiler HA, Vanstone CA, Razaghi M, Gharibeh N, Patel S, Wei SQ, McNally D. Disparities in Vitamin D Status of Newborn Infants from a Diverse Sociodemographic Population in Montreal, Canada. J Nutr 2021; 152:255-268. [PMID: 34612495 PMCID: PMC8754562 DOI: 10.1093/jn/nxab344] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/02/2021] [Accepted: 09/17/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vitamin D status at birth is reliant on maternal-fetal transfer of vitamin D during gestation. OBJECTIVES We aimed to examine the vitamin D status of newborn infants in a diverse population and to subsequently identify the modifiable correlates of vitamin D status. METHODS In this cross-sectional study, healthy mother-infant dyads (n = 1035) were recruited within 36 h after term delivery (March 2016-March 2019). Demographic and lifestyle factors were surveyed. Newborn serum 25-hydroxyvitamin D [25(OH)D] was measured (standardized chemiluminescence immunoassay) and categorized as deficient [serum 25(OH)D <30 nmol/L] or adequate (≥40 nmol/L). Serum 25(OH)D was compared among categories of maternal characteristics using ANOVA; each characteristic was tested in a separate model. Subgroups (use of multivitamins preconception and continued in pregnancy compared with during pregnancy only) were matched (n = 352/group) for maternal factors (ancestry, age, income, education, parity, and prepregnancy BMI) using propensity scores; logistic regression models were generated for odds of deficiency or adequacy. RESULTS Infants' mean serum 25(OH)D was 45.9 nmol/L (95% CI: 44.7, 47.0 nmol/L) (n = 1035), with 20.8% (95% CI: 18.3%, 23.2%) deficient and 60.7% (95% CI: 55.2%, 66.2%) adequate. Deficiency prevalence ranged from 14.6% of white infants to 41.7% of black infants. Serum 25(OH)D was higher (P < 0.0001) in infants of mothers with higher income, BMI < 25 kg/m2, exercise and sun exposure in pregnancy, and use of multivitamins preconception. In the matched-subgroup analysis, multivitamin supplementation preconception plus during pregnancy relative to only during pregnancy was associated with lower odds for vitamin D deficiency (ORadj: 0.55; 95% CI: 0.36, 0.86) and higher odds for adequate vitamin D status (ORadj: 1.47; 95% CI: 1.04, 2.07). CONCLUSIONS In this study most newborn infants had adequate vitamin D status, yet one-fifth were vitamin D deficient with disparities between population groups. Guidelines for a healthy pregnancy recommend maternal use of multivitamins preconception and continuing in pregnancy. An emphasis on preconception use may help to achieve adequate neonatal vitamin D status.This trial was registered at clinicaltrials.gov as NCT02563015.
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Affiliation(s)
| | - Catherine A Vanstone
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Maryam Razaghi
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Nathalie Gharibeh
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Sharina Patel
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Shu Q Wei
- Québec National Institute of Public Health, Montréal, Québec, Canada
| | - Dayre McNally
- Division of Critical Care, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
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15
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Finch SL, Rosenberg AM, Kusalik AJ, Maleki F, Rezaei E, Baxter-Jones A, Benseler S, Boire G, Cabral D, Campillo S, Chédeville G, Chetaille AL, Dancey P, Duffy C, Duffy KW, Guzman J, Houghton K, Huber AM, Jurencak R, Lang B, Laxer RM, Morishita K, Oen KG, Petty RE, Ramsey SE, Roth J, Schneider R, Scuccimarri R, Stringer E, Tse SML, Tucker LB, Turvey SE, Szafron M, Whiting S, Yeung RS, Vatanparast H. Higher concentrations of vitamin D in Canadian children with juvenile idiopathic arthritis compared to healthy controls are associated with more frequent use of vitamin D supplements and season of birth. Nutr Res 2021; 92:139-149. [PMID: 34311227 DOI: 10.1016/j.nutres.2021.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 05/05/2021] [Accepted: 05/23/2021] [Indexed: 10/21/2022]
Abstract
A number of studies have demonstrated that patients with autoimmune disease have lower levels of vitamin D prompting speculation that vitamin D might suppress inflammation and immune responses in children with juvenile idiopathic arthritis (JIA). The objective of this study was to compare vitamin D levels in children with JIA at disease onset with healthy children. We hypothesized that children and adolescents with JIA have lower vitamin D levels than healthy children and adolescents. Data from a Canadian cohort of children with new-onset JIA (n= 164, data collection 2007-2012) were compared to Canadian Health Measures Survey (CHMS) data (n=4027, data collection 2007-2011). We compared 25-hydroxy vitamin D (25(OH)D) concentrations with measures of inflammation, vitamin D supplement use, milk intake, and season of birth. Mean 25(OH)D level was significantly higher in patients with JIA (79 ± 3.1 nmol/L) than in healthy controls (68 ± 1.8 nmol/L P <.05). Patients with JIA more often used vitamin D containing supplements (50% vs. 7%; P <.05). The prevalence of 25(OH)D deficiency (<30 nmol/L) was 6% for both groups. Children with JIA with 25(OH)D deficiency or insufficiency (<50 nmol/L) had higher C-reactive protein levels. Children with JIA were more often born in the fall and winter compared to healthy children. In contrast to earlier studies, we found vitamin D levels in Canadian children with JIA were higher compared to healthy children and associated with more frequent use of vitamin D supplements. Among children with JIA, low vitamin D levels were associated with indicators of greater inflammation.
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Affiliation(s)
- Sarah L Finch
- University of Saskatchewan, Saskatoon, Canada; University of Prince Edward Island, Charlottetown, Canada
| | | | | | | | | | | | - Susanne Benseler
- Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - David Cabral
- BC Children's Hospital and The University of British Columbia, Vancouver, Canada
| | | | | | | | - Paul Dancey
- Janeway Children's Health and Rehabilitation Centre, St. John's, Canada
| | - Ciaran Duffy
- Children's Hospital of Eastern Ontario, Ottawa, Canada
| | | | - Jaime Guzman
- BC Children's Hospital and The University of British Columbia, Vancouver, Canada
| | - Kristin Houghton
- BC Children's Hospital and The University of British Columbia, Vancouver, Canada
| | - Adam M Huber
- IWK Health Centre and Dalhousie University, Halifax, Canada
| | | | - Bianca Lang
- IWK Health Centre and Dalhousie University, Halifax, Canada
| | - Ron M Laxer
- The University of Toronto and The Hospital for Sick Children, Toronto, Canada
| | - Kimberly Morishita
- BC Children's Hospital and The University of British Columbia, Vancouver, Canada
| | - Kiem G Oen
- University of Manitoba, Winnipeg, Canada
| | - Ross E Petty
- BC Children's Hospital and The University of British Columbia, Vancouver, Canada
| | | | - Johannes Roth
- Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Rayfel Schneider
- The University of Toronto and The Hospital for Sick Children, Toronto, Canada
| | | | | | - Shirley M L Tse
- The University of Toronto and The Hospital for Sick Children, Toronto, Canada
| | - Lori B Tucker
- BC Children's Hospital and The University of British Columbia, Vancouver, Canada
| | - Stuart E Turvey
- BC Children's Hospital and The University of British Columbia, Vancouver, Canada
| | | | | | - Rae Sm Yeung
- The University of Toronto and The Hospital for Sick Children, Toronto, Canada
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16
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Liu H, Wang DJ, Wan KX, Zhang J, Yuan ZJ, Yu CW, Yang J, Zou L. Simultaneous quantification of fat-soluble vitamins A, 25-hydroxylvitamin D and vitamin E in plasma from children using liquid chromatography coupled to Orbitrap mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2021; 1177:122795. [PMID: 34098179 DOI: 10.1016/j.jchromb.2021.122795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 04/06/2021] [Accepted: 05/21/2021] [Indexed: 10/21/2022]
Abstract
The fat-soluble vitamins A, D, E and K are micronutrients essential for physiological activity, metabolism and growth. Accurate and sensitive analytical methods are needed to support growing research into fat-soluble vitamins and their impact on children's growth and health. Here we report the first method for simultaneous quantification of fat-soluble vitamins A (retinol), 25-hydroxylvitamin D2, 25-hydroxylvitamin D3, and vitamin E (α-tocopherol) using a Q-Exactive Orbitrap mass spectrometer in high-resolution, parallel reaction monitoring mode. This method can select desired ions with high efficiency, potentially making it superior to triple-quadrupole mass spectrometers that employ multiple reaction monitoring. The proposed method offers excellent accuracy, specificity, and sensitivity, as demonstrated with plasma samples from healthy children.
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Affiliation(s)
- Hao Liu
- Center for Clinical Molecular Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, People's Republic of China.
| | - Dong-Juan Wang
- Center for Clinical Molecular Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, People's Republic of China
| | - Ke-Xing Wan
- Center for Clinical Molecular Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, People's Republic of China
| | - Juan Zhang
- Center for Clinical Molecular Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, People's Republic of China
| | - Zhao-Jian Yuan
- Center for Clinical Molecular Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, People's Republic of China
| | - Chao-Wen Yu
- Center for Clinical Molecular Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, People's Republic of China
| | - Jing Yang
- Center for Clinical Molecular Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, People's Republic of China
| | - Lin Zou
- Center for Clinical Molecular Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, People's Republic of China
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17
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Thorsen SU, Collier F, Pezic A, O'Hely M, Clarke M, Tang MLK, Burgner D, Vuillermin P, Ponsonby AL. Maternal and Cord Blood 25-Hydroxyvitamin D 3 Are Associated with Increased Cord Blood and Naive and Activated Regulatory T Cells: The Barwon Infant Study. THE JOURNAL OF IMMUNOLOGY 2021; 206:874-882. [PMID: 33431661 DOI: 10.4049/jimmunol.2000515] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 12/02/2020] [Indexed: 12/21/2022]
Abstract
Vitamin D has shown immune-modulatory effects but mostly in in vitro and animal studies. Regulatory T cells (Treg) are important for a balanced immune system. The relationship between vitamin D on the number of circulating neonatal Treg is unclear. We sought to investigate the association between maternal and neonatal vitamin D metabolites and cord blood (CB) Treg subsets. In a cohort of Australian infants (n = 1074), recruited using an unselected antenatal sampling frame, 158 mother-infant pairs had data on the following: 1) 25-hydroxyvitamin D3 (25(OH)D3) measures in both maternal peripheral blood (28- to 32-wk gestation) and infant CB; 2) proportions (percentage of CD4+ T cells) of CB Treg subsets (CD4+CD45RA+ FOXP3low naive Treg, and CD4+CD45RA- FOXP3high activated Treg [aTreg]); and 3) possible confounders, including maternal personal UV radiation. Multiple regression analyses were used. The median 25(OH)D3 was 85.4 and 50.7 nmol/l for maternal and CB samples, respectively. Higher maternal 25(OH)D3 levels were associated with increased CB naive Treg (relative adjusted mean difference [AMD] per 25 nmol/l increase: 5%; 95% confidence interval [CI]: 1-9%), and aTreg (AMD per 25 nmol/l increase: 17%; 95% CI: 6-28%). Furthermore, a positive association between CB 25(OH)D3 levels and CB aTreg (AMD per 25 nmol/l increase: 29%; 95% CI: 13-48%) was also evident. These results persisted after adjustment for other factors such as maternal personal UV radiation and season of birth. 25(OH)D3, may play a role in the adaptive neonatal immune system via induction of FOXP3+ Tregs. Further studies of immune priming actions of antenatal 25(OH)D3 are warranted.
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Affiliation(s)
- Steffen U Thorsen
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria 3052, Australia.,Copenhagen Diabetes Research Center (CPH-DIRECT), Department of Paediatrics, Herlev and Gentofte University Hospital, 2730 Herlev, Denmark.,Department of Biomedical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
| | - Fiona Collier
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria 3052, Australia.,Geelong Center for Emerging Infectious Diseases Laboratory, University Hospital, Barwon Health, Geelong, Victoria 3220, Australia.,Child Research Unit, University Hospital, Barwon Health, Geelong, Victoria 3220, Australia.,School of Medicine, Deakin University, Geelong, Victoria 3220, Australia
| | - Angela Pezic
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Martin O'Hely
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Michael Clarke
- Biological and Molecular Mass Spectrometry Facility, Centre for Microscopy, Characterisation and Analysis, University of Western Australia, Perth, Western Australia 6009, Australia; and
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria 3052, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Peter Vuillermin
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria 3052, Australia.,Child Research Unit, University Hospital, Barwon Health, Geelong, Victoria 3220, Australia.,School of Medicine, Deakin University, Geelong, Victoria 3220, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Victoria 3052, Australia; .,The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria 3052, Australia
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18
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Xu B, Feng Y, Gan L, Zhang Y, Jiang W, Feng J, Yu L. Vitamin D Status in Children With Short Stature: Accurate Determination of Serum Vitamin D Components Using High-Performance Liquid Chromatography-Tandem Mass Spectrometry. Front Endocrinol (Lausanne) 2021; 12:707283. [PMID: 34721288 PMCID: PMC8548707 DOI: 10.3389/fendo.2021.707283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 09/03/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Vitamin D is critical for calcium and bone metabolism. Vitamin D insufficiency impairs skeletal mineralization and bone growth rate during childhood, thus affecting height and health. Vitamin D status in children with short stature is sparsely reported. The purpose of the current study was to investigate various vitamin D components by high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) to better explore vitamin D storage of short-stature children in vivo. METHODS Serum circulating levels of 25-hydroxyvitamin D2 [25(OH)D2], 25-hydroxyvitamin D3 [25(OH)D3], and 3-epi-25-hydroxyvitamin D3 [3-epi-25(OH)D3, C3-epi] were accurately computed using the LC-MS/MS method. Total 25(OH)D [t-25(OH)D] and ratios of 25(OH)D2/25(OH)D3 and C3-epi/25(OH)D3 were then respectively calculated. Free 25(OH)D [f-25(OH)D] was also measured. RESULTS 25(OH)D3 and f-25(OH)D levels in short-stature subgroups 2 (school age: 7~12 years old) and 3 (adolescence: 13~18 years old) were significantly lower compared with those of healthy controls. By contrast, C3-epi levels and C3-epi/25(OH)D3 ratios in all the three short-stature subgroups were markedly higher than the corresponding healthy cases. Based on cutoff values developed by Endocrine Society Recommendation (but not suitable for methods 2 and 3), sufficient storage capacities of vitamin D in short-stature subgroups 1, 2, and 3 were 42.8%, 23.8%, and 9.0% as determined by Method 3 [25(OH)D2/3+25(OH)D3], which were lower than those of 57.1%, 28.6%, and 18.2% as determined by Method 1 [25(OH)D2+25(OH)D3+C3-epi] and 45.7%, 28.5%, and 13.6% as determined by Method 2 [25(OH)D2/3+25(OH)D3+C3-epi]. Levels of 25(OH)D2 were found to be weakly negatively correlated with those of 25(OH)D3, and higher 25(OH)D3 levels were positively correlated with higher levels of C3-epi in both short-stature and healthy control cohorts. Furthermore, f-25(OH)D levels were positively associated with 25(OH)D3 and C3-epi levels in children. CONCLUSIONS The current LC-MS/MS technique can not only separate 25(OH)D2 from 25(OH)D3 but also distinguish C3-epi from 25(OH)D3. Measurement of t-25(OH)D [25(OH)D2+25(OH)D3] alone may overestimate vitamin D storage in children, and short-stature children had lower vitamin D levels compared with healthy subjects. Ratios of C3-epi/25(OH)D3 and 25(OH)D2/25(OH)D3 might be alternative markers for vitamin D catabolism/storage in short-stature children. Further studies are needed to explore the relationships and physiological roles of various vitamin D metabolites.
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Affiliation(s)
| | | | | | | | | | | | - Lin Yu
- *Correspondence: Jiafu Feng, ; Lin Yu,
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19
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Abstract
Vitamin D is essential for bone health and is known to be involved in immunomodulation and cell proliferation. Vitamin D status remains a significant health issue worldwide. However, there has been no clear consensus on vitamin D deficiency and its measurement in serum, and clinical practice of vitamin D deficiency treatment remains inconsistent. The major circulating metabolite of vitamin D, 25-hydroxyvitamin D (25(OH)D), is widely used as a biomarker of vitamin D status. Other metabolic pathways are recognised as important to vitamin D function and measurement of other metabolites may become important in the future. The utility of free 25(OH)D rather than total 25(OH)D needs further assessment. Data used to estimate the vitamin D intake required to achieve a serum 25(OH)D concentration were drawn from individual studies which reported dose-response data. The studies differ in their choice of subjects, dose of vitamin D, frequency of dosing regimen and methods used for the measurement of 25(OH)D concentration. Baseline 25(OH)D, body mass index, ethnicity, type of vitamin D (D2 or D3) and genetics affect the response of serum 25(OH)D to vitamin D supplementation. The diversity of opinions that exist on this topic are reflected in the guidelines. Government and scientific societies have published their recommendations for vitamin D intake which vary from 400-1000 IU/d (10-25 μg/d) for an average adult. It was not possible to establish a range of serum 25(OH)D concentrations associated with selected non-musculoskeletal health outcomes. To recommend treatment targets, future studies need to be on infants, children, pregnant and lactating women.
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Validation and Determination of 25(OH) Vitamin D and 3-Epi25(OH)D3 in Breastmilk and Maternal- and Infant Plasma during Breastfeeding. Nutrients 2020; 12:nu12082271. [PMID: 32751196 PMCID: PMC7469027 DOI: 10.3390/nu12082271] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 12/22/2022] Open
Abstract
Vitamin D deficiency in pregnant women and their offspring may result in unfavorable health outcomes for both mother and infant. A 25hydroxyvitamin D (25(OH)D) level of at least 75 nmol/L is recommended by the Endocrine Society. Validated, automated sample preparation and liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods were used to determine the vitamin D metabolites status in mother-infant pairs. Detection of 3-Epi25(OH)D3 prevented overestimation of 25(OH)D3 and misclassification of vitamin D status. Sixty-three percent of maternal 25(OH)D plasma levels were less than the recommended level of 25(OH)D at 3 months. Additionally, breastmilk levels of 25(OH)D decreased from 60.1 nmol/L to 50.0 nmol/L between six weeks and three months (p < 0.01). Furthermore, there was a positive correlation between mother and infant plasma levels (p < 0.01, r = 0.56) at 3 months. Accordingly, 31% of the infants were categorized as vitamin D deficient (25(OH)D < 50 nmol/L) compared to 25% if 3-Epi25(OH)D3 was not distinguished from 25(OH)D3. This study highlights the importance of accurate quantification of 25(OH)D. Monitoring vitamin D metabolites in infant, maternal plasma, and breastmilk may be needed to ensure adequate levels in both mother and infant in the first 6 months of infant life.
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Al-Zohily B, Al-Menhali A, Gariballa S, Haq A, Shah I. Epimers of Vitamin D: A Review. Int J Mol Sci 2020; 21:ijms21020470. [PMID: 31940808 PMCID: PMC7013384 DOI: 10.3390/ijms21020470] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/08/2020] [Accepted: 01/08/2020] [Indexed: 12/12/2022] Open
Abstract
In this review, we discuss the sources, formation, metabolism, function, biological activity, and potency of C3-epimers (epimers of vitamin D). We also determine the role of epimerase in vitamin D-binding protein (DBP) and vitamin D receptors (VDR) according to different subcellular localizations. The importance of C3 epimerization and the metabolic pathway of vitamin D at the hydroxyl group have recently been recognized. Here, the hydroxyl group at the C3 position is orientated differently from the alpha to beta orientation in space. However, the details of this epimerization pathway are not yet clearly understood. Even the gene encoding for the enzyme involved in epimerization has not yet been identified. Many published research articles have illustrated the biological activity of C3 epimeric metabolites using an in vitro model, but the studies on in vivo models are substantially inadequate. The metabolic stability of 3-epi-1α,25(OH)2D3 has been demonstrated to be higher than its primary metabolites. 3-epi-1 alpha, 25 dihydroxyvitamin D3 (3-epi-1α,25(OH)2D3) is thought to have fewer calcemic effects than non-epimeric forms of vitamin D. Some researchers have observed a larger proportion of total vitamin D as C3-epimers in infants than in adults. Insufficient levels of vitamin D were found in mothers and their newborns when the epimers were not included in the measurement of vitamin D. Oral supplementation of vitamin D has also been found to potentially cause increased production of epimers in mice but not humans. Moreover, routine vitamin D blood tests for healthy adults will not be significantly affected by epimeric interference using LC-MS/MS assays. Recent genetic models also show that the genetic determinants and the potential factors of C3-epimers differ from those of non-C3-epimers.Most commercial immunoassays techniques can lead to inaccurate vitamin D results due to epimeric interference, especially in infants and pregnant women. It is also known that the LC-MS/MS technique can chromatographically separate epimeric and isobaric interference and detect vitamin D metabolites sensitively and accurately. Unfortunately, many labs around the world do not take into account the interference caused by epimers. In this review, various methods and techniques for the analysis of C3-epimers are also discussed. The authors believe that C3-epimers may have an important role to play in clinical research, and further research is warranted.
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Affiliation(s)
- Bashar Al-Zohily
- Department of Chemistry, College of Science, United Arab Emirates University, Al Ain 15551, UAE;
| | - Asma Al-Menhali
- Department of Biology, College of Science, United Arab Emirates University, Al Ain 15551, UAE
- Correspondence: (A.A.-M.); (I.S.)
| | - Salah Gariballa
- Internal Medicine, Faculty of Medicine & Health Sciences, United Arab Emirates University, Al Ain 15551, UAE;
| | - Afrozul Haq
- Department of Food Technology, School of Interdisciplinary Sciences and Technology, Jamia Hamdard University, New Delhi-110062, India;
| | - Iltaf Shah
- Department of Chemistry, College of Science, United Arab Emirates University, Al Ain 15551, UAE;
- Correspondence: (A.A.-M.); (I.S.)
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Savard C, Gagnon C, Morisset AS. Disparities in the timing and measurement methods to assess vitamin D status during pregnancy: A Narrative Review. INT J VITAM NUTR RES 2019; 88:176-189. [PMID: 30747608 DOI: 10.1024/0300-9831/a000507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Studies that examined associations between low circulating 25-hydroxyvitamin D (25(OH)D) and adverse pregnancy outcomes used various designs, assay methods and time points for measurement of 25(OH)D concentrations, which creates some confusion in the current literature. We aimed to investigate the variability in the timing and measurement methods used to evaluate vitamin D status during pregnancy. Analysis of 198 studies published between 1976 and 2017 showed an important variability in the choice of 1) threshold values for 25(OH)D insufficiency or deficiency, 2) 25(OH)D measurement methods, and 3) trimester in which 25(OH)D concentrations were measured. Blood samples were taken once during pregnancy in a large majority of studies, which may not be representative of vitamin D status throughout pregnancy. Most studies reported adjustment for confounding factors including season of blood sampling, but very few studies used the 25(OH)D gold standard assay, the LC-MS/MS. Prospective studies assessing maternal 25(OH)D concentrations 1) by standardized and validated methods, 2) at various time points during pregnancy, and 3) after considering potential confounding factors, are needed.
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Affiliation(s)
- Claudia Savard
- 1 School of Nutrition, Laval University.,2 Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec, Canada.,3 Institute of Nutrition and Functional Foods, Laval University Quebec City, Québec, Canada
| | - Claudia Gagnon
- 2 Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec, Canada.,3 Institute of Nutrition and Functional Foods, Laval University Quebec City, Québec, Canada.,4 Department of Medicine, Laval University, Quebec City, Québec, Canada
| | - Anne-Sophie Morisset
- 1 School of Nutrition, Laval University.,2 Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec, Canada.,3 Institute of Nutrition and Functional Foods, Laval University Quebec City, Québec, Canada
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Hara K, Ikeda K, Koyama Y, Wada Y, Hasegawa T. Comparison of serum 25-hydroxyvitamin D levels between radioimmunoassay and liquid chromatography-tandem mass spectrometry in infants and postpartum women. J Pediatr Endocrinol Metab 2018; 31:1105-1111. [PMID: 30231011 DOI: 10.1515/jpem-2018-0275] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 08/27/2018] [Indexed: 11/15/2022]
Abstract
Background Liquid chromatography-tandem mass spectrometry (LC-MS/MS) has become the gold standard for the measurement of serum 25-hydroxyvitamin D (25(OH)D) levels instead of the conventional method, radioimmunoassay (RIA). However, there was no study that compared RIA and LC-MS/MS for measuring serum 25(OH)D levels in infants and their mothers. The aim of this study was to assess the agreement of RIA and LC-MS/MS for measuring the serum levels in infants and postpartum women. Methods This study enrolled 70 preterm infants, 113 term infants (134 samples), and 120 postpartum women. Serum concentration of 25(OH)D was measured by RIA and LC-MS/MS. We evaluated the correlation between RIA and LC-MS/MS. Also, we evaluated the bias between RIA and LC-MS/MS using Bland-Altman analysis. Results Sixty percent of preterm infants had serum 25(OH)D levels below the lower limit of quantification (LOQ) (4 ng/mL) and 90% of them were classified as vitamin D deficient. The serum 25(OH)D levels measured by RIA were significantly correlated with those measured by LC-MS/MS in all groups. According to the Bland-Altman plot, the serum 25(OH)D levels of infants measured by RIA had constant positive bias (mean±standard deviation [SD] [95% confidence interval, CI], preterm: +4.8± 2.4 ng/mL [4.2-5.4], term: +5.8±4.0 [5.1-6.5]) and proportional bias (preterm: r=0.44, p<0.01, term: r=0.50, p<0.01) compared with LC-MS/MS. The serum 25(OH)D levels of postpartum women measured by RIA had constant positive bias compared with LC-MS/MS, but no proportional bias was found. Conclusions RIA demonstrated falsely high 25(OH)D levels when used for infants and postpartum women.
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Affiliation(s)
- Kaori Hara
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Kazushige Ikeda
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.,Department of Neonatology, Saitama City Hospital, Saitama, Japan
| | | | | | - Tomonobu Hasegawa
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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Aghajafari F, Pond D, Catzikiris N, Cameron I. Quality assessment of systematic reviews of vitamin D, cognition and dementia. BJPsych Open 2018; 4:238-249. [PMID: 29998819 PMCID: PMC6060489 DOI: 10.1192/bjo.2018.32] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 05/03/2018] [Accepted: 05/19/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND There is conflicting evidence regarding the association of vitamin D with cognition performance and dementia.AimsWe aimed to summarise the evidence on the association of vitamin D with cognitive performance, dementia and Alzheimer disease through a qualitative assessment of available systematic reviews and meta-analyses. METHOD We conducted an overview of the systematic reviews of all study types with or without meta-analyses on vitamin D and either Alzheimer disease, dementia or cognitive performance up to June 2017. RESULTS Eleven systematic reviews were identified, nine of which were meta-analyses with substantial heterogeneity, differing statistical methods, variable methodological quality and quality of data abstraction. A Measurement Tool to Assess Systematic Reviews checklist scores ranged from 4 to 10 out of 11, with seven reviews of 'moderate' and four of 'high' methodological quality. Out of six meta-analyses on the association between low serum concentration of 25-hydroxyvitamin D and risk of dementia, five showed a positive association. Results of meta-analyses on the association between low serum concentration of 25-hydroxyvitamin D and memory function tests showed conflicting results. CONCLUSIONS This systematic evaluation of available systematic reviews provided a clearer understanding of the potential link between low serum vitamin D concentrations and dementia. This evaluation also showed that the quality of the available evidence is not optimal because of both the low methodological quality of the reviews and low quality of the original studies. Interpretation of these systematic reviews should therefore be made with care.Declaration of interestNone.
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Affiliation(s)
- Fariba Aghajafari
- Assistant Professor, Department of Family Medicine, Cumming School of Medicine, University of Calgary Sunridge Family Medicine Teaching Centre, Canada
| | - Dimity Pond
- Professor and Head of Department of Family Medicine, University of Newcastle, Australia
| | - Nigel Catzikiris
- Research Assistant, School of Medicine and Public Health, Faculty of Medicine, The University of Newcastle, Australia
| | - Ian Cameron
- Professor, Northern Clinical School, Rehabilitation Studies Unit, Sydney Medical School, The University of Sydney, Australia
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25
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Lee S, Metcalfe A, Raman M, Leung Y, Aghajafari F, Letourneau N, Panaccione R, Kaplan GG, Seow CH. Pregnant Women with Inflammatory Bowel Disease Are at Increased Risk of Vitamin D Insufficiency: A Cross-Sectional Study. J Crohns Colitis 2018; 12:702-709. [PMID: 29546360 PMCID: PMC5972591 DOI: 10.1093/ecco-jcc/jjy030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/07/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS Vitamin D insufficiency is prevalent in individuals with inflammatory bowel disease [IBD], as well as in pregnant women; however, the prevalence of vitamin D insufficiency in pregnant women with IBD is unknown. This study assessed the prevalence of vitamin D insufficiency in pregnant women with IBD and the adequacy of recommended supplementation. METHODS A cross-sectional study was conducted in pregnant women with inflammatory bowel disease [Crohn's disease = 61, ulcerative colitis = 41] and without inflammatory bowel disease [n = 574]. Chi square tests and log binomial regression were used to examine the prevalence of vitamin D insufficiency. Covariates included ethnicity and season. Adequacy of vitamin D supplementation during pregnancy was also assessed. RESULTS The prevalence of vitamin D insufficiency [25-OHD ≤75 nmol/L] in those with Crohn's disease was 50.8% (95% confidence interval [CI]: 38.4%-63.2%) and 60.9% [95% CI: 45.3%-74.7%] with ulcerative colitis compared with 17.4% [95% CI: 14.6%-20.8%] without inflammatory bowel disease. Women with inflammatory bowel disease were more likely to be vitamin D insufficient after adjusting for ethnicity and season (Crohn's disease-adjusted relative risk [aRR] = 2.98,;: 2.19-4.04; ulcerative colitis-aRR = 3.61; 95% CI: 2.65-4.93). Despite vitamin D supplementation, 32.3% [95% CI: 17.8%-51.2%] of those with Crohn's disease, 58.3% [95% CI: 37.1%-76.9%] of those with with ulcerative colitis, and 10.8% [95% CI: 6.9%-16.6%] of those without inflammatory bowel disease were still vitamin D insufficient. CONCLUSIONS Pregnant women with inflammatory bowel disease are at increased risk of vitamin D insufficiency compared with those without inflammatory bowel disease. The current guidelines for vitamin D supplementation may be inadequate for pregnant women with inflammatory bowel disease.
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Affiliation(s)
- Sangmin Lee
- University of Calgary Cumming School of Medicine, Community Health Sciences, Calgary, AB, Canada
| | - Amy Metcalfe
- University of Calgary Cumming School of Medicine, Calgary, AB, Canada,Obstetrics & Gynecology, Calgary, AB, Canada,Community Health Sciences, Medicine, Calgary, AB, Canada
| | - Maitreyi Raman
- University of Calgary Cumming School of Medicine, Medicine, Calgary, AB, Canada
| | - Yvette Leung
- University of British Columbia, Medicine, Vancouver, BC, Canada
| | - Fariba Aghajafari
- University of Calgary Cumming School of Medicine, Community Health Sciences, AB, Canada,Family Medicine, Calgary, AB, Canada
| | - Nicole Letourneau
- University of Calgary Cumming School of Medicine, Community Health Sciences, AB, Canada,University of Calgary Cumming School of Medicine, Medicine, AB, Canada,University of Calgary Cumming School of Medicine, Pediatrics & Psychiatry, AB, Canada,University of Calgary Faculty of Nursing, Nursing, Calgary, AB, Canada
| | - Remo Panaccione
- University of Calgary, Inflammatory Bowel Disease Clinic, Calgary, AB, Canada
| | - Gilaad G Kaplan
- University of Calgary, Division of Gastroenterology, Departments of Medicine, Calgary, AB, Canada
| | - Cynthia H Seow
- University of Calgary, Department of Medicine, Calgary, AB, Canada,Corresponding author: Dr Cynthia H. Seow, TRW building, Room 6D18, 3280 Hospital Drive NW, Calgary, AB, Canada, T2N 4Z6.
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26
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Functional indicators of vitamin D adequacy for very low birth weight infants. J Perinatol 2018; 38:550-556. [PMID: 29743660 PMCID: PMC6382072 DOI: 10.1038/s41372-018-0098-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 12/05/2017] [Accepted: 12/18/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To identify the vitamin D status to optimize calcium and bone health in preterm infants. STUDY DESIGN Very low birth weight infants had measurement of 25-hydroxyvitamin D status and markers of calcium and bone health from birth to term age. Piecewise linear regression modeling was performed to identify a 25-hydroxyvitamin D threshold associated with stable parathyroid hormone concentration and bone mineralization. RESULTS In a cohort of 89 infants at term age, femur BMC and density increased linearly with 25-hydroxyvitamin D status until reaching a threshold of 48 ng/mL and 46 ng/mL, respectively. Parathyroid hormone status decreased as vitamin D status increased until reaching a plateau at 25-hydroxyvitamin D of 42 ng/mL. CONCLUSION Preterm infant vitamin D status was significantly associated with PTH status and femur mineralization with suggestion that achieving a specific 25-hydroxyvitamin concentration is associated with optimal calcium homeostasis and femur bone mineralization.
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Concentration of 25-hydroxyvitamin D from neonatal dried blood spots and the relation to gestational age, birth weight and Ponderal Index: the D-tect study. Br J Nutr 2018; 119:1416-1423. [PMID: 29690937 DOI: 10.1017/s0007114518000879] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Studies have suggested that vitamin D status at birth may be associated with a range of neonatal outcomes. The aim of this study was to assess the association between neonatal 25-hydroxyvitamin D3 (25(OH)D3) concentration and gestational age, birth weight, Ponderal Index and size for gestational age. Neonatal capillary blood stored as dried blood spots was used to assess 25(OH)D3 concentrations among 2686 subjects selected from a random population sub-sample of individuals, born in Denmark from 1 May 1981 to 31 December 2002. There was an inverse association between 25(OH)D3 concentration and gestational age at birth of -0·006 (95 % CI -0·009, -0·003, P<0·001) weeks of gestation per 1 nmol/l increase in 25(OH)D3 concentration. An inverted U-shaped association between 25(OH)D3 and birth weight and Ponderal Index (P=0·04) was found, but no association with size for gestational age was shown. This study suggests that neonatal 25(OH)D3 concentration is associated with anthropometric measures at birth known to be correlated with many subsequent health outcomes such as obesity and type 2 diabetes.
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Jukic AMZ, Hoofnagle AN, Lutsey PL. Measurement of Vitamin D for Epidemiologic and Clinical Research: Shining Light on a Complex Decision. Am J Epidemiol 2018; 187:879-890. [PMID: 29020155 DOI: 10.1093/aje/kwx297] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 08/03/2017] [Indexed: 01/08/2023] Open
Abstract
Vitamin D is a fat-soluble vitamin that is synthesized in the skin with exposure to sunlight or is ingested from dietary supplements or food. There has been a dramatic increase in research on vitamin D, linking it with health outcomes as varied as reproductive function, infection, cardiovascular disease, and cancer. The study of vitamin D has generated much excitement, partly because there is an ideal intervention: Low levels may be common and can be remedied with widely available supplements. Determination of vitamin D status is complex and has advanced dramatically in the past 5 years. In this paper, we begin by describing important considerations for measurement of total 25-hydroxyvitamin D (25(OH)D), the biomarker traditionally assessed in epidemiologic studies. While 25(OH)D remains the most commonly measured biomarker, emerging evidence suggests that other related analytes may contribute to the characterization of an individual's vitamin D status (e.g., vitamin D-binding protein, bioavailable and free 25(OH)D, the C-3 epimer of 25(OH)D, 1,25-dihydroxyvitamin D, and 24,25-dihydroxyvitamin D). The measurement of these analytes is also complex, and there are important considerations for deciding whether their measurement is warranted in new research studies. Herein we discuss these issues and provide the reader with an up-to-date synthesis of research on vitamin D measurement options and considerations.
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Affiliation(s)
- Anne Marie Z Jukic
- Department of Chronic Disease Epidemiology, Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine, School of Medicine, University of Washington, Seattle, Washington
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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Aghajafari F, Field CJ, Weinberg AR, Letourneau N. Both Mother and Infant Require a Vitamin D Supplement to Ensure That Infants' Vitamin D Status Meets Current Guidelines. Nutrients 2018; 10:nu10040429. [PMID: 29596362 PMCID: PMC5946214 DOI: 10.3390/nu10040429] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/13/2018] [Accepted: 03/23/2018] [Indexed: 11/16/2022] Open
Abstract
We examined the association between maternal vitamin D intake during breastfeeding with their infants’ vitamin D status in infants who did or did not receive vitamin D supplements to determine whether infant supplementation was sufficient. Using plasma from a subset of breastfed infants in the APrON (Alberta Pregnant Outcomes and Nutrition) cohort, vitamin D status was measured by liquid chromatography-tandem mass spectrometry. Maternal and infants’ dietary data were obtained from APrON’s dietary questionnaires. The median maternal vitamin D intake was 665 International Units (IU)/day, while 25% reported intakes below the recommended 400 IU/day. Of the 224 infants in the cohort, 72% were exclusively breastfed, and 90% were receiving vitamin D supplements. Infants’ median 25(OH)D was 96.0 nmol/L (interquartile ranges (IQR) 77.6–116.2), and 25% had 25(OH)D < 75 nmol/L. An adjusted linear regression model showed that, with a 100 IU increase in maternal vitamin D intake, infants’ 25(OH)D increased by 0.9 nmol/L controlling for race, season, mid-pregnancy maternal 25(OH)D, birthweight, and whether the infant received daily vitamin D supplement (β = 0.008, 95% confidence interval (CI) 0.002, 0.13). These results suggest that, to ensure infant optimal vitamin D status, not only do infants require a supplement, but women also need to meet current recommended vitamin D intake during breastfeeding.
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Affiliation(s)
- Fariba Aghajafari
- Departments of Family Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
| | - Catherine J Field
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2R3, Canada.
| | - Amy R Weinberg
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2R3, Canada.
| | - Nicole Letourneau
- Faculty of Nursing and Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
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30
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Berger SE, Van Rompay MI, Gordon CM, Goodman E, Eliasziw M, Holick MF, Sacheck JM. Investigation of the C-3-epi-25(OH)D 3 of 25-hydroxyvitamin D 3 in urban schoolchildren. Appl Physiol Nutr Metab 2017; 43:259-265. [PMID: 29053944 DOI: 10.1139/apnm-2017-0334] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The physiological relevance C-3 epimer of 25-hydroxyvitamin D (3-epi-25(OH)D) is not well understood among youth. The objective of this study was to assess whether demographic/physiologic characteristics were associated with 3-epi-25(OH)D3 concentrations in youth. Associations between 3-epi-25(OH)D3 and demographics and between 3-epi-25(OH)D3, total 25-hydroxyvitamin (25(OH)D) (25(OH)D2 + 25(OH)D3), total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides were examined in racially/ethnically diverse schoolchildren (n = 682; age, 8-15 years) at Boston-area urban schools. Approximately 50% of participants had detectable 3-epi-25(OH)D3 (range 0.95-3.95 ng/mL). The percentage of 3-epi-25(OH)D3 of total 25(OH)D ranged from 2.5% to 17.0% (median 5.5%). Males were 38% more likely than females to have detectable 3-epi-25(OH)D3 concentrations. Both Asian and black race/ethnicity were associated with lower odds of having detectable 3-epi-25(OH)D3 compared with non-Hispanic white children (Asian vs. white, odds ratio (OR) 0.28, 95% confidence interval (CI) 0.14-0.53; black vs. white, OR 0.38, 95%CI 0.23-0.63, p < 0.001). Having an adequate (20-29 ng/mL) or optimal (>30 ng/mL) 25(OH)D concentration was associated with higher odds of having detectable 3-epi-25(OH)D3 than having an inadequate (<20 ng/mL) concentration (OR 4.78, 95%CI 3.23-6.94 or OR 14.10, 95%CI 7.10-28.0, respectively). There was no association between 3-epi-25(OH)D3 and blood lipids. However, when considering 3-epi-25(OH)D3 as a percentage of total 25(OH)D, total cholesterol was lower in children with percent 3-epi-25(OH)D3 above the median (mean difference -7.1 mg/dL, p = 0.01). In conclusion, among schoolchildren, sex, race/ethnicity, and total serum 25(OH)D concentration is differentially associated with 3-epi-25(OH)D. The physiological relevance of 3-epi-25(OH)D3 may be related to the 3-epi-25(OH)D3 as a percentage of total 25(OH)D and should be considered in future investigations.
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Affiliation(s)
- Samantha E Berger
- a Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Maria I Van Rompay
- a Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Catherine M Gordon
- b Divisions of Adolescent and Transition Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Elizabeth Goodman
- c MassGeneral Hospital for Children and Harvard Medical School, Boston, MA 02114, USA
| | - Misha Eliasziw
- d Department of Public Health and Community Medicine, Tufts University, Boston, MA 02111, USA
| | - Michael F Holick
- e Endocrinology, Diabetes and Nutrition Section, Department of Medicine, Boston University Medical Center, Boston, MA 02118, USA
| | - Jennifer M Sacheck
- a Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
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S-25-hydroxyvitamin D and C3-epimers in pregnancy and infancy: An Odense Child Cohort study. Clin Biochem 2017; 50:988-996. [PMID: 28697996 DOI: 10.1016/j.clinbiochem.2017.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/21/2017] [Accepted: 07/07/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Analysis of serum 25-hydroxyvitamin D (s-25(OH)D) may be complicated by the less active or in-active vitamin D metabolite C3-epi-25(OH)D3 (C3-epimer). We aimed to explore the relationship between s-C3-epimer and s-25(OH)D and other determinants and describe the longitudinal course of the C3-epimer fraction in paired mother-child samples. METHOD S-25(OH)D and s-C3-epimer were estimated by liquid chromatography mass spectrometry in 290 mother-infant pairs from the population-based Odense Child Cohort. Longitudinal analyses were feasible in two subcohorts; B) early and late pregnancy, cord, three and 18months (n=132); and C) early and late pregnancy, delivery and cord (n=105). RESULTS Mean s-25(OH)D was 50.6-110.4nmol/L at the six time points. The mean C3-epimer fraction was 10.1% at three months, 1.1%-3.0% at the other time points. In multivariate analyses, the s-C3-epimer correlated with s-25(OH)D (all time points, p<0.001), and season, maternal and infant age and maternal vitamin D supplementation at some time points. The C3-epimer fraction fluctuated between adjacent time points. By cosinor analyses, a season-dependent sinusoidal pattern for s-25(OH)D and C3-epimer fraction was found and changes between adjacent time points depended on season (p<0.007 or trend). In early infancy, subtraction of the C3-epi-25(OH)D3 from total s-25(OH)D resulted in reclassification of 8% of the children by use of the 75nmol/L cut off for s-25(OH)D. CONLCUSION The s-C3-epimer was independently correlated to s-25(OH)D, season, maternal vitamin D supplementation, maternal and infant age. The C3-epimer fraction was only of clinical importance in early infancy, where it could lead to misclassification of the vitamin D status.
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The Road Not So Travelled: Should Measurement of Vitamin D Epimers during Pregnancy Affect Our Clinical Decisions? Nutrients 2017; 9:nu9020090. [PMID: 28134839 PMCID: PMC5331521 DOI: 10.3390/nu9020090] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 01/15/2017] [Accepted: 01/19/2017] [Indexed: 01/03/2023] Open
Abstract
Observational studies suggest an adverse effect of maternal hypovitaminosis D during pregnancy. However, intervention studies failed to show convincing benefit from vitamin D supplementation during pregnancy. With analytical advances, vitamin D can now be measured in ten forms—including as epimers—which were thought to be biologically inactive, but can critically impair immunoassays. The aim of this commentary is to highlight the potential clinical and analytical significance of vitamin D epimers in the interpretation of vitamin D roles in pregnancy. Epimers may contribute a considerable proportion of total vitamin D—especially in the neonate—which renders the majority of common assays questionable. Furthermore, epimers have been suggested to have activity in laboratory studies, and evidence suggests that the fetus contributes significantly to epimer production. Maternal epimer levels contribute significantly to predict neonate circulating 25-hydroxyvitamin D concentrations. In conclusion, the existence of various vitamin D forms (such as epimers) has been established, and their clinical significance remains obscure. These results underscore the need for accurate measurements to appraise vitamin D status, in order to understand the current gap between observational and supplementation studies on the field.
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Assar S, Schoenmakers I, Koulman A, Prentice A, Jones KS. UPLC-MS/MS Determination of Deuterated 25-Hydroxyvitamin D (d 3-25OHD 3) and Other Vitamin D Metabolites for the Measurement of 25OHD Half-Life. Methods Mol Biol 2017; 1546:257-265. [PMID: 27896775 DOI: 10.1007/978-1-4939-6730-8_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Plasma 25-hydroxyvitamin D (25OHD) half-life (25OHDt 1/2) is a dynamic marker of vitamin D metabolism that can be used to assess vitamin D expenditure and help inform vitamin D requirements. Our group recently established an approach to determine the 25OHDt 1/2 as an alternative biomarker of 25OHD expenditure in humans. The approach uses a small oral dose of stable isotope labeled 25OHD3 [3-2H-25OHD3 (6,19,19-d3)] (d3-25OHD3) (tracer), which is distinguishable from endogenous 25OHD by liquid chromatography tandem-mass spectrometry (LC-MS/MS). We report here the method, which relies on protein precipitation, purification with solid phase extraction, derivatization with 4-phenyl-1,2,4-triazoline-3,5-dione (PTAD), and determination of the compounds by isotope-dilution UPLC-MS/MS. The method proved to be rapid and sensitive (LOQ 0.2 nmol/L) for the quantification of this tracer as well as the other vitamin D metabolites: 25OHD3, 25OHD2, and 24,25(OH)2D3 in human plasma.
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Affiliation(s)
- Shima Assar
- MRC Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge, CB1 9NL, UK.
| | - Inez Schoenmakers
- MRC Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge, CB1 9NL, UK
| | - Albert Koulman
- MRC Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge, CB1 9NL, UK
| | - Ann Prentice
- MRC Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge, CB1 9NL, UK
| | - Kerry S Jones
- MRC Elsie Widdowson Laboratory, 120 Fulbourn Road, Cambridge, CB1 9NL, UK
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Quantification of the 3α and 3β epimers of 25-hydroxyvitamin D 3 in dried blood spots by LC-MS/MS using artificial whole blood calibration and chemical derivatization. Talanta 2016; 165:398-404. [PMID: 28153274 DOI: 10.1016/j.talanta.2016.12.081] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 12/24/2016] [Accepted: 12/27/2016] [Indexed: 11/20/2022]
Abstract
While the biological function of the 3α epimer of 25-hydroxyvitamin D3 (25(OH)D3) remains unknown, its presence needs to be accurately captured and separated from the main 3β epimer, to avoid positive bias in vitamin D status analyses. Several recent LC-MS/MS assays for 25(OH)D3 successfully separate the 3α and 3β epimers by chromatography. Unfortunately, none of the existing LC-MS/MS assays, which utilize dried blood spots (DBS) as sampling/storage vessels, is able to quantify the individual epimers. DBS are often used for analysis of infant blood, however, and these samples are particularly likely to contain significant levels of interfering 3α epimer. Furthermore, proper calibration of DBS samples is much more difficult to achieve than for liquid serum or plasma samples. We addressed this important issue by creating an artificial vitamin D-free whole blood for calibration and then quantified 3α- and 3β-25(OH)D3 levels from DBS. After chemical derivatization, the vitamin D epimers were separated on a PFP column and concentrations determined by electrospray ionization LC-MS/MS on a triple quadrupole mass spectrometer. Calibration with artificial whole blood showed improved precision over standard addition (7.6 versus 31.5% RSD for 3β-25(OH)D3). The limits of quantification for 3β-25(OH)D3 and for 3α-25(OH)D3 were 1.0 and 0.1ng/mL, respectively. Excellent intra/interday precisions between 2.1 and 2.2% CV (intra) and 4.4-5.3% CV (inter) were established for 3β-25(OH)D3 and 3α-25(OH)D3. For 3β-25(OH)D3, only small concentration-independent bias and deviation of <3.3ng/mL were seen between serum LC-MS/MS and DBS-LC-MS/MS measurements; analyses of 3α-25(OH)D3 showed deviations of <0.8ng/mL in all experiments.
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Chun SK, Shin S, Kim MY, Joung H, Chung J. Effects of maternal genetic polymorphisms in vitamin D-binding protein and serum 25-hydroxyvitamin D concentration on infant birth weight. Nutrition 2016; 35:36-42. [PMID: 28241988 DOI: 10.1016/j.nut.2016.10.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/16/2016] [Accepted: 10/03/2016] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Vitamin D deficiency is a common problem during pregnancy and might contribute to adverse birth outcomes. Vitamin D-binding protein plays a key role in regulating vitamin D metabolism. We investigated whether maternal genetic variation in GC, the gene encoding vitamin-D binding protein, modulates the relationship between 25-hydroxyvitamin D [25(OH)D] levels and infant birth weight. METHODS We measured 25(OH)D concentrations in maternal and umbilical cord blood from 356 pregnant women and their infants by liquid chromatography tandem mass spectrometry. We extracted DNA from the maternal blood for genotyping GC single-nucleotide polymorphisms (SNPs). RESULTS The 25(OH)D concentrations were significantly higher in the maternal blood than in the cord blood, although the concentrations from each source were positively correlated with one another among individuals. Maternal GC SNPs rs12512631 and rs7041 were not significantly associated with infant birth weight. On the other hand, the GC SNPs rs12512631 and rs7041 significantly modified the relationships between the maternal and cord-blood concentrations of 25(OH)D and birth weight. Low 25(OH)D levels in the maternal and cord blood were significantly associated with decreased birth weight among infants born to mothers carrying the rs12512631 'C' allele but not in those born to mothers homozygous for the 'T' allele (P-interaction = 0.043 and 0.0008 for the maternal and cord blood, respectively). Low 25(OH)D levels in the cord blood were significantly associated with decreased birth weight only among infants born to mothers carrying the rs7041 'G' allele (P-interaction = 0.009). CONCLUSIONS Our findings suggest that the interaction between 25(OH)D status and some maternal GC variants influence the birth weight of infants.
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Affiliation(s)
- Soo-Kyung Chun
- Department of Food and Nutrition, College of Human Ecology, Kyung Hee University, Seoul, South Korea
| | - Sangah Shin
- Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Moon Young Kim
- Department of Obstetrics & Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, South Korea
| | - Hyojee Joung
- Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, South Korea.
| | - Jayong Chung
- Department of Food and Nutrition, College of Human Ecology, Kyung Hee University, Seoul, South Korea.
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Kiely ME, Zhang JY, Kinsella M, Khashan AS, Kenny LC. Vitamin D status is associated with uteroplacental dysfunction indicated by pre-eclampsia and small-for-gestational-age birth in a large prospective pregnancy cohort in Ireland with low vitamin D status. Am J Clin Nutr 2016; 104:354-61. [PMID: 27357092 DOI: 10.3945/ajcn.116.130419] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/25/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Associations between vitamin D and pregnancy outcomes have been inconsistent. OBJECTIVES We described the distribution of 25-hydroxyvitamin D3 [25(OH)D3], 3-epi-25(OH)D3, and 25(OH)D2 in early pregnancy and investigated associations with pre-eclampsia and small-for-gestational-age (SGA) birth, which are indicative of uteroplacental dysfunction. DESIGN The SCOPE (Screening for Pregnancy Endpoints) Ireland prospective pregnancy cohort study included 1768 well-characterized low-risk, nulliparous women resident at 52°N. Serum 25(OH)D3, 3-epi-25(OH)D3, and 25(OH)D2 were quantified at 15 wk of gestation with the use of a CDC-accredited liquid chromatography-tandem mass spectrometry method. RESULTS The mean ± SD total 25(OH)D concentration was 56.7 ± 25.9 nmol/L, and 17% and 44% of women had 25(OH)D concentrations <30 and <50 nmol/L, respectively. The prevalence of pre-eclampsia was 3.8%, and 10.7% of infants were SGA. There was a lower risk of pre-eclampsia plus SGA combined (13.6%) at 25(OH)D concentrations >75 nmol/L (adjusted OR: 0.64; 95% CI: 0.43, 0.96). The main predictors of 25(OH)D were the use of vitamin D-containing supplements (adjusted mean difference: 20.1 nmol/L; 95% CI: 18.5, 22.7 nmol/L) and summer sampling (adjusted mean difference: 15.5 nmol/L; 95% CI: 13.4, 17.6 nmol/L). Non-Caucasian ethnicity (adjusted mean difference: -19.3 nmol/L; 95% CI: -25.4, -13.2 nmol/L) and smoking (adjusted mean difference: -7.0 nmol/L; 95% CI: -10.5, -3.6 nmol/L) were negative predictors of 25(OH)D. The mean ± SD concentration of 3-epi-25(OH)D3, which was detectable in 99.9% of samples, was 2.6 ± 1.6 nmol/L. Determinants of 3-epi-25(OH)D3 were 25(OH)D3 (adjusted mean difference: 0.052 nmol/L; 95% CI: 0.050, 0.053 nmol/L) and maternal age (adjusted mean difference: -0.018 nmol/L; 95% CI: -0.026, -0.009 nmol/L). The mean ± SD concentration of 25(OH)D2 was 3.1 ± 2.7 nmol/L, which was present in all samples. No adverse effects of 25(OH)D concentrations >125 nmol/L were observed. CONCLUSIONS In the first report to our knowledge of CDC-accredited 25(OH)D data and pregnancy outcomes from a large, clinically validated, prospective cohort study, we observed a protective association of a 25(OH)D concentration >75 nmol/L and a reduced risk of uteroplacental dysfunction as indicated by a composite outcome of SGA and pre-eclampsia. Well-designed, adequately powered randomized controlled trials are required to verify this observation. The SCOPE pregnancy cohort was registered at www.anzctr.org.au as ACTRN12607000551493.
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Affiliation(s)
- Mairead E Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, The Irish Centre for Fetal and Neonatal Translational Research, and
| | - Joy Y Zhang
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
| | - Michael Kinsella
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
| | - Ali S Khashan
- The Irish Centre for Fetal and Neonatal Translational Research, and Departments of Epidemiology and Public Health and
| | - Louise C Kenny
- The Irish Centre for Fetal and Neonatal Translational Research, and Obstetrics and Gynecology, University College Cork, Cork, Ireland
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The Current Recommended Vitamin D Intake Guideline for Diet and Supplements During Pregnancy Is Not Adequate to Achieve Vitamin D Sufficiency for Most Pregnant Women. PLoS One 2016; 11:e0157262. [PMID: 27367800 PMCID: PMC4930210 DOI: 10.1371/journal.pone.0157262] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 05/26/2016] [Indexed: 12/27/2022] Open
Abstract
Background The aims of this study were to determine if pregnant women consumed the recommended vitamin D through diet alone or through diet and supplements, and if they achieved the current reference range vitamin D status when their reported dietary intake met the current recommendations. Methods Data and banked blood samples collected in second trimester from a subset of 537 women in the APrON (Alberta Pregnant Outcomes and Nutrition) study cohort were examined. Frozen collected plasma were assayed using LC-MS/MS (liquid chromatography-tandem mass spectrometry) to determine 25(OH)D2, 25(OH)D3, 3-epi-25(OH)D3 concentrations. Dietary data were obtained from questionnaires including a Supplement Intake Questionnaire and a 24-hour recall of the previous day’s diet. Results Participants were 87% Caucasian; mean (SD) age of 31.3 (4.3); BMI 25.8 (4.7); 58% were primiparous; 90% had education beyond high school; 80% had a family income higher than CAN $70,000/year. 25(OH)D2, 25(OH)D3, and 3-epi-25(OH)D3) were identified in all of the 537 plasma samples;3-epi-25(OH)D3 contributed 5% of the total vitamin D. The median (IQR) total 25(OH)D (D2+D3) was 92.7 (30.4) nmol/L and 20% of women had 25(OH)D concentration < 75 nmol/L. The median (IQR) reported vitamin D intake from diet and supplements was 600 (472) IU/day. There was a significant relationship between maternal reported dietary vitamin D intake (diet and supplement) and 25(OH)D and 3-epi-25(OH)D3 concentrations in an adjusted linear regression model. Conclusions We demonstrated the current RDA (600 IU/ day) may not be adequate to achieve vitamin D status >75 nmol/L in some pregnant women who are residing in higher latitudes (Calgary, 51°N) in Alberta, Canada and the current vitamin D recommendations for Canadian pregnant women need to be re-evaluated.
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