Functional Assessment of Vitamin D Status by a Novel Metabolic Approach: The Low Vitamin D Profile Concept.
Clin Chem
; 69(11): 1307-1316, 2023 11 02.
Article
em En
| MEDLINE
| ID: mdl-37798100
ABSTRACT
BACKGROUND:
Determining serum 25-hydroxyvitamin D [25(OH)D], 24,25-dihydroxyvitamin D [24,25(OH)2D] and the vitamin D metabolite ratio (VMR) allows the identification of individuals with a low vitamin D metabolite profile. Here, we evaluated if such a functional approach provides superior diagnostic information to serum 25(OH)D alone.METHODS:
25(OH)D, 24,25(OH)2D, and the VMR were determined in participants of the DESIRE (Desirable Vitamin D Concentrations, n = 2010) and the LURIC (Ludwigshafen Risk and Cardiovascular Health, n = 2456) studies. A low vitamin D metabolite profile (vitamin D insufficiency) was defined by a 24,25(OH)2D concentration <1.2â ng/mL (<3â nmol/L) and a VMR <4%. Parathyroid hormone (PTH) and bone turnover markers were measured in both cohorts, whereas 10-year mortality data was recorded in LURIC only.RESULTS:
The median age in DESIRE and LURIC was 43.3 and 63.8 years, respectively. Median 25(OH)D concentrations were 27.2â ng/mL (68.0â nmol/L) and 15.5â ng/mL (38.8â nmol/L), respectively. Serum 25(OH)D deficiency, defined as <20.2â ng/mL (<50â nmol/L), was present in 483 (24.0%) and 1701 (69.3%) participants of DESIRE and LURIC, respectively. In contrast, only 77 (3.8%) and 521 (21.2%) participants had a low vitamin D metabolite profile. Regardless of the serum 25(OH)D concentration, a low vitamin D metabolite profile was associated with a significantly higher PTH, accelerated bone metabolism, and higher all-cause mortality than an unremarkable vitamin D metabolite profile.CONCLUSIONS:
The personalized assessment of vitamin D status using a functional approach better identifies patients with accelerated bone metabolism and increased mortality than the use of a fixed 25(OH)D cutoff of 20â ng/mL (50â nmol/L).
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Deficiência de Vitamina D
Limite:
Adult
/
Humans
/
Middle aged
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article