Nanne Dreier Mydtskov1, Sine Lykkedegn2, Palle Back Nielsen Fruekilde3, Jan Nielsen4, Torben Barington5, Henrik Thybo Christesen6. 1. Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, J. B. Winsløws Vej 19, 5000 Odense C, Denmark. 2. Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, J. B. Winsløws Vej 19, 5000 Odense C, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 25, 5000 Odense C, Denmark. 3. Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark. 4. Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, J. B. Winsløws Vej 19, 5000 Odense C, Region Southern Denmark, Denmark; Centre for Clinical Epidemiology, Odense University Hospital, Sdr. Boulevard, 29 5000 Odense C, Denmark. 5. Department of Clinical Immunology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark; OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Sdr. Boulevard 29, 5000 Odense C, Denmark. 6. Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, J. B. Winsløws Vej 19, 5000 Odense C, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 25, 5000 Odense C, Denmark. Electronic address: henrik.christesen@rsyd.dk.
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.
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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