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Vitamin D C3 epimer in a mid-Swedish region: Analytical measurement and epidemiology
Örebro University, School of Medical Sciences. Department of Endocrinology.
Örebro University, School of Medical Sciences. Department of Clinical Chemistry, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Medical Sciences. Department of Pediatrics.ORCID iD: 0000-0002-1440-9961
Department of Endocrinology, School of Medical Sciences, Örebro University, Örebro, Sweden.
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2018 (English)In: Clinica Chimica Acta, ISSN 0009-8981, E-ISSN 1873-3492, Vol. 478, p. 182-187Article in journal (Refereed) Published
Abstract [en]

Background: The discovery of an epimeric form of 25(OH)D3 may complicate the interpretation of vitamin Dstatus. The aim of this study was to examine the prevalence and determinants of 25-hydroxy-3-epi-vitamin D3 (3- epi-25(OH)D3) in a mid-Swedish region and to investigate how the measurement of 3-epi-25(OH)D3 would affect the assessment of vitamin D status using current thresholds.

Methods: We conducted a cross-sectional study of 8286 in- and outpatients in primary as well as secondary care settings. Plasma 25(OH)D, 25(OH)D2, 25(OH)D3 and 3-epi-25(OH)D3 were measured using High Pressure Liquid Chromatography – Tandem Mass Spectrometry (HPLC – MS/MS). The relative 3-epi-25(OH)D3 contribution was calculated as a percentage of the total 25(OH)D3. Blood samples were collected between March 2014 and July 2015 providing a seasonal aspect to the results.

Results: 3-epi-25(OH)D3was detected in 635 cases (7.7% of all subjects), and the mean concentration was8.4 ± 3.5 nmol/L. 3-epi-25(OH)D3correlated significantly with 25(OH)D3(r =0.38, p < 0.001).A multivariateanalysis among the detected showed that male gender and winter season were independently associatedwith higher 3-epi-25(OH)D3/25(OH)D3percentage ratio (R2=0.044). Infants and children had a significantlyhigher detection rate compared to the reference age category (18–45 years) as well as those who were testedduring the summer season.

Conclusions: We report findings from the first epidemiologic study of 3-epi-25(OH)D3 conducted in Sweden, based on a large population sample. 3-epi-25(OH)D3 was detected in 7.7% of the study population and the mean concentration was 8.4 nmol/L. The quantification of 3-epi-25(OH)D3 would not significantly influence the clinical interpretation of vitamin D levels. Additional studies are needed to understand the metabolic pathway and the possible physiological functions of this metabolite.

Place, publisher, year, edition, pages
Amsterdam, Netherlands: Elsevier, 2018. Vol. 478, p. 182-187
Keywords [en]
3-epi 25(OH)D(3), 25(OH)D(3), High Pressure Liquid Chromatography – Tandem Mass Spectrometry (HPLC – MS/MS), Vitamin D
National Category
Biomedical Laboratory Science/Technology
Identifiers
URN: urn:nbn:se:oru:diva-64072DOI: 10.1016/j.cca.2018.01.002ISI: 000425070000028PubMedID: 29305842OAI: oai:DiVA.org:oru-64072DiVA, id: diva2:1173314
Note

Funding Agency:

Örebro University  ALF 2016:1 OLL-615521

Available from: 2018-01-12 Created: 2018-01-12 Last updated: 2018-03-28Bibliographically approved
In thesis
1. Vitamin D and its role in obesity and other associated conditions
Open this publication in new window or tab >>Vitamin D and its role in obesity and other associated conditions
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Vitamin D has received much attention in recent years due to the re-emergence of vitamin D deficiency as a global health issue along with increasing evidence indicating that 1,25-dihydroxivitamin D, the hormonally active form of vita-min D, not only acts in calcium and bone metabolism but also generates ex-traskeletal biological responses.

In this thesis, the role of vitamin D in obesity and other associated condi-tions has been studied.

In paper 1, the prevalence of vitamin D deficiency and secondary hyperpara-thyroidism over the long term after Roux-en-Y gastric bypass (RYGB) were evaluated. We found a substantial prevalence of vitamin D deficiency and secondary hyperparathyroidism after RYGB, whereas calcium levels remained within normal range. An expected improvement in vitamin D status after weight loss could have been countered by the malabsorption induced by surgery.

In paper 2, the prevalence of anemia and related deficiencies over the long term after RYGB were studied. We found that 27% of the patients had anemia postoperatively, 20% had iron deficiency, 12% had folate deficiency and 2% had vitamin B12 deficiency. Anemia was mainly due to iron deficiency, and its frequency did not seem to progress with time after surgery.

In paper 3, the effects of vitamin D supplementation on body composition and cardiorespiratory fitness in overweight men with vitamin D deficiency at baseline were investigated. No statistically significant difference between the placebo and the intervention group regarding changes in percentage body fat, maximum oxygen uptake, BMI and maximum load was found.

In paper 4, the prevalence and determinants of 3-epi-25(OH)D3 were exam-ined. 3-epi-25(OH)D3 was detected in 7.7% of the study population and the mean concentration was 8.4 nmol/L. The quantification of 3-epi-25(OH)D3 would not significantly influence the clinical interpretation of vitamin D levels.

In conclusion, new knowledge about vitamin D is continuously emerging but there is a discrepancy between cross-sectional studies associating low vitamin D levels to obesity and other related metabolic complications and the lack of effects of vitamin D supplementation in clinical trials. Large RCTs with longer duration in obese subjects with baseline vitamin D deficiency are warranted.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2018. p. 67
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 177
Keywords
Vitamin D, obesity, Roux-en-Y gastric bypass, secondary hyperpara-thyroidism, anemia, iron deficiency, body composition, cardiorespiratory fitness, Vitamin D C3 epimer
National Category
General Practice
Identifiers
urn:nbn:se:oru:diva-64979 (URN)978-91-7529-238-0 (ISBN)
Public defence
2018-04-20, Örebro universitet, Campus USÖ, hörsal C3, Södra Grev Rosengatan 32, Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2018-02-12 Created: 2018-02-12 Last updated: 2018-03-28Bibliographically approved

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Karefylakis, ChristosPettersson-Pablo, PaulSärnblad, Stefan

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