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Plasma 3-Epi-25-Hydroxycholecalciferol Can Alter the Assessment of Vitamin D Status Using the Current Reference Ranges for Pregnant Women and Their Newborns.
J Nutr. 2016 Jan; 146(1):70-5.JN

Abstract

BACKGROUND

Vitamin D is critical for healthy pregnancies and normal fetal development. It is important to accurately ascertain vitamin D status in mothers and their newborns to establish the optimal vitamin D concentration during pregnancy. There are many different metabolites and epimers of vitamin D in peripheral blood and controversy as to the importance of epimers in estimating vitamin D status in maternal and infant health.

OBJECTIVES

We undertook this study to measure 25-hydroxyvitamin D metabolites and epimers and their relations in maternal and cord blood and to evaluate the impact of the inclusion of epimers on assessing vitamin D status.

METHODS

We performed a substudy in a longitudinal cohort of pregnant women and their infants in Alberta, Canada [APrON (Alberta Pregnancy Outcomes and Nutrition) Study]. Maternal and cord blood plasma collected at the time of newborn delivery was stored at -70°C until testing and assayed for 25-hydroxyergocalciferol [25(OH)D2], 25-hydroxycholecalciferol [25(OH)D3], and 3-epi-25-hydroxycholecalciferol [3-epi-25(OH)D3] by using LC-tandem mass spectrometry. The effect of 3-epi-25(OH)D3 on estimates of vitamin D adequacy was explored by using McNemar's chi-square test at both recommended thresholds of 50 and 75 nmol/L.

RESULTS

Ninety-two pairs of maternal and cord blood samples were obtained. 3-Epi-25(OH)D3 was detected in all samples, comprising 6.0% and 7.8% of 25(OH)D3 in maternal and cord blood, respectively. Positive correlations were found between 25(OH)D3 and 3-epi-25(OH)D3 for both maternal and cord blood (maternal blood: r = 0.34, P = 0.01; cord blood: r = 0.44, P = 0.01). In addition, regression analysis showed a significant association between vitamin D supplementation and 3-epi-25(OH)D3 in maternal and cord blood (β: 0.423; 95% CI: 0.173, 0.672). When 3-epi-25(OH)D3 was not included in plasma vitamin D estimations, 38% of women and 80% of neonates were classified as having an insufficient concentration (<75 nmol/L); however, with 3-epi-25(OH)D3 included, the estimates of insufficiency were significantly lower: 33% and 73% for women and neonates, respectively.

CONCLUSIONS

Using LC-MS/MS we showed the presence of 3-epi-25(OH)D3 in all samples of pregnant women and their cord blood, and when the 3-epimer was included in the estimation of status the prevalence of vitamin D insufficiency (<75 nmol/L) was significantly lower. Our data suggest that the high use of dietary supplements in this group of women contributes to 3-epi-25(OH)D3 concentrations in both maternal and cord blood. Further research on the role of the epimers in characterizing vitamin D status in pregnancy and infancy is imperative.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Aghajafari F
Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Departments of fariba.aghajafari@ucalgary.ca.
Field CJ
Agricultural, Food, and Nutritional Science and.
Rabi D
Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Departments of.
Kaplan BJ
Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Departments of.
Maggiore JA
Research and Development, Doctor's Data, Inc., St. Charles, IL; and.
O'Beirne M
Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Departments of.
Hanley DA
Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Departments of.
Eliasziw M
Department of Public Health and Community Medicine, Tufts University, Boston, MA.
Dewey D
Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Departments of.
Ross S
Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada;
APrON Study Team
No affiliation info available

MeSH

AdultCalcifediolCanadaChromatography, LiquidDietary SupplementsFemaleFetal BloodHumansInfant, NewbornLinear ModelsLongitudinal StudiesMaternal Nutritional Physiological PhenomenaMiddle AgedPregnancyPrevalenceReference ValuesSocioeconomic FactorsTandem Mass SpectrometryVitamin DVitamin D DeficiencyYoung Adult

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26609169

Citation

Aghajafari, Fariba, et al. "Plasma 3-Epi-25-Hydroxycholecalciferol Can Alter the Assessment of Vitamin D Status Using the Current Reference Ranges for Pregnant Women and Their Newborns." The Journal of Nutrition, vol. 146, no. 1, 2016, pp. 70-5.
Aghajafari F, Field CJ, Rabi D, et al. Plasma 3-Epi-25-Hydroxycholecalciferol Can Alter the Assessment of Vitamin D Status Using the Current Reference Ranges for Pregnant Women and Their Newborns. J Nutr. 2016;146(1):70-5.
Aghajafari, F., Field, C. J., Rabi, D., Kaplan, B. J., Maggiore, J. A., O'Beirne, M., Hanley, D. A., Eliasziw, M., Dewey, D., & Ross, S. (2016). Plasma 3-Epi-25-Hydroxycholecalciferol Can Alter the Assessment of Vitamin D Status Using the Current Reference Ranges for Pregnant Women and Their Newborns. The Journal of Nutrition, 146(1), 70-5. https://doi.org/10.3945/jn.115.220095
Aghajafari F, et al. Plasma 3-Epi-25-Hydroxycholecalciferol Can Alter the Assessment of Vitamin D Status Using the Current Reference Ranges for Pregnant Women and Their Newborns. J Nutr. 2016;146(1):70-5. PubMed PMID: 26609169.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Plasma 3-Epi-25-Hydroxycholecalciferol Can Alter the Assessment of Vitamin D Status Using the Current Reference Ranges for Pregnant Women and Their Newborns. AU - Aghajafari,Fariba, AU - Field,Catherine J, AU - Rabi,Doreen, AU - Kaplan,Bonnie J, AU - Maggiore,Jack A, AU - O'Beirne,Maeve, AU - Hanley,David A, AU - Eliasziw,Misha, AU - Dewey,Deborah, AU - Ross,Sue, AU - ,, Y1 - 2015/11/25/ PY - 2015/07/29/received PY - 2015/10/28/accepted PY - 2015/11/27/entrez PY - 2015/11/27/pubmed PY - 2016/5/11/medline KW - 25(OH)D KW - 3-epi-25(OH)D3 KW - LC-MS/MS KW - cord blood KW - pregnancy SP - 70 EP - 5 JF - The Journal of nutrition JO - J Nutr VL - 146 IS - 1 N2 - BACKGROUND: Vitamin D is critical for healthy pregnancies and normal fetal development. It is important to accurately ascertain vitamin D status in mothers and their newborns to establish the optimal vitamin D concentration during pregnancy. There are many different metabolites and epimers of vitamin D in peripheral blood and controversy as to the importance of epimers in estimating vitamin D status in maternal and infant health. OBJECTIVES: We undertook this study to measure 25-hydroxyvitamin D metabolites and epimers and their relations in maternal and cord blood and to evaluate the impact of the inclusion of epimers on assessing vitamin D status. METHODS: We performed a substudy in a longitudinal cohort of pregnant women and their infants in Alberta, Canada [APrON (Alberta Pregnancy Outcomes and Nutrition) Study]. Maternal and cord blood plasma collected at the time of newborn delivery was stored at -70°C until testing and assayed for 25-hydroxyergocalciferol [25(OH)D2], 25-hydroxycholecalciferol [25(OH)D3], and 3-epi-25-hydroxycholecalciferol [3-epi-25(OH)D3] by using LC-tandem mass spectrometry. The effect of 3-epi-25(OH)D3 on estimates of vitamin D adequacy was explored by using McNemar's chi-square test at both recommended thresholds of 50 and 75 nmol/L. RESULTS: Ninety-two pairs of maternal and cord blood samples were obtained. 3-Epi-25(OH)D3 was detected in all samples, comprising 6.0% and 7.8% of 25(OH)D3 in maternal and cord blood, respectively. Positive correlations were found between 25(OH)D3 and 3-epi-25(OH)D3 for both maternal and cord blood (maternal blood: r = 0.34, P = 0.01; cord blood: r = 0.44, P = 0.01). In addition, regression analysis showed a significant association between vitamin D supplementation and 3-epi-25(OH)D3 in maternal and cord blood (β: 0.423; 95% CI: 0.173, 0.672). When 3-epi-25(OH)D3 was not included in plasma vitamin D estimations, 38% of women and 80% of neonates were classified as having an insufficient concentration (<75 nmol/L); however, with 3-epi-25(OH)D3 included, the estimates of insufficiency were significantly lower: 33% and 73% for women and neonates, respectively. CONCLUSIONS: Using LC-MS/MS we showed the presence of 3-epi-25(OH)D3 in all samples of pregnant women and their cord blood, and when the 3-epimer was included in the estimation of status the prevalence of vitamin D insufficiency (<75 nmol/L) was significantly lower. Our data suggest that the high use of dietary supplements in this group of women contributes to 3-epi-25(OH)D3 concentrations in both maternal and cord blood. Further research on the role of the epimers in characterizing vitamin D status in pregnancy and infancy is imperative. SN - 1541-6100 UR - https://www.unboundmedicine.com/medline/citation/26609169/Plasma_3_Epi_25_Hydroxycholecalciferol_Can_Alter_the_Assessment_of_Vitamin_D_Status_Using_the_Current_Reference_Ranges_for_Pregnant_Women_and_Their_Newborns_ DB - PRIME DP - Unbound Medicine ER -