title: Assessment of 3-epi-25-hydroxyvitamin D levels during cholecalciferol supplementation in adults with chronic liver diseases.
abstract: Recently, hepatic immaturity was cited as a possible reason for high levels of the C-3 epimer of 25-hydroxyvitamin (25(OH)D) in premature infants: however what role, if any, the liver plays in controlling epimer concentrations is unknown. This study assesses 3-epi-25-hydroxyvitamin D (3-epi-25(OH)D) levels during the course of cholecalciferol supplementation in adults with chronic liver diseases (CLD). Vitamin D metabolites were analyzed in 65 CLD patients with 25(OH)D <30 ng/mL who received 20 000 IU cholecalciferol/week for 6 months. The primary outcome assessed serum 25(OH)D and 3-epi-25(OH)D in response to supplementation. Corresponding values from 16 CLD patients with sufficient vitamin D levels receiving no supplementation were compared. The epimer was detected in all samples and at lower relative concentrations with lower vitamin D baseline status, i.e., severe vitamin D deficiency (<10 ng/mL) as compared with deficient (10-19.9 ng/mL), insufficient (20-29.9 ng/mL), or sufficient (≥30 ng/mL) vitamin D levels (2.4% vs. 4.8%, 5.2%, 5.8%, respectively; P < 0.001). Similar relative concentrations for 3-epi-25(OH)D, ranging from 4.3%-7.1% (absolute concentrations: 1.1-4.0 ng/mL; all P < 0.001), were obtained in response to cholecalciferol in all supplemented patients, regardless of inadequacy threshold. Epimer levels significantly decreased (P = 0.007) in unsupplemented patients, coinciding with decreasing serum 25(OH)D concentrations over time. No epimer differences between patients with (n = 17) or without (n = 48) cirrhosis were demonstrated. The 3-epi-25(OH)D was present in serum of all patients at comparable levels to those reported by others. Epimer levels increased linearly with increasing 25(OH)D levels after supplementation. However, no effect of cirrhosis on epimer concentrations was observed.
authors.affiliation: a Department of Medicine II, Saarland University Medical Center, Saarland University, Kirrberger Str. 100, 66421 Homburg, Germany.
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Stokes
authors.affiliation: b Institute of Bioanalytical Chemistry, Saarland University, Saarbrücken, Germany.
authors.forename: Dietrich A
authors.initials: DA
authors.lastname: Volmer
mesh_terms: D015415:Biomarkers / Q000097:blood; D002112:Calcifediol / Q000097:blood* / Q000737:chemistry / Q000378:metabolism; D002762:Cholecalciferol / Q000378:metabolism / Q000627:therapeutic use*; D002908:Chronic Disease; D015331:Cohort Studies; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008099:Liver / Q000378:metabolism* / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications / Q000503:physiopathology; D008107:Liver Diseases / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008968:Molecular Conformation; D009752:Nutritional Status; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013237:Stereoisomerism; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000178:diet therapy* / Q000378:metabolism
chemical_list: D015415:Biomarkers; D002762:Cholecalciferol; D002112:Calcifediol
keywords: calcidiol; cirrhose; cirrhosis; detection limits; hormone stéroïdienne; limites de détection; mass spectrometry; spectrométrie de masse; steroid hormone; vitamin D; vitamine D