Vitamin D metabolism in the premature newborn: A randomized trial. Issue 4 (August 2016)

• Record Type: Journal Article
• Authors: Hanson, Corrine; Jones, Glenville; Lyden, Elizabeth; Kaufmann, Martin; Armas, Laura; Anderson-Berry, Ann
• Is Part Of: Clinical nutrition. Volume 35:Issue 4(2016:Aug.)
• Page Start: 835
• Page End: 841
• Publication Date: 2016-08
• Subjects: Vitamin D -- Prematurity -- Vitamin D metabolism -- Infant nutrition; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2015.07.023
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: Background & aims: Vitamin D status during infancy has been associated with important pediatric health outcomes; however concentrations of many vitamin D metabolites in premature infants are not yet described. The objective of this study was to evaluate concentrations of 25(OH)D3, 24, 25(OH)2 D3, and 3-epi-25(OH)D3 in premature infants. Methods: 32 infants <32 weeks gestation were randomized to receive 400 or 800 IU/day of vitamin D3 orally. Vitamin D metabolites from serum obtained monthly were analyzed in triplicate using a novel, very sensitive Liquid Chromatography-Tandem Mass Spectrometry-based method. Statistical analysis was conducted using the Fisher's exact test, Wilcoxon Rank Sum test, and Spearman correlation coefficients. Measurements over time were fit with linear mixed effect models. A p-value of <0.05 was considered statistically significant. Results: Mean serum 25(OH)D3 concentrations in cord blood were 17.3 ng/mL; mean 3-epi-25(OH)D3 were 1.3 ng/mL, mean 24, 25(OH)2 D3 were 1.4 ng/mL. Both 25(OH)D3 and 3-epi-25(OH)D3 increased significantly over time, and the percent of total 25(OH)D3 concentration that was 3-epi-25(OH)D3 also increased significantly (7.2% vs. 29.7%, p < 0.0001 for cord blood vs. 8 weeks). Serum 25(OH)D3 :24, 25(OH)2 D3 ratios at weeks 4 and 8 were higher than ratios reported in older children and adults. Conclusion: Vitamin D metabolism in infants appears to have distinct differences from adults. Vitamin D supplementation was effective in raising 25(OH)D3 concentrations; however significant increases in 3-epi-25(OH)D3 also occurred. Increased 25(OH)D3 : 24, 25(OH)2 D3 ratios in premature infants may be due to immature expression of CYP24A1. Further work is necessary to determine if there are developmental advantages to this unique vitamin D metabolism.