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Vitamin D metabolome in preterm infants: insights into postnatal metabolism

  • Tomas Matejek ORCID logo EMAIL logo , Lukas Prchal , Bara Zapletalova , Veronika Pokorna ORCID logo , Jana Malakova , Vladimir Palicka ORCID logo and Ondrej Soukup
Published/Copyright: May 22, 2025
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 63 Issue 9

Abstract

Objectives

To describe the structure of vitamin D metabolome and investigate the possible cause of high serum levels of C3 epimers of 25-(OH)D in preterm infants, we compared the vitamin D metabolites in umbilical cord blood with serum samples taken at 28 days of age.

Methods

We analysed 40 preterm infants (29+0–32+6 weeks of gestation). Cholecalciferol, 25-(OH)D, and its C3-epimers were measured using liquid chromatography. A microsomal study with human liver and kidney microsomes was conducted to assess vitamin D metabolism. Identified metabolites were then examined in cord blood and serum samples.

Results

Cholecalciferol, 25-(OH)D, and its C3-epimers were significantly lower in cord blood compared to serum at 28 days of age (p<0.001 for all metabolites). Conversely, metabolites from the microsomal study (monohydroxylated-, dihydroxylated-, and mono-oxylated dihydroxylated-cholecalciferol and their C3-epimers) were significantly higher in cord blood (p<0.001 for all).

Conclusions

Our findings indicate that cholecalciferol, 25-(OH)D, and its C3-epimers increase during the first month of life, suggesting functional biosynthesis and postnatal accumulation of these metabolites. Conversely, based on microsomal study results, it seems that biotransformation responsible for a degradation of vitamin D during the first month of life in preterm infants is functionally impaired.

Keywords: metabolome; metabolomics; microsomes; LC-MS/MS; preterm infant; vitamin D
Corresponding author: Tomas Matejek, MD, PhD, Department of Paediatrics, Faculty of Medicine Hradec Kralove, Charles University in Prague, Sokolska 581, Hradec Kralove, 500 05, Czech Republic; and Department of Paediatrics, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic, E-mail:

Funding source: Ministerstvo ZdravotnictvÖCeské Republiky

Award Identifier / Grant number: UHHK, 00179906

Acknowledgments

The authors are grateful to Ian McColl MD, PhD for assistance with the manuscript (proofreading) and to Ing. Vojtech Drahy for statistical analysis.

  1. Research ethics: The study was approved by the local Ethics Committee of The University Hospital Hradec Kralove (reference number 202205 P01).

  2. Informed consent: Informed written consent was obtained from parents before inclusion of the newborn into the study.

  3. Author contributions: Dr Tomas Matejek conceptualised and designed the study and the instrumental methods for data collection, coordinated and supervised data collection, drafted the initial manuscript, and critically reviewed and revised the final version of the manuscript. Dr Bara Zapletalova and Dr Veronika Pokorna collected data, carried out the initial analyses, and critically reviewed and revised the manuscript. Dr. Jana Malakova and Dr. Lukas Prchal coordinated and supervised biochemical analysis of the samples, and critically reviewed and revised the manuscript. Prof Ondrej Soukup and Prof Vladimir Palicka conceptualized and designed the study and critically reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  4. Use of Large Language Models, AI and Machine Learning Tools: ChatGPT to improve language.

  5. Conflict of interest: The authors state no conflict of interest. The authors alone are responsible for the content and writing of the paper.

  6. Research funding: This work was supported by University Hospital Hradec Kralove, Czech Republic project MH CZ – DRO (UHHK, 00179906).

  7. Data availability: The data that support the findings of this study are not publicly available due to their containing information that could compromise the privacy of research participants, but are available from the corresponding author (T.M.).

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Received: 2025-03-14
Accepted: 2025-04-28
Published Online: 2025-05-22
Published in Print: 2025-08-26

© 2025 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2025-0311
Keywords for this article
metabolome; metabolomics; microsomes; LC-MS/MS; preterm infant; vitamin D

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Macroprolactinaemia – some progress but still an ongoing problem
  4. Review
  5. Understanding the circulating forms of cardiac troponin: insights for clinical practice
  6. Opinion Papers
  7. New insights in preanalytical quality
  8. IFCC recommendations for internal quality control practice: a missed opportunity
  9. Genetics and Molecular Diagnostics
  10. Evaluation of error detection and treatment recommendations in nucleic acid test reports using ChatGPT models
  11. General Clinical Chemistry and Laboratory Medicine
  12. Pre-analytical phase errors constitute the vast majority of errors in clinical laboratory testing
  13. Improving the efficiency of quality control in clinical laboratory with an integrated PBRTQC system based on patient risk
  14. IgA-type macroprolactin among 130 patients with macroprolactinemia
  15. Prevalence and re-evaluation of macroprolactinemia in hyperprolactinemic patients: a retrospective study in the Turkish population
  16. Defining dried blood spot diameter: implications for measurement and specimen rejection rates
  17. Screening primary aldosteronism by plasma aldosterone-to-angiotensin II ratio
  18. Assessment of serum free light chain measurements in a large Chinese chronic kidney disease cohort: a multicenter real-world study
  19. Beyond the Hydrashift assay: the utility of isoelectric focusing for therapeutic antibody and paraprotein detection
  20. Direct screening and quantification of monoclonal immunoglobulins in serum using MALDI-TOF mass spectrometry without antibody enrichment
  21. Effect of long-term frozen storage on stability of kappa free light chain index
  22. Impact of renal function impairment on kappa free light chain index
  23. Standardization challenges in antipsychotic drug monitoring: insights from a national survey in Chinese TDM practices
  24. Potential coeliac disease in children: a single-center experience
  25. Vitamin D metabolome in preterm infants: insights into postnatal metabolism
  26. Candidate Reference Measurement Procedures and Materials
  27. Development of commutable candidate certified reference materials from protein solutions: concept and application to human insulin
  28. Reference Values and Biological Variations
  29. Biological variation of serum cholinesterase activity in healthy subjects
  30. Hematology and Coagulation
  31. Diagnostic performance of morphological analysis and red blood cell parameter-based algorithms in the routine laboratory screening of heterozygous haemoglobinopathies
  32. Cancer Diagnostics
  33. Promising protein biomarkers for early gastric cancer: clinical performance of combined detection
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  35. The accuracy of presepsin in diagnosing neonatal late-onset sepsis in critically ill neonates: a prospective study
  36. Corrigendum
  37. The Unholy Grail of cancer screening: or is it just about the Benjamins?
  38. Letters to the Editor
  39. Analytical validation of hemolysis detection on GEM Premier 7000
  40. Reconciling reference ranges and clinical decision limits: the case of thyroid stimulating hormone
  41. Contradictory definitions give rise to demands for a right to unambiguous definitions
  42. Biomarkers to measure the need and the effectiveness of therapeutic supplementation: a critical issue
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