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Higher 25(OH)D2 is associated with lower 25(OH)D3 and 1,25(OH)2D3
Christine M Swanson1, Carrie M Nielson, Smriti Shrestha
1Division of Endocrinology (C.M.S., C.G.L., E.S.O.), Bone and Mineral Unit (C.M.S., C.M.N., S.S., C.G.L., E.S.O.), and Department of Public Health and Preventive Medicine (C.M.N.), Oregon Health & Science University, Portland, Oregon 97239; Research Service (C.G.L.), Portland Veterans Affairs Medical Center, Portland, Oregon 97239; Division of Epidemiology (E.B.-C.), Department of Family & Preventive Medicine, University California San Diego, La Jolla, California 92093-0607; Laboratory of Diagnostic Medicine (I.J., D.V.), KU Leuven, University of Leuven, 3000 Leuven, Belgium; Department of Epidemiology (J.A.C.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261; and Division of Geriatric Medicine and Centre for Metabolic Bone Diseases (S.B.), and Laboratory of Clinical and Experimental Endocrinology (R.B., D.V.), KU Leuven, University of Leuven, 3000 Leuven, Belgium.
Context:
Despite common use of supplemental vitamin D2 in clinical practice, the associations of serum vitamin D2 concentrations with other vitamin D metabolites and total vitamin D are unclear.
Objective:
The aim of the study was to measure vitamin D2 and D3 levels and examine their associations with each other and with total vitamin D.
Design:
We performed a cross-sectional analysis of 679 randomly selected participants from the Osteoporotic Fractures in Men Study. 25-Hydroxyvitamin D2 [25(OH)D2], 25(OH)D3, 1,25-dihydroxyvitamin D2 [1,25(OH)2D2], and 1,25(OH)2D3 were measured using liquid chromatography-tandem mass spectrometry and were summed to obtain total 25(OH)D and 1,25(OH)2D. Associations between all metabolites (D2, D3, and total levels) were examined using Wilcoxon rank-sum tests and Spearman correlations.
Results:
25(OH)D2 and 1,25(OH)2D2 were detectable in 189 (27.8%) and 178 (26.2%) of the men, respectively. Higher 25(OH)D2 levels did not correlate with higher total 25(OH)D (r = 0.10; P = .17), although median total 25(OH)D was slightly higher in those with detectable vs undetectable 25(OH)D2 (25.8 vs 24.3 ng/mL; P < .001). 25(OH)D2 was not positively associated with total 1,25(OH)2D levels (r = -0.11; P = .13), and median 1,25(OH)2D level was not higher in those with detectable vs undetectable 25(OH)D2. Higher 25(OH)D2 was associated with lower 25(OH)D3 (r = -0.35; P < .001) and 1,25(OH)2D3 (r = -0.32; P < .001), with median levels of both D3 metabolites 18-35% higher when D2 metabolites were undetectable.
Conclusions:
In a cohort of older men, 25(OH)D2 is associated with lower levels of 25(OH)D3 and 1,25(OH)2D3, suggesting that vitamin D2 may decrease the availability of D3 and may not increase calcitriol levels.
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