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Dynamics of the vitamin D C3-epimer levels in preterm infants

Tomas Matejek1, Bara Zapletalova1, Martin Stepan2

  • 1Department of Paediatrics, Faculty of Medicine Hradec Kralove, Charles University in Prague, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.

Clinical Chemistry and Laboratory Medicine
|January 20, 2023
PubMed

Insights

C3-epimers, a form of vitamin D, are produced by very low birth weight infants from birth. Their levels increase throughout the first month, independent of prematurity or growth restriction.

Area of Science:

  • Neonatology
  • Endocrinology
  • Nutritional Science

Background:

  • Vitamin D is crucial for infant health, with 25-hydroxyvitamin-D [25(OH)D] being a key indicator.
  • C3-epi-25(OH)D is a less common but potentially important metabolite of vitamin D.
  • Understanding vitamin D metabolism in vulnerable infant populations is essential.

Purpose of the Study:

  • To determine C3-epi-25(OH)D levels in very low birth weight (VLBW) infants.
  • To investigate the influence of preterm birth, intrauterine growth restriction (IUGR), and season of birth on C3-epimer production.

Main Methods:

  • Analysis of 25(OH)D and C3-epi-25(OH)D in maternal serum, cord blood, and infant serum at multiple time points (days 14, 28, discharge).
  • Inclusion of 127 VLBW infants (birth weight <1500g).
  • Statistical correlation analysis to assess relationships between vitamin D metabolites and influencing factors.

Main Results:

  • C3-epi-25(OH)D levels increased significantly from birth to discharge in VLBW infants.
  • C3-epimers constituted a growing proportion of total 25(OH)D, reaching over 20% by discharge.
  • Neither prematurity severity nor IUGR impacted C3-epimer production; seasonal differences were noted in maternal and cord samples.

Conclusions:

  • C3-epi-25(OH)D production is active in VLBW newborns, originating from fetal stores and influenced by maternal 25(OH)D.
  • The C3-epimer becomes a significant component of total vitamin D metabolites within the first month of life.
  • These findings highlight the functional vitamin D system in preterm infants and its developmental trajectory.
Abstract

Keywords:
C3-epi-25(OH)DC3-epimernewbornpreterm infantsvitamin D

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