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Vitamin D metabolome in preterm infants: insights into postnatal metabolism

Tomas Matejek1,2, Lukas Prchal3, Bara Zapletalova1,2

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

Clinical Chemistry and Laboratory Medicine
|May 26, 2025
PubMed

Insights

Vitamin D metabolites like cholecalciferol and 25-(OH)D increase in preterm infants after birth. Their bodies may struggle to break down vitamin D in the first month of life.

Area of Science:

  • Neonatal metabolism and vitamin D biochemistry.
  • Endocrinology and pediatric research.

Background:

  • Preterm infants often exhibit altered vitamin D metabolism.
  • Understanding vitamin D metabolite dynamics is crucial for infant health.

Purpose of the Study:

  • To elucidate the structure of the vitamin D metabolome in preterm infants.
  • To investigate the reasons for elevated C3 epimers of 25-hydroxyvitamin D (25-(OH)D) in preterm infants' serum.
  • To compare vitamin D metabolites in cord blood versus serum at 28 days of age.

Main Methods:

  • Analysis of 40 preterm infants (gestational age 29+0-32+6 weeks).
  • Quantification of cholecalciferol, 25-(OH)D, and C3-epimers using liquid chromatography.
  • In vitro microsomal study using human liver and kidney microsomes to assess vitamin D metabolism.

Main Results:

  • Cholecalciferol, 25-(OH)D, and C3-epimers were significantly lower in cord blood than in serum at 28 days.
  • Metabolites indicating vitamin D degradation pathways were significantly higher in cord blood.
  • Microsomal studies revealed higher levels of monohydroxylated, dihydroxylated, and mono-oxylated dihydroxylated cholecalciferol and their C3-epimers in cord blood.

Conclusions:

  • Vitamin D metabolites (cholecalciferol, 25-(OH)D, C3-epimers) increase postnatally, indicating functional biosynthesis and accumulation.
  • Preterm infants appear to have impaired biotransformation and degradation of vitamin D during the first month of life.
Abstract

Keywords:
LC-MS/MSmetabolomemetabolomicsmicrosomespreterm infantvitamin D

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