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Does Vitamin D-Binding Protein Predict Response to Vitamin D Supplementation in Term and Preterm Newborns? A

Burcu Cebeci1, Mehmet Emin Arvas2, Dilek Kurnaz1

  • 1Department of Neonatology, Haseki Training and Research Hospital, University of Health Sciences, 34265 Istanbul, Türkiye.

Journal of Clinical Medicine
|July 15, 2026
PubMed

Insights

Neonatal vitamin D supplementation with 800 IU/day for 8 weeks effectively increased 25-hydroxyvitamin D levels in infants. Baseline vitamin D-binding protein did not predict supplementation response, indicating it offers no additional clinical value.

Area of Science:

  • Neonatal nutrition and metabolism
  • Endocrinology and vitamin D research
  • Pediatric supplementation efficacy

Background:

  • Vitamin D-binding protein (DBP) is crucial for transporting 25-hydroxyvitamin D [25(OH)D] in circulation.
  • Neonates synthesize their own DBP, but its role in predicting vitamin D supplementation response is not well understood.
  • Clarifying DBP's predictive value is essential for optimizing neonatal vitamin D therapy.

Purpose of the Study:

  • To determine if neonatal vitamin D-binding protein (DBP) levels at birth predict the response to vitamin D supplementation.
  • To assess the predictive value of baseline DBP beyond baseline 25-hydroxyvitamin D [25(OH)D] levels.
  • To evaluate the efficacy of 800 IU/day oral cholecalciferol supplementation in neonates.

Main Methods:

  • A prospective cohort study involving 101 neonates was conducted.
  • Fifty-nine neonates with 25(OH)D < 20 ng/mL received 800 IU/day cholecalciferol for 8 weeks.
  • Serum 25(OH)D and DBP levels were measured at baseline and 8 weeks; multivariable regression analyzed predictors of change in 25(OH)D.

Main Results:

  • Supplementation significantly increased 25(OH)D levels (median Δ = 17.7 ng/mL), with 93.2% achieving sufficiency.
  • Gestational age (β = -0.440, p = 0.001) and baseline 25(OH)D (β = -0.314, p = 0.015) independently predicted greater increases in 25(OH)D.
  • Baseline DBP levels did not significantly predict the change in 25(OH)D (β = 0.072, p = 0.551).

Conclusions:

  • Baseline DBP levels do not independently predict neonatal vitamin D supplementation response.
  • Lower gestational age and lower baseline 25(OH)D are associated with greater vitamin D increases post-supplementation.
  • Routine DBP measurement is not clinically valuable for guiding neonatal vitamin D supplementation; 800 IU/day is effective.

Keywords:
25-hydroxyvitamin Dneonatal vitamin D deficiencynewbornpreterm infantsupplementationvitamin Dvitamin D-binding protein

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