Vitamin D metabolome in preterm infants: insights into postnatal metabolism

Clin Chem Lab Med. 2025 May 22;63(9):1823-1833. doi: 10.1515/cclm-2025-0311. Print 2025 Aug 26.

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: LC-MS/MS; metabolome; metabolomics; microsomes; preterm infant; vitamin D.

MeSH terms

  • Cholecalciferol / blood
  • Cholecalciferol / metabolism
  • Chromatography, Liquid
  • Female
  • Fetal Blood / chemistry
  • Fetal Blood / metabolism
  • Humans
  • Infant, Newborn
  • Infant, Premature* / blood
  • Infant, Premature* / metabolism
  • Male
  • Metabolome*
  • Microsomes / metabolism
  • Microsomes, Liver / metabolism
  • Vitamin D* / blood
  • Vitamin D* / metabolism

Substances

  • Vitamin D
  • Cholecalciferol