{"doi":"10.1093/clinchem/hvad151","title":"Functional Assessment of Vitamin D Status by a Novel Metabolic Approach: The Low Vitamin D Profile Concept","abstract":"<jats:title>Abstract</jats:title>\n               <jats:sec>\n                  <jats:title>Background</jats:title>\n                  <jats:p>Determining serum 25-hydroxyvitamin D [25(OH)D], 24,25-dihydroxyvitamin D [24,25(OH)2D] and the vitamin D metabolite ratio (VMR) allows the identification of individuals with a low vitamin D metabolite profile. Here, we evaluated if such a functional approach provides superior diagnostic information to serum 25(OH)D alone.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Methods</jats:title>\n                  <jats:p>25(OH)D, 24,25(OH)2D, and the VMR were determined in participants of the DESIRE (Desirable Vitamin D Concentrations, n = 2010) and the LURIC (Ludwigshafen Risk and Cardiovascular Health, n = 2456) studies. A low vitamin D metabolite profile (vitamin D insufficiency) was defined by a 24,25(OH)2D concentration &amp;lt;1.2 ng/mL (&amp;lt;3 nmol/L) and a VMR &amp;lt;4%. Parathyroid hormone (PTH) and bone turnover markers were measured in both cohorts, whereas 10-year mortality data was recorded in LURIC only.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>The median age in DESIRE and LURIC was 43.3 and 63.8 years, respectively. Median 25(OH)D concentrations were 27.2 ng/mL (68.0 nmol/L) and 15.5 ng/mL (38.8 nmol/L), respectively. Serum 25(OH)D deficiency, defined as &amp;lt;20.2 ng/mL (&amp;lt;50 nmol/L), was present in 483 (24.0%) and 1701 (69.3%) participants of DESIRE and LURIC, respectively. In contrast, only 77 (3.8%) and 521 (21.2%) participants had a low vitamin D metabolite profile. Regardless of the serum 25(OH)D concentration, a low vitamin D metabolite profile was associated with a significantly higher PTH, accelerated bone metabolism, and higher all-cause mortality than an unremarkable vitamin D metabolite profile.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions</jats:title>\n                  <jats:p>The personalized assessment of vitamin D status using a functional approach better identifies patients with accelerated bone metabolism and increased mortality than the use of a fixed 25(OH)D cutoff of 20 ng/mL (50 nmol/L).</jats:p>\n               </jats:sec>","journal":"Clinical Chemistry","year":2023,"id":637878,"datarank":0.49983067652628066,"base_score":3.332204510175204,"endowment":3.332204510175204,"self_citation_contribution":0.49983067652628066,"citation_network_contribution":0.0,"self_endowment_contribution":0.49983067652628066,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":27,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":162222,"name":"Sieglinde Zelzer","orcid":null,"position":1,"is_corresponding":false},{"id":330064,"name":"Etienne Cavalier","orcid":"0000-0003-0947-2226","position":2,"is_corresponding":false},{"id":1656473,"name":"Marcus Kleber","orcid":null,"position":3,"is_corresponding":false},{"id":1656476,"name":"Camilla Drexler-Helmberg","orcid":null,"position":4,"is_corresponding":false},{"id":1656478,"name":"Peter Schlenke","orcid":null,"position":5,"is_corresponding":false},{"id":1656480,"name":"Pero Curcic","orcid":null,"position":6,"is_corresponding":false},{"id":1656482,"name":"Martin H Keppel","orcid":null,"position":7,"is_corresponding":false},{"id":1656483,"name":"Dietmar Enko","orcid":null,"position":8,"is_corresponding":false},{"id":21822,"name":"Hubert Scharnagl","orcid":"0000-0002-2750-006X","position":9,"is_corresponding":false},{"id":3313,"name":"Stefan Pilz","orcid":"0000-0002-7959-1311","position":10,"is_corresponding":false},{"id":21968,"name":"Winfried März","orcid":"0000-0001-6083-8946","position":11,"is_corresponding":false},{"id":986536,"name":"Markus Herrmann","orcid":"0000-0002-3559-9899","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Functional Assessment of Vitamin D Status by a Novel Metabolic Approach: The Low Vitamin D Profile Concept","abstract":"<jats:title>Abstract</jats:title>\n               <jats:sec>\n                  <jats:title>Background</jats:title>\n                  <jats:p>Determining serum 25-hydroxyvitamin D [25(OH)D], 24,25-dihydroxyvitamin D [24,25(OH)2D] and the vitamin D metabolite ratio (VMR) allows the identification of individuals with a low vitamin D metabolite profile. Here, we evaluated if such a functional approach provides superior diagnostic information to serum 25(OH)D alone.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Methods</jats:title>\n                  <jats:p>25(OH)D, 24,25(OH)2D, and the VMR were determined in participants of the DESIRE (Desirable Vitamin D Concentrations, n = 2010) and the LURIC (Ludwigshafen Risk and Cardiovascular Health, n = 2456) studies. A low vitamin D metabolite profile (vitamin D insufficiency) was defined by a 24,25(OH)2D concentration &amp;lt;1.2 ng/mL (&amp;lt;3 nmol/L) and a VMR &amp;lt;4%. Parathyroid hormone (PTH) and bone turnover markers were measured in both cohorts, whereas 10-year mortality data was recorded in LURIC only.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>The median age in DESIRE and LURIC was 43.3 and 63.8 years, respectively. Median 25(OH)D concentrations were 27.2 ng/mL (68.0 nmol/L) and 15.5 ng/mL (38.8 nmol/L), respectively. Serum 25(OH)D deficiency, defined as &amp;lt;20.2 ng/mL (&amp;lt;50 nmol/L), was present in 483 (24.0%) and 1701 (69.3%) participants of DESIRE and LURIC, respectively. In contrast, only 77 (3.8%) and 521 (21.2%) participants had a low vitamin D metabolite profile. Regardless of the serum 25(OH)D concentration, a low vitamin D metabolite profile was associated with a significantly higher PTH, accelerated bone metabolism, and higher all-cause mortality than an unremarkable vitamin D metabolite profile.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions</jats:title>\n                  <jats:p>The personalized assessment of vitamin D status using a functional approach better identifies patients with accelerated bone metabolism and increased mortality than the use of a fixed 25(OH)D cutoff of 20 ng/mL (50 nmol/L).</jats:p>\n               </jats:sec>","is_dataset_classified":null,"base_score":3.332204510175204,"endowment":3.332204510175204,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"37798100","pmcid":null,"openalex_id":"https://openalex.org/W4387359029","authors":[],"funders":[],"total_grants":0,"fwci":4.7905,"citation_percentile":0.95988749,"influential_citations":0,"citation_trend":[{"year":2023,"count":3},{"year":2024,"count":11},{"year":2025,"count":6},{"year":2026,"count":7}],"oa_status":"hybrid","license":"cc-by","oa_locations":[{"url":"https://academic.oup.com/clinchem/advance-article-pdf/doi/10.1093/clinchem/hvad151/51904864/hvad151.pdf","host_type":"journal"},{"url":"https://academic.oup.com/clinchem/advance-article-pdf/doi/10.1093/clinchem/hvad151/51904864/hvad151.pdf","host_type":"publisher"},{"url":"https://academic.oup.com/clinchem/article-pdf/69/11/1307/53519200/hvad151.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1093/clinchem/hvad151","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/37798100","host_type":"repository"},{"url":"https://orbi.uliege.be/handle/2268/309480","host_type":"repository"},{"url":"https://orbi.uliege.be/bitstream/2268/309480/1/hvad151.pdf","host_type":"repository"}],"fields_of_study":["Vitamin D Research Studies","Parathyroid Disorders and Treatments","Biotin and Related Studies"],"mesh_terms":["Adult","Humans","Middle Aged","Parathyroid Hormone","Vitamin D","Vitamin D Deficiency"],"keywords":["Vitamin D and neurology","Metabolite","Internal medicine","Endocrinology","Parathyroid hormone","vitamin D deficiency","Chemistry","Vitamin","Medicine","Calcium"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-06T19:40:51.923385Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}