Department of Laboratory Medicine, Santai Country People's Hospital, Mianyang, 621100, P.R. China.
Department of Laboratory Medicine, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, 621000, P.R. China.
BMC Pediatr. 2024 Sep 13;24(1):577. doi: 10.1186/s12887-024-05072-8.
Recently, the C3-epimer of 25-hydroxyvitamin D [C3-epi-25(OH)D] has become a topic of interest among 25-hydroxyvitamin D [25(OH)D] metabolites. Although it can lead to an overestimation of vitamin D storage, its relationship with disease occurrence remains controversial, possibly related to the great extent of tracking of 25(OH)D by C3-epi-25(OH)D over time. This study aimed to investigate the differential performance of C3-epi-25(OH)D3 and its percentage [%C3-epi-25(OH)D3] with respect to 20 common paediatric diseases.
This study involved 805 healthy children and adolescents and 2962 patients with common paediatric diseases. We investigated sex, age, and seasonal differences in C3-epi-25(OH)D3 and %C3-epi-25(OH)D3 levels; their variations on 20 common paediatric diseases; and their degree of correlation with 25(OH)D3 levels and various diseases.
Among the healthy underage participants, C3-epi-25(OH)D3 and %C3-epi-25(OH)D3 changed similarly, with no sex differences. Moreover, their levels were higher in the infant period than in the other periods (t = 5.329-5.833, t = 4.640-5.711, all Padj < 0.001), and in spring and summer than in autumn and winter (t = 3.495-6.061, t = 3.495-5.658, all Padj < 0.01). Under healthy and disease conditions, C3-epi-25(OH)D3 was positively correlated with 25(OH)D3 (ρ = 0.318 ~ 0.678, all P < 0.017), whereas %C3-epi-25(OH)D3 was not, except in patients with nephrotic syndrome (ρ=-0.393, P = 0.001). Before and after adjusting for 25(OH)D3, the relationship of C3-epi-25(OH)D3 with the diseases was notably different. However, it was almost consistent for %C3-epi-25(OH)D3. Our results indicated that %C3-epi-25(OH)D3 was associated with short stature, nephrotic syndrome, lymphocytic leukaemia, rickets, paediatric malnutrition, and hypovitaminosis D (OR = 0.80 ~ 1.21, all P < 0.05).
The %C3-epi-25(OH)D3 can correct the properties of C3-epi-25(OH)D3 to better track 25(OH)D3 and may be more suitable for exploring its pathological relevance. Further detailed studies of each disease should be conducted.
最近，25-羟基维生素 D [25(OH)D] 的 C3-差向异构体已成为 25(OH)D 代谢物的研究热点。虽然它可能导致维生素 D 储存的高估，但它与疾病发生的关系仍存在争议，这可能与 C3-差向异构体在时间上对 25(OH)D 的极大程度的跟踪有关。本研究旨在探讨 C3-差向异构体-25-羟维生素 D3[C3-epi-25(OH)D3]及其百分比 [%C3-epi-25(OH)D3]与 20 种常见儿科疾病的差异表现。
本研究纳入了 805 名健康儿童和青少年以及 2962 名患有常见儿科疾病的患者。我们研究了 C3-epi-25(OH)D3 和 %C3-epi-25(OH)D3 水平的性别、年龄和季节性差异；它们在 20 种常见儿科疾病中的变化；以及它们与 25(OH)D3 水平和各种疾病的相关性程度。
在健康未成年参与者中，C3-epi-25(OH)D3 和 %C3-epi-25(OH)D3 的变化相似，无性别差异。此外，它们的水平在婴儿期高于其他时期（t=5.329-5.833，t=4.640-5.711，均 Padj<0.001），在春季和夏季高于秋季和冬季（t=3.495-6.061，t=3.495-5.658，均 Padj<0.01）。在健康和疾病状态下，C3-epi-25(OH)D3 与 25(OH)D3 呈正相关（ρ=0.3180.678，均 P<0.017），而 %C3-epi-25(OH)D3 则不然，除了肾病综合征患者（ρ=-0.393，P=0.001）。在调整 25(OH)D3 前后，C3-epi-25(OH)D3 与疾病的关系明显不同。然而，对于 %C3-epi-25(OH)D3 几乎是一致的。我们的结果表明，%C3-epi-25(OH)D3 与身材矮小、肾病综合征、淋巴细胞白血病、佝偻病、儿科营养不良和维生素 D 缺乏症有关（OR=0.801.21，均 P<0.05）。
%C3-epi-25(OH)D3 可以纠正 C3-epi-25(OH)D3 的特性，以更好地跟踪 25(OH)D3，可能更适合探索其病理相关性。应进一步对每种疾病进行详细研究。
