25-hydroxyvitamin D; Arab adolescents; VMR; osteomalacia; vitamin D metabolite ratio; vitamin D metabolites; Food Science; Endocrinology, Diabetes and Metabolism; Nutrition and Dietetics
Abstract :
[en] [en] INTRODUCTION: We previously reported a high prevalence of biochemical osteomalacia among apparently healthy Arab adolescents using combined mineralization markers. This study examined whether advanced LC-MS/MS-based vitamin D metabolite profiling, including the vitamin D metabolite ratio (VMR), can serve as indicators of biochemical osteomalacia in Arab adolescents.
METHODS: A total of 976 age- and body mass index-matched adolescents (522 girls, mean age 14.9 ± 1.8 years, body mass index, BMI 23.0 ± 5.9; 454 boys, mean age 14.9 ± 1.7 years, BMI 23.7 ± 5.8) were included in this cross-sectional study. Anthropometrics and biochemical parameters [glucose, lipid profile, calcium (Ca), inorganic phosphorus (Pi), alkaline phosphatase (ALP)] were measured using routine assays. Circulating vitamin D metabolites [24,25(OH)₂D (24, 25 VD), VD2, VD3, total VD] were quantified using LC-MS/MS, and VMR calculated as [24,25 VD/VD] × 100. Deficiency cut-offs were: VD <30 nmol/L, 24,25 VD <3.0 nmol/L, VMR <4%. Biochemical osteomalacia was defined as ≥ 2 abnormal markers (low VD, high ALP, low Ca, or low Pi).
RESULTS: All vitamin D metabolites were significantly lower in the biochemical osteomalacia group. Overall, VD showed the highest predictive value (AUC 0.71, Youden index 0.40). Stratified analyses revealed VMR as a modest marker in girls (AUC 0.60), while VD3 performed best in boys (AUC 0.77, Youden index 0.60).
CONCLUSION: VD metabolites as a single test are modest predictors of biochemical osteomalacia in adolescents and differ in accuracy according to sex. Findings in this study should be interpreted as exploratory rather than diagnostic, serving to generate hypotheses and lay groundwork for future clinical and public health applications.
Disciplines :
Laboratory medicine & medical technology
Author, co-author :
Sabico, Shaun; Chair for Biomarkers of Chronic Diseases, Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
Al-Daghri, Nasser ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé ; Chair for Biomarkers of Chronic Diseases, Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
Alenad, Amal; Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
Al-Saleh, Yousef; Department of Medicine, Health Oasis Hospital, Riyadh, Saudi Arabia
Khattak, Malak N K; Chair for Biomarkers of Chronic Diseases, Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
Wani, Kaiser; Chair for Biomarkers of Chronic Diseases, Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
Alnaami, Abdullah M; Chair for Biomarkers of Chronic Diseases, Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique ; Protein Research Chair, Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
Alokail, Majed S; Protein Research Chair, Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
Cavalier, Etienne ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale
Language :
English
Title :
Sexual dimorphism in LC-MS/MS-based vitamin D metabolite profiling and nutrition-acquired biochemical osteomalacia among adolescents.
The author(s) declare that financial support was received for the research and/or publication of this article. The authors are thankful to the Ongoing Research Funding Program - Research Chairs (ORF-RC-2025-1400), King Saud University, Riyadh, Saudi Arabia, for funding this research.
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