{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:23:12Z","timestamp":1790914992111,"version":"4.1.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:00:00Z","timestamp":1696464000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,2]]},"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\u2005ng\/mL (&amp;lt;3\u2005nmol\/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\u2005ng\/mL (68.0\u2005nmol\/L) and 15.5\u2005ng\/mL (38.8\u2005nmol\/L), respectively. Serum 25(OH)D deficiency, defined as &amp;lt;20.2\u2005ng\/mL (&amp;lt;50\u2005nmol\/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\u2005ng\/mL (50\u2005nmol\/L).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/clinchem\/hvad151","type":"journal-article","created":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T01:13:52Z","timestamp":1696554832000},"page":"1307-1316","source":"Crossref","is-referenced-by-count":28,"title":["Functional Assessment of Vitamin D Status by a Novel Metabolic Approach: The Low Vitamin D Profile Concept"],"prefix":"10.1093","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3559-9899","authenticated-orcid":false,"given":"Markus","family":"Herrmann","sequence":"first","affiliation":[{"name":"Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz , Graz , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sieglinde","family":"Zelzer","sequence":"additional","affiliation":[{"name":"Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz , Graz , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0947-2226","authenticated-orcid":false,"given":"Etienne","family":"Cavalier","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, University of Liege , Liege , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Kleber","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 5 (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Mannheim Medical Faculty, University of Heidelberg , Mannheim , Germany"},{"name":"Synlab Human Genetics Laboratory, Synlab AG , Mannheim , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Drexler-Helmberg","sequence":"additional","affiliation":[{"name":"Department for Blood Group Serology and Transfusion Medicine, Medical University of Graz , Graz , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Schlenke","sequence":"additional","affiliation":[{"name":"Department for Blood Group Serology and Transfusion Medicine, Medical University of Graz , Graz , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pero","family":"Curcic","sequence":"additional","affiliation":[{"name":"Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz , Graz , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin H","family":"Keppel","sequence":"additional","affiliation":[{"name":"Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz , Graz , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar","family":"Enko","sequence":"additional","affiliation":[{"name":"Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz , Graz , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2750-006X","authenticated-orcid":false,"given":"Hubert","family":"Scharnagl","sequence":"additional","affiliation":[{"name":"Clinical Institute of 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