{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T21:56:12Z","timestamp":1789682172200,"version":"4.0.1"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Endocr Disord"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Vitamin D deficiency is diagnosed by total serum 25-hydroxyvitamin D (25(OH)D) concentration and is associated with poor health and increased mortality; however, some populations have low 25(OH) D concentrations without manifestations of vitamin D deficiency. The Vitamin D Metabolite Ratio (VMR) has been suggested as a superior indicator of vitamin D status. Therefore, VMR was determined in a population with type 2 diabetes at high risk for vitamin D deficiency and correlated with diabetic complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Research design and methods<\/jats:title>\n                <jats:p>Four hundred sisty patients with type 2 diabetes (T2D) were recruited, all were vitamin D<jats:sub>3<\/jats:sub> supplement naive. Plasma concentration of 25-hydroxyvitamin D<jats:sub>3<\/jats:sub> (25(OH)D<jats:sub>3<\/jats:sub>) and its metabolites 1,25-dihydroxyvitamin D<jats:sub>3<\/jats:sub> (1,25(OH)<jats:sub>2<\/jats:sub>D<jats:sub>3<\/jats:sub>) and 24,25-dihydroxyvitamin D<jats:sub>3<\/jats:sub> (24,25(OH)<jats:sub>2<\/jats:sub>D<jats:sub>3<\/jats:sub>) and its epimer, 3-epi-25-hydroxyvitamin D<jats:sub>3<\/jats:sub> (3-epi-25(OH)D<jats:sub>3<\/jats:sub>), were measured by LC-MS\/MS analysis. VMR-1 was calculated as a ratio of 24,25(OH)<jats:sub>2<\/jats:sub>D<jats:sub>3<\/jats:sub>:25(OH)D<jats:sub>3<\/jats:sub>; VMR-2 as a ratio of 1,25(OH)<jats:sub>2<\/jats:sub>D<jats:sub>3<\/jats:sub>:25(OH)D<jats:sub>3<\/jats:sub>; VMR-3 was calculated as a ratio of 3-epi-25(OH)D<jats:sub>3<\/jats:sub>: 25(OH)D<jats:sub>3.<\/jats:sub><\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>An association means that there were significant differences between the ratios found for those with versus those without the various diabetic complications studied. VMR-1 was associated with diabetic retinopathy (<jats:italic>p<\/jats:italic>\u2009=\u20090.001) and peripheral artery disease (<jats:italic>p<\/jats:italic>\u2009=\u20090.012); VMR-2 associated with hypertension (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), dyslipidemia (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), diabetic retinopathy (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), diabetic neuropathy (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), coronary artery disease (<jats:italic>p<\/jats:italic>\u2009=\u20090.001) and stroke (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). VMR-3 associated with hypertension (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), dyslipidemia (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and coronary artery disease (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In this cross sectional study, whilst not causal, VMR-2 was shown to be the superior predictor of diabetic and cardiovascular complications though not demonstrative of causality in this cross-sectional study population over VMR-1, VMR-3 and the individual vitamin D concentration measurements; VMR-2 associated with both microvascular and cardiovascular indices and therefore may have utility in predicting the development of diabetic complications.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12902-020-00641-1","type":"journal-article","created":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T12:05:57Z","timestamp":1603800357000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Vitamin D3 metabolite ratio as an indicator of vitamin D status and its association with diabetes complications"],"prefix":"10.1186","volume":"20","author":[{"given":"Lina H. 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