{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T20:39:33Z","timestamp":1782938373505,"version":"3.54.5"},"reference-count":38,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T00:00:00Z","timestamp":1727136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Distinguished Scientists Fellowship Programme of the King Saud University, Riyadh, Kingdom of Saudi Arabia"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: The vitamin D metabolite ratio (VMR) has recently been identified as a potentially better indicator of vitamin D deficiency than 25-hydroxyvitamin D (25(OH)D) alone. This study aims to validate these findings by demonstrating that VMR is more strongly correlated with parathyroid hormone (PTH) levels than 25(OH)D and 24,25-dihydroxyvitamin D (24,25(OH)2D). In addition, the study investigates VMR as a more effective predictor of mortality than 25(OH)D and 24,25(OH)2D. Methods: The SarcoPhAge cohort is a Belgian cohort of community-dwelling older adults. Levels of 25(OH)D and 24,25(OH)2D were measured in 204 serum samples collected at the second year of follow-up using liquid chromatography\u2013tandem mass spectrometry (LC\u2013MS\/MS), and VMR was calculated using the formula: VMR = (24,25(OH)D\/25(OH)D) \u00d7 100. Vitamin D deficiency cut-offs were defined at 25(OH)D &lt; 20 ng\/mL, 24,25(OH)2D &lt; 1.2 ng\/mL, or VMR &lt; 4% according to previously proposed cut-offs. Participants were followed for up to 9 years. Results: A total of 35 individuals (17.2%) had 25(OH)D &lt; 20 ng\/mL, 40 individuals (19.6%) had 24,25(OH)2D &lt; 1.2 ng\/mL, and 14 individuals (7.0%) had VMR &lt; 4%. All three markers, 25(OH)D, 24,25(OH)2D, and VMR, were independently associated with PTH levels, with VMR showing the strongest correlation (rho: \u22120.292; p &lt; 0.0001). When categorized into quartiles, only 24,25(OH)2D and VMR showed significant increases in PTH levels across quartiles (p = 0.002 and p &lt; 0.0001, respectively). When cut-offs for low vitamin D status were applied, patients with low VMR had the highest rate of all-cause mortality. However, in a Cox proportional hazard regression model, both low VMR profile and low 25(OH)D profile were risk factors for all-cause mortality. Conclusions: This study confirms that VMR is an efficient biomarker for assessing functional vitamin D deficiency.<\/jats:p>","DOI":"10.3390\/nu16193224","type":"journal-article","created":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T03:49:46Z","timestamp":1727149786000},"page":"3224","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Investigation of the Vitamin D Metabolite Ratio (VMR) as a Marker of Functional Vitamin D Deficiency: Findings from the SarcoPhAge Cohort"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5316-3108","authenticated-orcid":false,"given":"Aur\u00e9lie","family":"Ladang","sequence":"first","affiliation":[{"name":"Department of Clinical Chemistry, CIRM, CHU de Li\u00e8ge, University of Li\u00e8ge, 4000 Li\u00e8ge, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Sophie","family":"Gendebien","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, CIRM, CHU de Li\u00e8ge, University of Li\u00e8ge, 4000 Li\u00e8ge, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phanie","family":"Kovacs","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, CIRM, CHU de Li\u00e8ge, University of Li\u00e8ge, 4000 Li\u00e8ge, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7089-6605","authenticated-orcid":false,"given":"C\u00e9line","family":"Demonceau","sequence":"additional","affiliation":[{"name":"Research Unit in Public Health, Epidemiology and Health Economics, University of Li\u00e8ge, 4000 Li\u00e8ge, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Beaudart","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology and Toxicology Research Unit (URPC), NARILIS, Department of Biomedical Sciences, University of Namur, 5000 Namur, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phanie","family":"Peeters","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, CIRM, CHU de Li\u00e8ge, University of Li\u00e8ge, 4000 Li\u00e8ge, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majed S.","family":"Alokail","sequence":"additional","affiliation":[{"name":"Protein Research Chair, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5472-1725","authenticated-orcid":false,"given":"Nasser M.","family":"Al-Daghri","sequence":"additional","affiliation":[{"name":"Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7816-3705","authenticated-orcid":false,"given":"Caroline","family":"Le Goff","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, CIRM, CHU de Li\u00e8ge, University of Li\u00e8ge, 4000 Li\u00e8ge, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6290-752X","authenticated-orcid":false,"given":"Jean-Yves","family":"Reginster","sequence":"additional","affiliation":[{"name":"Protein Research Chair, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4269-9393","authenticated-orcid":false,"given":"Olivier","family":"Bruyere","sequence":"additional","affiliation":[{"name":"Research Unit in Public Health, Epidemiology and Health Economics, University of Li\u00e8ge, 4000 Li\u00e8ge, Belgium"},{"name":"Department of Physical Activity and Rehabilitation, University of Li\u00e8ge, 4000 Li\u00e8ge, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etienne","family":"Cavalier","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, CIRM, CHU de Li\u00e8ge, University of Li\u00e8ge, 4000 Li\u00e8ge, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1038\/s41430-020-0558-y","article-title":"Vitamin D Deficiency 2.0: An Update on the Current Status Worldwide","volume":"74","author":"Amrein","year":"2020","journal-title":"Eur. 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