Multiple outcomes have been achieved throughout the project, including novel analytical method developments to measure multiple phase I and phase II vitamin D metabolites, alongside their translational applications for the analysis of vitamin D metabolism in human observational studies. Liquid chromatography tandem mass spectrometry (LC-MS/MS) methods have been developed and validated, including a method for the simultaneous quantitation of 13 mono- and di-hydroxy metabolites across different metabolic pathways in the circulation. A further LC-MS/MS method combined with enzyme hydrolysis has been developed for the quantitation of four phase II conjugated metabolite forms in the circulation. These methods have been used to perform vitamin D metabolite measurements in different biological settings in order to compare circulating, excretory (urine and bile) and tissue metabolism. LC-MS/MS method parameters have also been established for the quantitation of the vitamin D transporter protein (vitamin D binding protein).
The developed LC-MS/MS methods have been applied to the analysis of samples from multiple observational studies to investigate vitamin D metabolism beyond 25-hydroxyvitamin D measurements in different population groups. A key cohort incorporated into this analysis has been samples from the Concord Health and Ageing in Men Project (CHAMP) cohort that consists of males aged over 70. This analysis has revealed important metabolism profiles of vitamin D in older men that have not previously been reported, including the measurement of circulating metabolites derived from the CYP11A1 metabolism pathway of vitamin D. Different biomarkers were linked with markers of bone health across the entire body, highlighting that 1,25-dihydroxyvitamin D3 is the most significant biomarker associated with bone health in this cohort.
Analysis of phase II conjugated vitamin D metabolites in the circulation has revealed that sulfate conjugated vitamin D metabolites circulate in high abundance and at similar levels to their unconjugated counterparts with minimal amounts excreted in urine and bile. This analysis highlighted differences in the abundance of conjugated forms between individuals and their vitamin D supplementation status. A further observational study investigated changes in the metabolism of vitamin D during and after exercise, revealing short and long term differences between metabolites. These results may have significant implications for the assessment of vitamin D status as current methods do not incorporate these high abundant conjugate forms.
The project findings have been disseminated across multiple platforms including two open access journal publications in the Journal of Clinical Endocrinology and Metabolism, and Clinical Chemistry and Laboratory Medicine. Project results have also been disseminated through presentations at multiple conferences including the British Endocrine Society meeting. Ongoing exploitation of these findings include application notes describing the developed analytical methods and metabolism pathways, and how these findings can contribute to future policies for the assessing vitamin D status.