ArticleClinical chemistry2023
The Vitamin D Metabolite Ratio (VMR) is a Biomarker of Vitamin D Status That is Not Affected by Acute Changes in Vitamin D Binding Protein.
Article in Clinical chemistry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 21 citations in OpenAlex.
- Vitamin D as a cellular endocrine system: Tissue-specific microcircuits, immune reprogramming, and metabolic resistance.iScience · 2026Review
- Association of the vitamin D metabolite ratio with bone turnover markers and changes in volumetric BMD.JBMR plus · 2026Article
- Increased Levels of the Vitamin D Metabolite Ratio Are Protective Against Progression From Islet Autoimmunity to T1D.The Journal of clinical endocrinology and metabolism · 2026Article
- Therapeutic Plasma Exchange and Changes in Calcium, Phosphate, Parathyroid Hormone, and Fibroblast Growth Factor-23.The Journal of clinical endocrinology and metabolism · 2026Article
- Quantification of 24,25-Dihydroxyvitamin DInternational journal of analytical chemistry · 2026Article
- Construction and validation of a risk prediction model for vitamin D deficiency in patients with type 2 diabetes mellitus.Frontiers in nutrition · 2026Article
- Article
- Can the use of vitamin D-fortified sunscreen cream be the solution to the vitamin D deficiency pandemic?Archives of dermatological research · 2025Article
- Microbial phytase and 25-hydroxy-vitamin D3 fed to growing pigs increase digestibility of calcium and phosphorus and influence plasma vitamin D metabolites and serum bone biomarkers, but effects are not always additive.Journal of animal science · 2025Article
- Novel aspects of biochemical assessment of bone remodeling and mineralization.Frontiers in endocrinology · 2025Review
- Vitamin D-Do Diet Recommendations for Health Remain Strong?Current osteoporosis reports · 2024Review
- Vitamin D beyond the blood: Tissue distribution of vitamin D metabolites after supplementation.Life sciences · 2024Review
- Investigation of the Vitamin D Metabolite Ratio (VMR) as a Marker of Functional Vitamin D Deficiency: Findings from the SarcoPhAge Cohort.Nutrients · 2024Article
- The Vitamin D Metabolite Ratio Is Associated With Volumetric Bone Density in Older Men.The Journal of clinical endocrinology and metabolism · 2024Article
- Review
- Vitamin D receptorTherapeutic advances in infectious diseaseArticle
Corrections and comments
- Erratum issued
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
background25-hydroxyvitamin D[25(OH)D] may be a poor marker of vitamin D status due to variability in levels of vitamin D binding protein (VDBP). The vitamin D metabolite ratio (VMR) is the ratio of 24,25-dihydroxyvitamin D[24,25(OH)2D3] to 25(OH)D3 and has been postulated to reflect vitamin D sufficiency independent of variability in VDBP. Therapeutic plasma exchange (TPE) is a procedure that removes plasma, including VDBP, and may lower bound vitamin D metabolite concentrations. Effects of TPE on the VMR are unknown.
methodsWe measured 25(OH)D, free 25(OH)D, 1,25-dihydroxyvitamin D[1,25(OH)2D], 24,25(OH)2D3, and VDBP in persons undergoing TPE, before and after treatment. We used paired t-tests to assess changes in these biomarkers during a TPE procedure.
resultsStudy participants (n = 45) had a mean age of 55 ± 16 years; 67% were female; and 76% were white. Compared to pretreatment concentrations, TPE caused a significant decrease in total VDBP by 65% (95%CI 60,70%), as well as all the vitamin D metabolites-25(OH)D by 66% (60%,74%), free 25(OH)D by 31% (24%,39%), 24,25(OH)2D3 by 66% (55%,78%) and 1,25(OH)2D by 68% (60%,76%). In contrast, there was no significant change in the VMR before and after a single TPE treatment, with an observed mean 7% (-3%, 17%) change in VMR.
conclusionsChanges in VDBP concentration across TPE parallel changes in 25(OH)D, 1,25(OH)2D, and 24,25(OH)2D3, suggesting that concentrations of these metabolites reflect underlying VDBP concentrations. The VMR is stable across a TPE session despite a 65% reduction in VDBP. These findings suggest that the VMR is a marker of vitamin D status independent of VDBP levels.
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