Vitamin D is required for healthy growth and development, but data on human milk vitamin D content is limited. We describe a liquid chromatography tandem mass spectrometry (LC-MS/MS) method for the analysis of vitamin D metabolites in human milk, and its application in samples collected on two consecutive days from women in rural Gambia. Vitamin D compounds were extracted from 1mL of milk by liquid-liquid extraction and derivatised with 4-phenyl-1,2,4-triazoline-3,5-dione (PTAD) prior to analysis by LC-MS/MS. The limit of quantification was 0.05 nmol/L for vitamin D2, 0.025 nmol/L for vitamin D3 and 0.1 nmol/L for 25(OH)D2 and 25(OH)D3. Within- and between-day imprecision was <12% for all analytes except vitamin D2 (14%). From all data combined, geometric mean (-/+ 1SD) vitamin D3 concentration was 0.94 (0.43, 1.80) nmol/L and for 25(OH)D3 0.32 (0.23, 0.42) nmol/L. The intra-individual coefficient of variation (%CV) was 32% and 12% for vitamin D3 and 25(OH)D3, respectively. Inter-individual %CVs were 89% and 34% for vitamin D3 and 25(OH)D3, respectively. There was no significant association between vitamin D metabolite concentrations and milk fat (creamatocrit). Mean vitamin D content of human milk as ARA averaged 42 IU/L with 25(OH)D3 responsible for around two-thirds of the biological activity. In conclusion, this work describes a reliable LC-MS/MS method for quantification of vitamin D and 25(OH)D in low volumes of human milk providing a platform for future work. This study contributes to current understanding of variability of milk vitamin D content.
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