New research from Wake Forest Baptist Medical Center suggests
that physicians are ordering vitamin D deficiency screening tests for
preventive care purposes rather than after patients develop conditions caused
by decreased bone density.
For older patients, having a low vitamin D level is a condition
that can cause weakening of bones, which can lead to fractures, and in children
the deficiency can lead to rickets. The 2011 Institute of Medicine guidelines
for vitamin D and calcium emphasize their importance in skeletal health and
increased research findings, along with widespread media reports, have raised
awareness about vitamin D deficiency, the researchers reported.
Karen E. Huang, M.S., a research specialist in the Center for
Dermatology Research at Wake Forest Baptist Medical Center and lead author of
the study, said the rise in vitamin D deficiency awareness among doctors warranted
a look at how often doctors were diagnosing this condition during visits.
“From 2007 to 2010, we noted that the number of diagnoses for
vitamin D deficiency rapidly increased and tripled from 2008 to 2010,” Huang
said. “Previously, diagnoses of low vitamin D levels largely may have been used
to identify why someone had a fracture or weak bones. In our data, we found
that only 10 percent of visits with low vitamin D mentioned the
patient having weak bones or a fracture.”
The study is published in the April issue of Southern Medical
Journal of the Southern Medical Association. Huang and colleagues used data
from The National Ambulatory Medical Care and National Hospital Ambulatory
Medical Care surveys to assess the rate of vitamin D deficiency diagnoses made
between 2007 and 2010 during outpatient visits. An estimated 7.5 million visits
were linked with the condition at outpatient visits in the United States during
this time frame.
At visits where patients were diagnosed with low vitamin D levels,
the average patient age was 56.9 and females were 2.6 times more likely to be
diagnosed with vitamin D deficiency than males. Individuals 65 years or older
were also almost three times more likely to be diagnosed as deficient compared
to individuals younger than 65, according to the study.
“We believe this increase in visits with a diagnosis of vitamin D
deficiency, but without a diagnosis of weak or fractured bones, suggests that a
lot of doctors now are checking patients for this deficiency so that they can
help prevent the patients from developing weak bones,” Huang said.
Still, several prominent health organizations such as The
Endocrine Society and The Institute of Medicine only recommend patients undergo
vitamin D deficiency testing if they’re at risk as there is no evidence that
testing everyone is beneficial, Huang said.
Co-authors include Brandy-Joe
Milliron, Ph.D.; Scott A. Davis, M.A.; and Steven R. Feldman, M.D., Ph.D., all
of the Center for Dermatology Research, which is supported by an unrestricted
educational grant from Galderma Laboratories. Milliron is supported by the National Cancer Institute of the National Institutes
of Health under award number 5 R25 CA122061-05.