Abstract Title:

Can a model predictive of vitamin D status be developed from common laboratory tests and demographic parameters?

Abstract Source:

South Med J. 2011 Sep ;104(9):636-9. PMID: 21886082

Abstract Author(s):

Alan N Peiris, Beth A Bailey, Bhuvana N Guha, Rebecca Copeland, Todd Manning

Article Affiliation:

Department of Internal Medicine, East Tennessee State University, Johnson City, TN 37614, USA. [email protected]

Abstract:

OBJECTIVES: Vitamin D deficiency is highly prevalent and has been linked to increased morbidity and mortality. There has been an increase in testing for vitamin D with a concomitant increase in costs. While individual factors are significantly linked to vitamin D status, prior studies have not yielded a model predictive of vitamin D status or 25(OH)D levels. The purpose of this investigation was to determine if a prediction model of vitamin D could be developed using extensive demographic data and laboratory parameters.

METHODS: Patient data from 6 Veterans Administration Medical Centers were extracted from medical charts.

RESULTS: For the 14,920 available patients, several factors including triglyceride level, race, total cholesterol, body mass index, calcium level, and number of missed appointments were significantly linked to vitamin D status. However, these variables accounted for less than 15% of the variance in vitamin D levels. While the variables correctly classified vitamin D deficiency status for 71% of patients, only 33% of those who were actually deficient were correctly identified as deficient.

CONCLUSION: Given the failure to find a sufficiently predictive model for vitamin D deficiency, we propose that there is no substitute for laboratory testing of 25(OH)D levels. A baseline vitamin D 3 daily replacement of 1000-2000 IU initially with further modification based on biannual testing appears to factor in the wide variation in dose response observed with vitamin D replacement and is especially important in high-risk groups such as ethnic minorities.

Study Type : Review

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