Should You Regularly Screen for Vitamin D Deficiency?

In community-dwelling, nonpregnant adults, there is no clear evidence that either supports or contests regular screening for vitamin D deficiency, according to a recent statement from the U.S. Preventive Services Task Force (USPSTF).

“The USPSTF recognizes that there is no consensus on how to define vitamin D deficiency and does not endorse the use of a specific threshold to identify it,” said Michael L. LeFevre, MD, MSPH, author of the statement on behalf of the U.S. Preventitive Services Task Force.
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“For the purposes of this recommendation statement, the term “vitamin D deficiency” is used to reflect evidence from study populations generally representing total serum 25-(OH)D levels of 75 nmol/L (30 ng/mL) or less or subpopulations of studies with levels less than 50 nmol/L (<20 ng/mL),” he said.

In order to systematically review the harms and benefits of regular screening, researchers conducted a meta-analysis of available data from randomized trials and case-controlled studies on the effects of vitamin D deficiency.

Overall, they were unable to find any significant evidence that suggests that low levels of vitamin D increases risk, fractures, diabetes, cancer, cardiovascular disease, and depression. They did note a possible association between a reduction in the number of falls and risk of death in institutionalized elderly adults and treatment with vitamin D.

“Future research is needed to reduce assay variability; determine appropriate thresholds for vitamin D deficiency; and clarify effects of screening, subsequent treatment, and the subpopulations most likely to benefit,” they concluded.

The complete statement is published in the November issue of Annals of Internal Medicine.

-Michelle Canales

References:

LeBlanc ES, Zakher B, Daeges M, et al. Screening for vitamin d deficiency in adults: U.S. preventive services task force recommendation statement. Ann Intern Med. 2014 November [epub ahead of print] doi: 10.7326/M14-2450.