Mundt D, Askar W, Heslin K, Klumph M, Reid K. The incidence of vitamin D deficiency in the internal medicine clinic at Aurora Sinai Medical Center. Poster presented at: Aurora Scientific Day; May 20, 2020; virtual webinar hosted in Milwaukee, WI.
Poster presented at: Aurora Scientific Day; May 20, 2020; virtual webinar hosted in Milwaukee, WI.
Background: According to the Centers for Disease Control and Prevention, 10% of the U.S. population has severe vitamin D deficiency (VDD), with African Americans having the highest prevalence of low vitamin D concentration. Studies have shown that VDD is significantly higher among urban midwestern populations. The detrimental effects of VDD on the bone are well known; however, recent studies suggest that VDD also might be involved in the immune, cardiovascular, and neurological system. Nevertheless, Supplement www.aah.org/jpcrr 357 there is still debate surrounding who, how, and how often individuals should be screened for VDD.
Purpose: To assess the prevalence of VDD in one internal medicine clinic and identify risk factors.
Methods: Data were retrospectively collected on unique adult patients (≥18 years old) who attended the clinic at any point from January 2018 to December 2018. Vitamin D levels of ≥30 ng/ml were considered normal, while levels of <30 ng/ml were considered deficient. Patients who had more than one vitamin D test were tracked for further analyses. Basic descriptive statistics were used to describe the population. Chi-squared tests and t-tests were used as appropriate to compare groups.
Results: Of the patient cohort (n=3,976), only 17.56% had vitamin D levels tested and 12% had a prior diagnosis of VDD. Of those tested, 68% were females, 72% were African Americans, and the average age was 59 years. Unlike race (P=0.80), women, patients with a previous diagnosis of bone fracture, and those with a current diagnosis of alcohol use disorder, celiac disease, or chronic kidney disease were significantly more likely to have vitamin D levels tested (P<0.01). As expected, individuals were more likely to be tested in winter than in any other season (42%), and the majority of patients tested had VDD (71%), including individuals with chronic kidney disease (P=0.002). However, there were no differences in VVD based on race (P=0.464). In addition, if a patient was re-tested, they were more likely to show improvement of vitamin D levels (42%), although 28% stayed the same.
Conclusion: Although African Americans are generally known to have lower levels of vitamin D when compared to other races, we found they were not more likely to be tested nor have more vitamin D deficiency. Improvement of vitamin D levels for those re-tested indicates that interventions are being utilized. Parallel to results previously reported, patients with chronic kidney disease are more likely to have VDD and could benefit from annual testing for vitamin D levels. Awareness of these differences could help to lower rates of VDD in this at-risk population.