Serum Vitamin D Testing – A Necessity Or An Injudicious Expenditure

Authors

  • Athar Iqbal Paracha Department of Chemical Pathology, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Muhammad Qaiser Alam Khan Department of Chemical Pathology, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Muhammad Younas Department of Chemical Pathology, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Zujaja Hina Haroon Department of Chemical Pathology, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Muhammad Anwar Department of Chemical Pathology, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Muhammad Usman Munir Department of Chemical Pathology, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i5.11656

Keywords:

Cost-Effectiveness, Vitamin D, Vitamin D Deficiency, Vitamin D Supplementation.

Abstract

Objective: To evaluate the serum vitamin D levels and to determine the justification for vitamin D testing in patients.

Study Design: Cross-Sectional study.

Place and Duration of Study: Department of Chemical Pathology, Armed Forces Institute of Pathology Rawalpindi, Pakistan from Oct to Dec 2022.

Methodology: Patients of either gender coming for vitamin D level estimation were included. Vitamin D levels were analyzed on Immunoassay auto-analyzer. Data was analyzed using SPSS version 26.

Results: Out of 249 patients, 87(34.9%) were male while 162(65.1%) were female, with mean age 41.09±19.10 years and mean Vitamin D levels 73.08±45.86nmol/l. None of the patients (0%) had vitamin D deficiency, 174(69.9%) had vitamin D insufficiency, 72(28.9%) had vitamin D sufficiency, while 3(1.2%) had vitamin D excess. Major reasons for Vitamin D testing was bone pains, which were present in 72(28.9%) patients. A significant difference in vitamin D levels according to reason of testing (p<0.05) was observed. Total expense on vitamin D testing for 249 patients was PKR 722100/- (249x2900), as compared to cost of supplementation PKR 199200/- (249x800) in clinical suspected cases.

Conclusion: Majority of patients that tested for vitamin D were in lower risk group, and were not vitamin D deficient, with bone pains being the complaint due to which most patients were tested.

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References

1.Giustina A, Adler RA, Binkley N, Bollerslev J, Bouillon R, Dawson-Hughes B, et al. Consensus statement from 2nd International Conference on controversies in vitamin D. Rev Endocr Metab Disord 2020; 21(1): 89–116. http://doi.org/10.1007/s11154-019-09532-w

2.Bouillon R, Marcocci C, Carmeliet G, Bikle D, White JH, Dawson-Hughes B, et al. Skeletal and extraskeletal actions of vitamin D: Current evidence and outstanding questions. Endocr Rev 2019; 40(4): 1109–1151.

http://doi.org/10.1210/er.2018-00126

Janoušek J, Pilařová V, Macáková K, Nomura A, Veiga-Matos J, Silva DD, et al. Vitamin D: sources, physiological role, biokinetics, deficiency, therapeutic use, toxicity, and overview of analytical methods for detection of vitamin D and its metabolites. Crit Rev Clin Lab Sci 2022; 59(8): 517–554. http://doi.org/10.1080/10408363.2022.2070595

Borel P, Caillaud D, Cano NJ. Vitamin D bioavailability: state of the art. Crit Rev Food Sci Nutr 2015; 55(9): 1193–1205. http://doi.org/10.1080/10408398.2012.688897

Essig S, Merlo C, Reich O, Trottmann M. Potentially inappropriate testing for vitamin D deficiency: a cross-sectional study in Switzerland. BMC Health Serv Res 2020; 20: 1-8. https://doi.org/10.1186/s12913-020-05956-2

Amrein K, Scherkl M, Hoffmann M, Neuwersch-Sommeregger S, Köstenberger M, Tmava Berisha A, et al. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr 2020; 74(11): 1498–1513.

http://doi.org/10.1038/s41430-020-0558-y

Hofstede H, van der Burg HAM, Mulder BC, Bohnen AM, Bindels PJE, de Wit NJ, et al. Reducing unnecessary vitamin testing in general practice: barriers and facilitators according to general practitioners and patients. BMJ Open 2019; 9(10): e029760. http://doi.org/10.1136/bmjopen-2019-029760

Vitamin D. South Tees Hospitals. NHS Foundation Trust;2021. [Internet]. Available at:

https://www.southtees.nhs.uk/services/pathology/tests/vitamin-d/ (Accessed on December 8, 2022)

Rockwell MS, Wu Y, Salamoun M, Hulver MW, Epling JW. Patterns of clinical care subsequent to nonindicated vitamin D testing in primary care. J Am Board Fam Med 2020; 33(4): 569–579. http://dx.doi.org/10.3122/jabfm.2020.04.200007

Rockwell MS, Wu Y, Salamoun M, Hulver MW, Epling JW. Patterns of clinical care subsequent to nonindicated vitamin D testing in primary care. J Am Board Fam Med 2020; 33(4): 569-579. https://doi.org/10.3122/jabfm.2020.04.200007

LeFevre ML. Screening for vitamin D deficiency in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2015; 162(2): 133–140.

https://doi.org/10.7326/M14-2450

Holick MF, Binkley NC, Bischoff-Ferrari HA. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society Clinical practice guideline. J Clin Endocrinol Metab 2011; 96: 1911–1930. https://doi.org/10.1210/jc.2011-0385

Excellus: low value vitamin D testing in upstate NY. [Internet]. Available at:

https://www.bcbs.com/news/press-releases/most-people-dont-need-vitamin-dtesting. (Accessed on December 8, 2022)

Rozario NL, Sparling A, Burns R. Modifying provider vitamin D screening behavior in primary care. J Am Board Fam Med 2020; 33(2): 252–261. https://doi.org/10.3122/jabfm.2020.02.190323

Zuberi LM, Habib A, Haque N, Jabbar A. Vitamin D Deficiency in ambulatory patients. J Pak Med Assoc 2008; 58(9): 482–484.

Essig S, Merlo C, Reich O, Trottmann M. Potentially inappropriate testing for vitamin D deficiency: a cross-sectional study in Switzerland. BMC Health Serv Res 2020; 20(1): 1097. http://doi.org/10.1186/s12913-020-05956-2

Woodford HJ, Barrett S, Pattman S. Vitamin D: too much testing and treating? Clin Med 2018; 18(3): 196–200. http://doi.org/10.7861/clinmedicine.18-3-196

Pludowski P, Takacs I, Boyanov M, Belaya Z, Diaconu CC, Mokhort T, et al. Clinical practice in the prevention, diagnosis and treatment of vitamin D deficiency: A central and eastern European expert consensus statement. Nutrients 2022; 14(7): 1483. http://dx.doi.org/10.3390/nu14071483

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Published

31-10-2024

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Original Articles

How to Cite

1.
Paracha AI, Muhammad Qaiser Alam Khan, Muhammad Younas, Zujaja Hina Haroon, Muhammad Anwar, Muhammad Usman Munir. Serum Vitamin D Testing – A Necessity Or An Injudicious Expenditure. Pak Armed Forces Med J [Internet]. 2024 Oct. 31 [cited 2024 Dec. 22];74(5):1441-4. Available from: https://pafmj.org/PAFMJ/article/view/11656