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When should we measure vitamin D concentration in clinical practice?
Jean-Claude Souberbielle1, Marie Courbebaisse, Catherine Cormier
1Service des Explorations Fonctionnelles Hôpital Necker-Enfants malades, Assistance Publique-Hôpitaux de Paris, Paris, France. jean-claude.souberbielle@nck.aphp.fr.
Summary
Vitamin D testing, specifically 25-hydroxyvitamin D (25(OH)D), is recommended for specific patient groups. While widespread testing is debated, certain conditions warrant vitamin D status evaluation.
Area of Science:
- Endocrinology
- Nutritional Science
- Clinical Medicine
Background:
- Recent data highlight vitamin D's broad potential health impacts beyond bone metabolism.
- Clinical practice has seen a significant rise in vitamin D level testing.
- Measuring 25-hydroxyvitamin D (25(OH)D) is the established method for assessing vitamin D status.
Purpose of the Study:
- To clarify the appropriate indications for vitamin D status measurement.
- To identify patient populations who would benefit from vitamin D level assessment and targeted treatment.
- To guide clinical practice regarding vitamin D testing protocols.
Main Methods:
- Review of current medical literature and clinical guidelines.
- Analysis of evidence supporting vitamin D's role in various diseases.
- Identification of specific patient cohorts requiring vitamin D assessment.
Main Results:
- Only 25-hydroxyvitamin D (25(OH)D) measurement accurately reflects vitamin D status.
- Specific patient groups, including those with bone disorders, kidney disease, malabsorption, and certain endocrine or granulomatous conditions, benefit from testing.
- Testing is also indicated for patients with unexplained symptoms of deficiency/excess or those on medications affecting vitamin D metabolism.
Conclusions:
- Vitamin D testing is not universally indicated but is crucial for specific at-risk populations.
- Targeted testing ensures appropriate management for conditions where vitamin D plays a key role.
- Vitamin D assessment should be integrated into the evaluation of calcium and phosphorus metabolism.
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