Screening for vitamin D deficiency: a systematic review for the U.S. Preventive Services Task Force

Area of Science:

• Endocrinology
• Public Health
• Geriatrics

Background:

• Vitamin D deficiency is linked to negative health outcomes.
• The role of vitamin D screening in asymptomatic adults requires investigation.

Purpose of the Study:

• To systematically review the benefits and harms of vitamin D screening in asymptomatic adults.
• To evaluate the impact of vitamin D screening on clinical health outcomes.

Main Methods:

• Searched Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews.
• Included randomized trials of vitamin D screening and treatment, and nested case-control studies.
• Data abstraction and quality assessment were performed by independent investigators.

Main Results:

• No studies assessed the impact of vitamin D screening on clinical outcomes.
• Vitamin D treatment showed a potential mortality benefit in institutionalized elderly (RR, 0.83) but not in general populations.
• Treatment may reduce fall risk (RR, 0.84) but not fracture risk (RR, 0.98); no significant increase in adverse events was observed.

Conclusions:

• Evidence for vitamin D screening's clinical benefits in asymptomatic adults is lacking.
• Vitamin D treatment may benefit institutionalized elderly by reducing mortality and fall risk.
• Variability in study methodologies (assays, doses, calcium use) limits definitive conclusions.