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Examen de detección de deficiencia de vitamina D en adultos: informe de evidencia actualizado y revisión sistemática
Leila C Kahwati1,2, Erin LeBlanc3, Rachel Palmieri Weber1,4
1RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill, North Carolina.
JAMA
|April 13, 2021
Resumen
La detección de la deficiencia de vitamina D en adultos no mostró beneficios ni daños directos. El tratamiento con vitamina D no tuvo un impacto significativo en la mortalidad, las fracturas, las caídas u otros resultados de salud importantes en las poblaciones que viven en la comunidad.
Área de la Ciencia:
- Endocrinología
- La medicina preventiva
- Salud pública
Sus antecedentes:
- Los niveles bajos de vitamina D en suero están relacionados con resultados adversos para la salud.
- La identificación y el tratamiento de la deficiencia de vitamina D pueden mejorar potencialmente los resultados clínicos.
Objetivo del estudio:
- Revisar sistemáticamente las pruebas existentes sobre el cribado de la deficiencia de vitamina D en adultos.
- Evaluar la eficacia del tratamiento con vitamina D en personas con niveles bajos.
Principales métodos:
- Se realizó una búsqueda exhaustiva de la literatura en las principales bases de datos (PubMed, EMBASE, Cochrane Library) y registros de ensayos.
- Se incluyeron ensayos clínicos aleatorizados (ECA) equitativos o de buena calidad y estudios de intervención controlada no aleatorizados para los daños.
- La extracción de datos y la evaluación de la calidad fueron realizadas por dos revisores independientes, con metaanálisis realizados cuando fue apropiado.
Principales resultados:
- Ningún estudio evaluó directamente los beneficios o los daños del cribado de la deficiencia de vitamina D.
- El tratamiento con vitamina D no mostró una asociación significativa con la mortalidad, las fracturas, las caídas, la diabetes, las enfermedades cardiovasculares, el cáncer o la depresión en los adultos que viven en la comunidad.
- La evidencia sobre el impacto de la vitamina D en el funcionamiento físico y la infección fue mixta o limitada, con tasas similares de eventos adversos y cálculos renales entre los grupos de tratamiento y control.
Conclusiones:
- La evidencia actual no apoya los beneficios o daños directos para la salud de la detección de deficiencia de vitamina D.
- En adultos asintomáticos que viven en la comunidad y que tienen un bajo nivel de vitamina D, el tratamiento no parece mejorar los principales resultados de salud ni aumentar los eventos adversos.
- Se necesitan más investigaciones para aclarar los efectos de la suplementación con vitamina D en el funcionamiento físico y las tasas de infección.
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