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Rational use of vitamin D test: Is it a test? Or treatment?

Year 2019, , 168 - 178, 12.06.2019
https://doi.org/10.18663/tjcl.440877

Abstract

Aim: The worldwide increase in vitamin
D deficiency and vitamin D testing has led to lower vitamin D costs and lower
unnecessary testing. In this study, we aimed to shed light on clinical practice
by conducting a literature search on the rational use of vitamin D test.

Material and Methods: 4372 studies
published between April 2007 and April 2017 were examined to determine the
prevalence, vitamin D deficiency prevalence, treatment modalities and
approaches in the world. The scans were made using Cochrane Library, PubMed,
Ulakbim, Science Direct electronic databases. The scans were made using the
keywords "Vitamin D status", "Vitamin D screening", "Vitamin
D measurements", "Vitamin D Testing", "supplements".
Finally seventy-four studies that met the study limits were evaluated.

Results: It is found that the number of
vitamin D deficiency tests is increasing in our country and in the world,
increasing the financial burden on health care. It is demonstrated that it is
safe to start vitamin D supplementation without testing in risky groups in
which D vitamin toxicity is low. Guidelines published in the world do not refer
to test for lack of vitamin D, but rather raise awareness, make untested
vitamin D supplementation in certain groups, and test for vitamin D in certain
groups. Avoidance of high dose vitamin D therapy and awareness of the use of
vitamin D supplementation as a drop should be performed.







Conclusion: Regardless of the rate of
vitamin D, it is much easier, safer and cheaper to start vitamin D
supplementation with a doctor's assessment.

References

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  • 31. Voortman T, van den Hoovenet EH et al. Vitamin D deficiency in school-age children is associated with sociodemographic and lifestyle factors.The Journal of nutrition 2015; 145: 791-798.
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  • 33. Forrest KY, Stuhldreher WL.Prevalence and correlates of vitamin D deficiency in US adults. Nutrition Research 2011; 31: 48-54.
  • 34. Ginde AA, Liu MC, Camargo CA, Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004. Archives of İnternal Medicine 2009; 169: 626-32.
  • 35. Ginde AA, Sullivan AF, MansbachJM et al. Vitamin D insufficiency in pregnant and nonpregnant women of childbearing age in the United States. American Journal of Obstetrics and Gynecology 2010; 202: 436-38.
  • 36. Durvasula S, Kok C, Sambrook PN et al. Sunlight and health: attitudes of older people living in intermediate care facilities in southern Australia. Archives of Gerontology and Geriatrics 2010; 51: 94-99.
  • 37. Sohl E, van Schoor NM, de JonghRT et al. The impact of medication on vitamin D status in older individuals. European Journal of Endocrinology 2012; 166: 477-85.
  • 38. Jones G. Pharmacokinetics of vitamin D toxicity. The American Journal Of Clinical Nutrition 2008; 88: 582-86.
  • 39. Stephenson DW, Peiris AN.The lack of vitamin D toxicity with megadose of daily ergocalciferol (D2) therapy: a case report and literature review. Southern Medical Journal 2009; 102: 765-68.
  • 40. Hathcock JN, Shao A, ViethR and et al. Risk assessment for vitamin D. The American Journal of Clinical Nutrition 2007; 85: 6-18.
  • 41. Lefevre M L. Screening for Vitamin D Deficiency in Adults: US Preventive Services Task Force Recommendation StatementScreening for Vitamin D Deficiency in Adults. Annals of İnternal Medicine 2015; 162: 133-40.
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  • 43. Welch AK. The rising cost of vitamin D testing in Australia: time to establish guidelines for testing. Med J Aust 2012; 197: 90.
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D vitamini testinin akılcı kullanımı: Test mi? Ya da tedavi mi?

Year 2019, , 168 - 178, 12.06.2019
https://doi.org/10.18663/tjcl.440877

Abstract

Amaç: Dünya çapında D vitamini
eksikliğinin ve D vitamini test oranlarının artması, D vitamininin
yetersizliğini yönetmek ve gereksiz testleri azaltarak maliyeti düşürme gündeme
gelmiştir. Bu çalışmada D vitamini testinin akılcı kullanımı konusunda
literatür taraması yapılarak klinik uygulamaya ışık tutmak amaçlanmıştır.



Gereç ve Yöntemler: D vitamini eksiklik
prevalansı, tedavi şekilleri ve yaklaşımlar konusunda mevcut durumu ortaya
koyabilmek için 2007 Nisan ile 2017 Nisan tarihleri arasında yayınlanmış 4372
çalışma incelenmiştir. Taramalar Cochrane Library,  PubMed, 
Ulakbim, Science Direct elektronik veri tabanları kullanılarak
yapılmıştır. Taramalar “Vitamin D status”, “Vitamin D screening”, “Vitamin D
measurements”, “Vitamin D Testing”, “supplements” anahtar kelimeleri
kullanılarak yapılmıştır.  Çalışma
sınırlarına uyan 74 çalışma değerlendirilmiştir.



Bulgular: D vitamini eksikliği test
sayısı ülkemizde ve dünyada giderek önemli bir artış göstermekte ve sağlık
bakımına mali yük getirmektedir. D vitamini toksisitesinin az görüldüğü riskli
gruplarda D vitamini takviyesine test yapmadan başlanmasının güvenli olduğu
ortaya konulmaktadır. Dünyada yayınlanan rehberler D vitamini eksikliği için
test yapmak yerine, farkındalığın artırılması, belli gruplarda testsiz D
vitamini takviyesi yapıp, belli gruplarda D vitamini testi yapılmasını
önermektedir. Depo D vitamini tedavisinden kaçınılması, D vitamini takviyesinin
damla olarak kullanılması konusunda farkındalık yaratılması gerekmektedir.



SonuçAmaç: Dünya çapında D vitamini
eksikliğinin ve D vitamini test oranlarının artması, D vitamininin
yetersizliğini yönetmek ve gereksiz testleri azaltarak maliyeti düşürme gündeme
gelmiştir. Bu çalışmada D vitamini testinin akılcı kullanımı konusunda
literatür taraması yapılarak klinik uygulamaya ışık tutmak amaçlanmıştır.



Gereç ve Yöntemler: D vitamini eksiklik
prevalansı, tedavi şekilleri ve yaklaşımlar konusunda mevcut durumu ortaya
koyabilmek için 2007 Nisan ile 2017 Nisan tarihleri arasında yayınlanmış 4372
çalışma incelenmiştir. Taramalar Cochrane Library,  PubMed, 
Ulakbim, Science Direct elektronik veri tabanları kullanılarak
yapılmıştır. Taramalar “Vitamin D status”, “Vitamin D screening”, “Vitamin D
measurements”, “Vitamin D Testing”, “supplements” anahtar kelimeleri
kullanılarak yapılmıştır.  Çalışma
sınırlarına uyan 74 çalışma değerlendirilmiştir.



Bulgular: D vitamini eksikliği test
sayısı ülkemizde ve dünyada giderek önemli bir artış göstermekte ve sağlık
bakımına mali yük getirmektedir. D vitamini toksisitesinin az görüldüğü riskli
gruplarda D vitamini takviyesine test yapmadan başlanmasının güvenli olduğu
ortaya konulmaktadır. Dünyada yayınlanan rehberler D vitamini eksikliği için
test yapmak yerine, farkındalığın artırılması, belli gruplarda testsiz D
vitamini takviyesi yapıp, belli gruplarda D vitamini testi yapılmasını
önermektedir. Depo D vitamini tedavisinden kaçınılması, D vitamini takviyesinin
damla olarak kullanılması konusunda farkındalık yaratılması gerekmektedir.



Sonuç: D vitamini damla takviyesinin
kanda D vitamini oranına bakılmaksızın, doktor değerlendirmesi ile başlanması
çok daha kolay, güvenli ve ucuz bir yaklaşım olarak denenebilir.
: D vitamini damla takviyesinin
kanda D vitamini oranına bakılmaksızın, doktor değerlendirmesi ile başlanması
çok daha kolay, güvenli ve ucuz bir yaklaşım olarak denenebilir.

References

  • 1. Metabolik Sendrom Kılavuzu, Türkiye Endokrinoloji ve Metabolizma Derneği. Ankara, Tuna Matbaacılık, 2009: 8-11.
  • 2. Calvo MS, Whiting SJ, Barton CN, Vitamin D fortification in the United States and Canada: current status and data needs. The American Journal of Clinical Nutrition 2004; 80: 1710-16.
  • 3. Yetley EA, Assessing the vitamin D status of the US population. The American Journal of Clinical Nutrition 2008; 88: 558-64.
  • 4. Holick MF.Vitamin D deficiency. New England Journal of Medicine 2007; 357: 266-81.
  • 5. Karami S, Colt JS, Stewart PA et al. A case–control study of occupational sunlight exposure and renal cancer risk.International Journal of Cancer 2016; 138: 1626-33.
  • 6. Mokry LE, Ross S, Morris JA, Manousaki D, Forgetta V, Richards JB. Genetically decreased vitamin d and risk of alzheimer disease. Neurology 2016; 87: 2567-74.
  • 7. Uçar F, Taşlıpınar MY, Soydaş AÖ, Özcan N. Ankara etlik ihtisas eğitim ve araştırma hastanesine başvuran hastalarda 25-oh vitamin d düzeyleri. Eur J Basic Med Sci 2012; 2: 12-15.
  • 8. Pearce S, Cheetham TD. Diagnosis and management of vitamin d deficiency.Bmj, 2010; 340: 5664
  • 9. Oren Y, Shapira Y, Agmon-Levin N et al. Vitamin d insufficiency in a sunny environment: a demographic and seasonal analysis.IMAJ-Israel Medical Association Journal 2010; 12: 751.
  • 10. Lips P. Vitamin d status and nutrition in europe and asia.The Journal Of Steroid Biochemistry and Molecular Biology, 2007; 103: 620-25.
  • 11. Bilinski K, BoyagesS.Evidence of overtesting for vitamin D in Australia: an analysis of 4.5 years of Medicare Benefits Schedule (MBS) data. BMJ open 2013; 3: 2955.
  • 12. Bilinski KL, Boyages S C.The rising cost of vitamin D testing in Australia: time to establish guidelines for testing. Med J Aust 2012; 197: 90.
  • 13. Sattar N, Welsh P, Panarelli M, Forouhi NG. Increasing requests for vitamin D measurement: costly, confusing, and without credibility. The Lancet 2012; 379: 95-96.
  • 14. van Schoor NM, LipsP.Worldwide vitamin D status. Best Pract Res Clin Endocrinol Metab 2011; 25: 671-80.
  • 15. Ross AC, Manson JE, Abrams SA et al.The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. The Journal of Clinical Endocrinology & Metabolism 2011; 96:53-58.
  • 16. Aspray TJ, Bowring C, Fraser W et al. National osteoporosis society vitamin D guideline summary. Age and ageing 2014; 43: 592-95.
  • 17. Briot K, Audran M, Cortet B et al. Vitamin D: skeletal and extra skeletal effects; recommendations for good practice. Presse medicale (Paris, France: 1983), 2009; 38: 43-54.
  • 18. Francis R. Vitamin D and bone health: a practical clinical guideline for patient management. National Osteoporosis Society, 2013.
  • 19. ACOG Committee Opinion No. 495: Vitamin D: Screening and supplementation during pregnancy. Obstetrics and gynecology 2011; 118: 197.
  • 20. Souberbielle JC, Body JJ, Lappe JM, Plebaniet M. Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: recommendations for clinical practice. Autoimmunity reviews 2010; 9: 709-15.
  • 21. Yener M. Kas iskelet sistem ağrısı ile vitamin D düzeyleri arasındaki ilişkinin araştırılması. SDÜ Tıp Fakültesi Dergisi 2007; 14.
  • 22. Akpınar P, İçağasıoğluA, D vitamininin yaşam kalitesi ile ilişkisi. Türk Osteoporoz Dergisi 2012; 18: 13-18.
  • 23. Koluaçık Yıldırım S. Malatya il merkezinde 20 yaş ve üzeri kadınlarda d vitamini düzeyi ile üst solunum yolu enfeksiyonları arasındaki ilişki. Doktora Tezi, İnönü Üniversitesi Sağlık Bilimleri Enstitüsü, Malatya; 2013.
  • 24. Das G, Crocombe S, McGrath M, BerryJL.Hypovitaminosis D among healthy adolescent girls attending an inner city school. Arch Dis Child 2006; 91: 569-72.
  • 25. Lippi G,MontagnanaM, TargherG, Vitamin D deficiency among Italian children. Cmaj 2007; 177: 1529-30.
  • 26. Sahu M, Bhatia V, Aggarwal A et al. Vitamin D deficiency in rural girls and pregnant women despite abundant sunshine in northern India. Clin Endocrinol (Oxf) 2009; 70: 680-84.
  • 27. Mansoor S, Habib A, Ghani F et al. Prevalence and significance of vitamin D deficiency and insufficiency among apparently healthy adults. Clinical biochemistry 2010; 43: 1431-35.
  • 28. Østergård M, Arnberg K, Michaelsenet KF et al. Vitamin D status in infants: relation to nutrition and season. Eur J Clin Nutr 2011; 65: 657-60.
  • 29. Daly RM, Gagnon C, Lu ZX, Magliano DJ. Prevalence of vitamin D deficiency and its determinants in Australian adults aged 25 years and older: a national, population-based study. Clin Endocrinol (Oxf) 2012; 77: 26-35.
  • 30. Mellati AA, Sharifi F, Faghihzade S et al. Vitamin D status and its associations with components of metabolic syndrome in healthy children. Journal of Pediatric Endocrinology and Metabolism 2015; 28: 641-48.
  • 31. Voortman T, van den Hoovenet EH et al. Vitamin D deficiency in school-age children is associated with sociodemographic and lifestyle factors.The Journal of nutrition 2015; 145: 791-798.
  • 32. Mithal A, Wahl DA, Bonjour JP, Burckhardt P. Global vitamin D status and determinants of hypovitaminosis D. Osteoporosis International 2009; 20: 1807-20.
  • 33. Forrest KY, Stuhldreher WL.Prevalence and correlates of vitamin D deficiency in US adults. Nutrition Research 2011; 31: 48-54.
  • 34. Ginde AA, Liu MC, Camargo CA, Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004. Archives of İnternal Medicine 2009; 169: 626-32.
  • 35. Ginde AA, Sullivan AF, MansbachJM et al. Vitamin D insufficiency in pregnant and nonpregnant women of childbearing age in the United States. American Journal of Obstetrics and Gynecology 2010; 202: 436-38.
  • 36. Durvasula S, Kok C, Sambrook PN et al. Sunlight and health: attitudes of older people living in intermediate care facilities in southern Australia. Archives of Gerontology and Geriatrics 2010; 51: 94-99.
  • 37. Sohl E, van Schoor NM, de JonghRT et al. The impact of medication on vitamin D status in older individuals. European Journal of Endocrinology 2012; 166: 477-85.
  • 38. Jones G. Pharmacokinetics of vitamin D toxicity. The American Journal Of Clinical Nutrition 2008; 88: 582-86.
  • 39. Stephenson DW, Peiris AN.The lack of vitamin D toxicity with megadose of daily ergocalciferol (D2) therapy: a case report and literature review. Southern Medical Journal 2009; 102: 765-68.
  • 40. Hathcock JN, Shao A, ViethR and et al. Risk assessment for vitamin D. The American Journal of Clinical Nutrition 2007; 85: 6-18.
  • 41. Lefevre M L. Screening for Vitamin D Deficiency in Adults: US Preventive Services Task Force Recommendation StatementScreening for Vitamin D Deficiency in Adults. Annals of İnternal Medicine 2015; 162: 133-40.
  • 42. Cranney A, Horsley T, O'Donnell S et al. Effectiveness and safety of vitamin D in relation to bone health. Evid Rep Technol Assess (Full Rep) 2007; 158: 23-25.
  • 43. Welch AK. The rising cost of vitamin D testing in Australia: time to establish guidelines for testing. Med J Aust 2012; 197: 90.
  • 44. Rosen CJ, Abrams SA, Aloia JF et al. IOM committee members respond to Endocrine Society vitamin D guideline. J Clin Endocrinol Metab 2012; 97: 1146-52.
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There are 73 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Orıgınal Artıcle
Authors

Huri Seval Çakmak

Yunus Nadi Yüksek

Tanju Tütüncü

Emine Özer Küçük This is me

Turan Turhan This is me

Dilek Berker This is me

Rabia Kahveci

Publication Date June 12, 2019
Published in Issue Year 2019

Cite

APA Çakmak, H. S., Yüksek, Y. N., Tütüncü, T., Özer Küçük, E., et al. (2019). D vitamini testinin akılcı kullanımı: Test mi? Ya da tedavi mi?. Turkish Journal of Clinics and Laboratory, 10(2), 168-178. https://doi.org/10.18663/tjcl.440877
AMA Çakmak HS, Yüksek YN, Tütüncü T, Özer Küçük E, Turhan T, Berker D, Kahveci R. D vitamini testinin akılcı kullanımı: Test mi? Ya da tedavi mi?. TJCL. June 2019;10(2):168-178. doi:10.18663/tjcl.440877
Chicago Çakmak, Huri Seval, Yunus Nadi Yüksek, Tanju Tütüncü, Emine Özer Küçük, Turan Turhan, Dilek Berker, and Rabia Kahveci. “D Vitamini Testinin akılcı kullanımı: Test Mi? Ya Da Tedavi Mi?”. Turkish Journal of Clinics and Laboratory 10, no. 2 (June 2019): 168-78. https://doi.org/10.18663/tjcl.440877.
EndNote Çakmak HS, Yüksek YN, Tütüncü T, Özer Küçük E, Turhan T, Berker D, Kahveci R (June 1, 2019) D vitamini testinin akılcı kullanımı: Test mi? Ya da tedavi mi?. Turkish Journal of Clinics and Laboratory 10 2 168–178.
IEEE H. S. Çakmak, Y. N. Yüksek, T. Tütüncü, E. Özer Küçük, T. Turhan, D. Berker, and R. Kahveci, “D vitamini testinin akılcı kullanımı: Test mi? Ya da tedavi mi?”, TJCL, vol. 10, no. 2, pp. 168–178, 2019, doi: 10.18663/tjcl.440877.
ISNAD Çakmak, Huri Seval et al. “D Vitamini Testinin akılcı kullanımı: Test Mi? Ya Da Tedavi Mi?”. Turkish Journal of Clinics and Laboratory 10/2 (June 2019), 168-178. https://doi.org/10.18663/tjcl.440877.
JAMA Çakmak HS, Yüksek YN, Tütüncü T, Özer Küçük E, Turhan T, Berker D, Kahveci R. D vitamini testinin akılcı kullanımı: Test mi? Ya da tedavi mi?. TJCL. 2019;10:168–178.
MLA Çakmak, Huri Seval et al. “D Vitamini Testinin akılcı kullanımı: Test Mi? Ya Da Tedavi Mi?”. Turkish Journal of Clinics and Laboratory, vol. 10, no. 2, 2019, pp. 168-7, doi:10.18663/tjcl.440877.
Vancouver Çakmak HS, Yüksek YN, Tütüncü T, Özer Küçük E, Turhan T, Berker D, Kahveci R. D vitamini testinin akılcı kullanımı: Test mi? Ya da tedavi mi?. TJCL. 2019;10(2):168-7.


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