Putting Prevention into Practice

An Evidence-Based Approach

Screening for Vitamin D Deficiency in Adults

 

Am Fam Physician. 2021 Nov ;104(5):515-516.

Author disclosure: No relevant financial affiliations.

Case Study

A 49-year-old Black man with a history of hypertension, type 2 diabetes mellitus, and class I obesity (body mass index of 31.4 kg per m2) presents for a wellness examination. The patient's hypertension and diabetes are well controlled with lisinopril and metformin; they do not take any other medications. The patient feels well today, with no health complaints and a negative review of systems. The patient tells you that they recently read an online article about vitamin D and is concerned they might have a low vitamin D level.

Case Study Questions

1. According to the U.S. Preventive Services Task Force (USPSTF) recommendation statement, how should you address this patient's concerns?

  • A. Discuss with the patient that it is unclear whether they should be screened because the evidence is insufficient to assess the balance of benefits and harms of screening for vitamin D deficiency in asymptomatic adults.

  • B. The patient should be screened for vitamin D deficiency because screening is indicated in male patients.

  • C. The patient should not be screened for vitamin D deficiency because their age stratifies them in the low-risk category for vitamin D deficiency.

  • D. The patient should be screened for vitamin D deficiency because screening is recommended due to the high prevalence of vitamin D deficiency in the United States.

  • E. The patient should not be screened for vitamin D deficiency because there is a high risk of serious harms from treatment of vitamin D deficiency.

2. Which of the following statements about vitamin D deficiency are correct?

  • A. Vitamin D deficiency is defined as a serum level of 25-hydroxyvitamin D (25[OH]D) less than 20 ng per mL (50 nmol per L).

  • B. Serum 25(OH)D is currently considered the best marker of vitamin D status.

  • C. Laboratories are reliably well standardized in their testing methods.

  • D. Vitamin D requirements may vary by individual.

3. According to the USPSTF, which one of the following statements about risk factors for a low vitamin D level is

Author disclosure: No relevant financial affiliations.

References

1. Krist AH, Davidson KW, Mangione CM, et al. Screening for vitamin D deficiency in adults: US Preventive Services Task Force recommendation statement. JAMA. 2021;325(14):1436–1442.

2. Kahwati LC, LeBlanc E, Weber RP, et al. Screening for vitamin D deficiency in adults: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2021;325(14):1443–1463.

This PPIP quiz is based on the recommendations of the USPSTF. More information is available in the USPSTF Recommendation Statement and supporting documents on the USPSTF website (https://www.uspreventiveservicestaskforce.org). The practice recommendations in this activity are available at https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/vitamin-d-deficiency-screening.

This series is coordinated by Kenny Lin, MD, MPH, deputy editor.

A collection of Putting Prevention into Practice published in AFP is available at https://www.aafp.org/afp/ppip.

 

 

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