High prevalence of undetected vitamin D deficiency in an urban minority primary care practice

Objectives: To assess the prevalence of vitamin D deficiency among patients in an inner-city practice with a large African American population, and to evaluate the efficacy of vitamin D replacement as part of routine care. Methods: A chart review was undertaken to identify patients aged 18 years and more with at least one 25-hydroxyvitamin D level. When patients were found to be deficient (vitamin D <20) they were placed on 50 000 units ergocalciferol monthly or over-the-counter calcium supplements with vitamin D. Descriptive statistics were used to calculate the prevalence rate, and paired t tests were used to compare the vitamin D levels pre and post treatment. Results: A total of 369 (65%) out of 570 patients were found to be vitamin D deficient, and 253 were treated with ergocalciferol or vitamin D supplements. For patients deficient at baseline and treated with vitamin D supplementation (n = 253), significant differences were found between base-line and follow-up vitamin D levels (t_(1,120) = 11.56, p < .001). Among 253 patients deficient at baseline and treated, 201 were corrected with oral vitamin D (79%), leaving 52 patients (21%) deficient after vitamin D supplementation. Conclusions: The results of this study show that there is a very high prevalence of vitamin D deficiency in an urban, mostly African American population. This can be readily improved with the addition of oral vitamin D. The study also suggests that routine vitamin D screening may be helpful for the detection and treatment of vitamin D deficiency, especially in urban minority populations.