title: Quick and Easy Screening for Vitamin D Insufficiency in Adults: A Scoring System to Be Implemented in Daily Clinical Practice.
abstract: Vitamin D is essential regarding several health outcomes. Prevention of insufficiency (25-hydroxyvitamin D concentration ≤20 ng/mL) generally entails blood testing and/or supplementation, strategies that should target at-risk individuals because blood testing is costly, and unwarranted supplementation could result in vitamin D overload with unknown long-term consequences. Our objective was to develop a simple score (Vitamin D Insufficiency Prediction score, VDIP) for identifying adults at risk of vitamin D insufficiency. Subjects were 1557 non-vitamin D-supplemented middle-aged adults from the SU.VI.MAX cohort. Scoring points corresponded to the rounded odds ratio for each individual-level characteristic associated with vitamin D insufficiency in a multivariable logistic regression model. Receiver operating characteristic curve (area under curve), sensitivity, specificity, and positive and negative predictive values were computed. External validation was performed in an independent cohort (NutriNet-Santé, N = 781). For female sex, overweight, low physical activity, winter season, moderate sun exposure, and very fair or dark skin 1.5 points were attributed; 2 points for latitude ≥48°N and spring season; 2.5 points for obesity and late winter; 3 points for low sun exposure. Points were then summed up for each participant. The VDIP score had an AUC = 0.70 ± 0.01 (validation: 0.67 ± 0.02). With a score of 7 or more, 70% of the participants were vitamin D-insufficient (80% in those with a score ≥9), sensitivity/specificity were 0.67/0.63, and positive and negative predictive values were 0.70/0.59. The VDIP score performed well in identifying middle-aged adults at risk of vitamin D insufficiency (score ≥7, moderate risk; score≥9, high risk), using only simple individual-level characteristics easily assessable in day-to-day clinical practice. Implementation of this simple and costless score could thus obviate unwarranted supplementation and/or blood testing.
authors.affiliation: From the Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS) (MD, VAA, EK-G, PL-M, ND-P, FSdE, PG, SH, KE, MT), Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inra U1125, Cnam, Paris 13 University, Bobigny; Department of Physiology (J-CS), Necker Hospital, Inserm U845, Paris; Jean Verdier Hospital, Biochemistry Department (AS, NC), Inserm U698, Paris 13 University, Bondy; Public Health Department (SH), Avicenne Hospital, Bobigny; and Dermatology Department (KE), Henri Mondor Hospital, Paris, France.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Deschasaux
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Souberbielle
authors.forename: Valentina A
authors.initials: VA
authors.lastname: Andreeva
authors.forename: Angela
authors.initials: A
authors.lastname: Sutton
authors.forename: Nathalie
authors.initials: N
authors.lastname: Charnaux
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Kesse-Guyot
authors.forename: Paule
authors.initials: P
authors.lastname: Latino-Martel
authors.forename: Nathalie
authors.initials: N
authors.lastname: Druesne-Pecollo
authors.forename: Fabien
authors.initials: F
authors.lastname: Szabo de Edelenyi
authors.forename: Pilar
authors.initials: P
authors.lastname: Galan
authors.forename: Serge
authors.initials: S
authors.lastname: Hercberg
authors.forename: Khaled
authors.initials: K
authors.lastname: Ezzedine
authors.forename: Mathilde
authors.initials: M
authors.lastname: Touvier
mesh_terms: D000465:Algorithms; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods*; D018570:Risk Assessment; D014808:Vitamin D Deficiency / Q000097:blood / Q000175:diagnosis*