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Abstract
Introduction Evidence suggests that young people with obesity are likely to have low vitamin D status, a risk factor for future poor health. It is thought that blood testing vitamin D may not be a reliable tool in obese patients. Our obesity service routinely screens all young people for vitamin D status. With limited resources available to the NHS, the aim of this project was to evaluate this practice.
Method We retrospectively analysed data for patients seen for the first time in the obesity service between February 2013 and November 2014. We grouped patients according to the time of year in which they were seen, in two month blocks.
Results Data from 119 new young people aged 12–18 years were analysed. 62.2% (74/119) of patients had their vitamin D status assessed (Figure 1). 64.9% (48/74) of patients tested had a low vitamin D status at some point, defined as insufficiency (25≥ x <50ng/ml) and deficiency (x <25ng/ml). No patients had signs or symptoms attributed to low vitamin D. Of those tested, 29.7% (22/74) were deficient and 35.1% (26/74) were insufficient at some point. Grouping patients into 2 month blocks highlighted seasonal variation (Figure 2). The majority of results over winter months were deficient, and sufficient over summer months (Figure 3). 81.8% (18/22) of patients with deficiency and 34.6% (9/26) of patients with insufficiency received treatment. 48.8% (20/41) of patients who had low vitamin D levels at their initial consultation attended follow up, 27.3% (4/20) of those were rechecked by us. There was incomplete adherence to guidance on treating low vitamin D status, including prescribing supplementation and rechecking status once treated.
Conclusion Inconsistent measurement of vitamin D status, treatment and assessment of response provided insufficient evidence to recommend ongoing screening. Cessation of vitamin D measurements is therefore recommended in this population.