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. 2015 May;90(5):577-86.
doi: 10.1016/j.mayocp.2015.02.012.

Changing Incidence of Serum 25-Hydroxyvitamin D Values Above 50 ng/mL: A 10-Year Population-Based Study

Daniel V Dudenkov  1 , Barbara P Yawn  2 , Sara S Oberhelman  3 , Philip R Fischer  4 , Ravinder J Singh  5 , Stephen S Cha  6 , Julie A Maxson  3 , Stephanie M Quigg  3 , Tom D Thacher  3
Affiliations

Changing Incidence of Serum 25-Hydroxyvitamin D Values Above 50 ng/mL: A 10-Year Population-Based Study

Daniel V Dudenkov et al. Mayo Clin Proc. 2015 May.

Abstract

Objective: To determine the incidence trend of 25-hydroxyvitamin D (25(OH)D) values above 50 ng/mL and associated toxicity.

Patients and methods: We conducted a retrospective population-based study in Olmsted County, Minnesota, in the 10-year period from January 1, 2002, through December 31, 2011, by using the Rochester Epidemiology Project. Individuals were eligible if they resided in Olmsted County during the study period and had a measured 25(OH)D value above 50 ng/mL. The date of the first 25(OH)D value above 50 ng/mL was considered the index date for incidence determination. Hypercalcemia, the primary vitamin D toxicity, was considered potentially associated with the 25(OH)D concentration if it was measured within 3 months of the 25(OH)D measurement, and such cases had a medical record review.

Results: Of 20,308 total 25(OH)D measurements, 1714 (8.4%), 123 (0.6%), and 37 (0.2%) unique persons had 25(OH)D values above 50, 80 and above, and 100 ng/mL and above, respectively. The age- and sex-adjusted incidence of 25(OH)D values above 50 ng/mL increased from 9 to 233 cases per 100,000 person-years from 2002 to 2011 (P<.001), respectively, and was greatest in persons aged 65 years and older (P<.001) and in women (P<.001). Serum 25(OH)D values were not significantly related to serum calcium values (P=.20) or with the risk of hypercalcemia (P=.24). A medical record review identified 4 cases (0.2%) in whom 25(OH)D values above 50 ng/mL were temporally associated with hypercalcemia, but only 1 case had clinical toxicity associated with the highest observed 25(OH)D value of 364 ng/mL.

Conclusion: The incidence of 25(OH)D values above 50 ng/mL increased significantly between 2002 and 2011 without a corresponding increase in acute clinical toxicity.

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Figures

Figure 1
Figure 1
Age- and sex-adjusted incidence trend (per 100,000 person-years) of 25(OH)D values >50 ng/mL from 2002 through 2011. Displayed according to (A) age group (0-18 group is the reference for P-values) and (B) sex (males are the reference for P-values).
Figure 2
Figure 2
Age- and sex-adjusted incidence trend (per 100,000 person-years) of elevated vitamin D levels from 2002 to 2011 in Olmsted County, MN for individuals with 25(OH)D values ≥80 and ≥100 ng/mL. P-values represent the significance of the trend.
Figure 3
Figure 3
Bivariate plots of serum calcium, 25(OH)D, and PTH data in subjects with 25(OH)D values >50 ng/mL. (A) Relationship of total calcium with 25(OH)D concentrations (N=1035).(B) Relationship of PTH and total calcium (N=95).
See this image and copyright information in PMC

Comment in

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