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. 2023 Dec 28;16(1):111.
doi: 10.3390/nu16010111.

Intense Testing and Use of Vitamin D Supplements Leads to Slow Improvement in Vitamin D Adequacy Rates: A Cross-Sectional Analysis of Real-World Data

Rodis D Paparodis  1   2   3   4 , Dimitra Bantouna  3 , Evangelos Karvounis  5 , Ioannis Zoupas  6 , Sarantis Livadas  3   7   8 , Nicholas Angelopoulos  3   9 , Shahnawaz Imam  2 , Dimitrios T Papadimitriou  3   10 , Juan C Jaume  4
Affiliations

Intense Testing and Use of Vitamin D Supplements Leads to Slow Improvement in Vitamin D Adequacy Rates: A Cross-Sectional Analysis of Real-World Data

Rodis D Paparodis et al. Nutrients. .

Abstract

Background: Vitamin D testing (VDT) and supplement use (VDS) are on the rise, but most patients remain deficient (<30 ng/mL-VDD). We designed the present real-world study to assess this paradox.

Methods: We reviewed data from all patients visiting our clinics between 2014 and 2022. We estimated the rate of patients with vitamin D adequacy (≥30 ng/mL) (VDA) by year and month of testing, the dose of VDS (low (≤1200 IU/day), medium (1201-3000 I/day) and high dose (>3000 IU/day)), intake duration (short-term (<12 months) and long-term use (≥12 months)), and timing of use (current use, former use, no use).

Results: We enrolled n = 6912 subjects with vitamin D measurements: n = 5195 females (75.2%), age 44.0 ± 16.8 years, BMI 27.9 ± 6.5 kg/m2; never users: n = 5553 (80.3%), former users: n = 533 (7.7%), current users: n = 826 (12.0%). Current use of VDS was higher in females. VDT rose from 42.1% in 2014 to 92.7% in 2022, and VDA rose from 14.8% to 25.5% for the same time. VDA was found overall in n = 1511 (21.9%); Never users: n = 864 (15.6%), Former users: n = 123 (23.2%); and Current users: n = 370 (44.8%). The maximal VDA (67.9%) was found in subjects using high-dose VDS in the long term.

Conclusions: Despite the significant rise in VDT and VDS use, VDA was found in a minority of patients. Prolonged use of high-dose supplements produces modest improvements in VDA.

Keywords: cholecalciferol; vitamin D adequacy; vitamin D deficiency; vitamin D insufficiency; vitamin D supplementation.

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Conflict of interest statement

Paparodis has received speaker honoraria and has served as a consultant and/or advisor for the following pharmaceutical companies, which manufacture and/or distribute vitamin D supplements in Greece: ITF, Rafarm, Proton Pharma, Innovis, IBSA, Faran, Isoplus. All other authors have no relevant financial or non-financial interests to disclose.

Figures

Figure 1
Figure 1
A flow diagram of the study enrollment. Legend: NU: never users of vitamin D-containing supplements; FU: former users of vitamin D-containing supplements; CU: current users of vitamin D-containing supplements. H: high dose of vitamin D-containing supplements (>3000 IU daily); M: medium dose of vitamin D-containing supplements (1200–3000 IU daily); L: low dose of vitamin D-containing supplements (≤1200 IU daily); ST: short-term use of vitamin D-containing supplements (<12 months); LT: long-term use of vitamin D-containing supplements (≥12 months).
Figure 2
Figure 2
(A) The monthly rate of vitamin D deficiency (<30 ng/mL) of the entire cohort. (B) The monthly mean serum vitamin D concentration of each subgroup split by the history of vitamin D supplement use: never users (N) (those who never used any vitamin D-containing supplement), former users (F) (those who used vitamin D-containing supplements in the past), and current users (C) (those who currently use vitamin D-containing supplements).
Figure 3
Figure 3
(A) The frequency (%) of available vitamin D measurements in the entire clinic’s patient population each year. (B) The rate (%) of subjects with vitamin D adequacy (>30 ng/mL) per year. (C) The mean serum vitamin D concentration (ng/mL) of the entire cohort per year of study. (D) The rate (%) of subjects with any history of vitamin D-containing supplements use per year.
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