1. Introduction
respiratory disease, critically ill, VDI, Obese, cancer, −0.21, non-obese, diabetes
BONE DISEASE, RESPIRATORY DISEASE, OBESE, CRITICALLY ILL, CARDIOVASCULAR DISEASE, OBESE, CANCER, DISORDERS, SECONDARY, VITAMIN D DEFICIENCY, VITAMIN D DEFICIENCY, LOW LEVELS OF VITAMIN D, DISEASES, DIABETES
Vitamin D insufficiency has been linked to multiple conditions including bone disease, respiratory disease, cardiovascular disease, diabetes, and cancer. Observational studies indicate lower healthcare costs and healthcare utilization with sufficient vitamin D levels. The secondary aims of our previously published pragmatic clinical trial of vitamin D3 supplementation were comparisons of healthcare costs and healthcare utilization. Comparisons were made between the vitamin D3 at 5000 IU supplementation group and a non-supplemented control group. Costs of care between the groups differed but were not statistically significant. Vitamin D3 supplementation reduced healthcare utilization in four major categories: hospitalizations for any reason (rate difference: −0.19 per 1000 person-days, 95%-CI: −0.21 to −0.17 per 1000 person-days, Healthcare costs and healthcare utilization continue to rise [Vitamin D supplementation can be considered in light of previous studies linking vitamin D insufficiency to multiple diseases. Low vitamin D levels increase the risk for Vitamin D insufficiency is also associated with the risks of Vitamin D deficiency could be associated with the development of Associations between low vitamin D levels and Zhang et al. reported in a meta-analysis of seven cohort studies totaling 4204 participants that low levels of vitamin D were associated with increased hospital mortality in critically ill patients. This finding was consistent in all strata of subgroup analyses [Liu et al. analyzed the 2001–2010 National Health and Nutrition Examination Survey (NHANES) of a representative U.S. adult sample of 26,010 participants. 25-hydroxy vitamin D (25(OH)D) measurements were collected. Vitamin D deficiency (VDD) was defined as 25(OH)D less than 50 nanomoles/liter (nmol/L) while vitamin D insufficiency (VDI) was defined as 25(OH)D levels ≥50 nmol/L and ≤75 nmol/L. The analysis found a prevalence of VDD of 28.9% and a prevalence of VDI of 41.4% thus indicating low vitamin D levels in 70.3% of the U.S. population. There was a greater prevalence of VDD in adults who were black, current smokers, infrequent drinkers, less educated, obese, physically inactive, and poor. Non-Hispanic blacks had the highest prevalence of low vitamin D among racial groups. After adjustment for other potential factors, old adults were 63% more likely to have VDD and 46% more likely to have VDI than young adults. Among the independent predictors, being a minority was the strongest indicator for VDD and VDI. Obese adults had a 3.09 times higher prevalence of VDD and a 1.88 times higher prevalence of VDI than non-obese adults [In addition to correlations between medical disorders and insufficient vitamin D levels, there appears to be a connection between vitamin D insufficiency and increased healthcare costs and healthcare utilization. A Veterans Affairs (VA) facility in Northeastern Tennessee performed a retrospective electronic chart review of all patients seen between 2005 and 2007. Out of 42,588 patients seen at the VA center during this period, 886 had records of 25(OH)D. A total of 40.5% of the sample population (Similarly, vitamin D deficiency was associated with increased healthcare costs in two separate retrospective studies at six Veterans Affairs Medical Centers in the Southeastern United States [In a community hospital, a prospective observational study was conducted among 258 patients who were consecutively admitted to the surgical intensive care unit (ICU). Vitamin D levels were collected on all patients within 24 h of being admitted to the ICU. The group categorized vitamin D deficiencies as follows: severe was less than 13 ng/mL; moderate was 14 to 26 ng/mL; mild was 27 to 39 ng/mL; and normal was greater than 40 ng/mL. Only 1.2% of the patients had normal vitamin D levels at admission/baseline. Results showed a correlation of vitamin D deficiency categories from normal to severe with increasing costs, increasing lengths of stay, and increasing mortalities [Based on our literature review and clinical experience, we postulated that people with sufficient vitamin D levels would have lower healthcare costs and less healthcare utilization than those with lower vitamin D levels. Our previously published article [