Department of Internal Medicine, East Tennessee State University, Johnson City, USA.
J Natl Med Assoc. 2011 Jun;103(6):492-7. doi: 10.1016/s0027-9684(15)30363-1.
African Americans have lower vitamin D levels and reduced health outcomes compared to white Americans. Vitamin D deficiency may contribute to adverse health outcomes in African Americans. We hypothesized that race would be associated with vitamin D status and testing in African Americans veterans, and that vitamin D status is a major contributor to health care costs in African American veterans compared to white veterans. A retrospective analysis of the medical data in the Veterans Integrated Service Network 9 (southeastern United States) was performed, and 14148 male veterans were identified. Race was designated by the patient and its relationship to vitamin D levels/status and costs was assessed. Vitamin D levels were significantly lower and the percent of patients with vitamin D deficiency was significantly higher in African American veterans. This difference was independent of latitude and seasonality. Vitamin D testing was done significantly more in white veterans compared to African American veterans (5.4% vs 3.8%). While follow-up testing was 42% more likely if a patient was found to be vitamin D deficient, white veterans were 34% more likely than African American veterans to have at least 1 follow-up 25-hydroxyvitamin D performed. African American veterans had significantly higher health care costs, which were linked to lower vitamin D levels; however, the cost differential persisted even after adjusting for vitamin D status. Vitamin D deficiency is highly prevalent in African American veterans and needs improved management within the Veteran Administration system. Vitamin D status appears not to be the sole contributor to increased health care costs in African American veterans.
非裔美国人的维生素 D 水平较低，健康状况不如白种美国人。维生素 D 缺乏可能导致非裔美国人的健康状况不佳。我们假设种族与非裔美国退伍军人的维生素 D 状况和检测结果有关，并且与白种美国退伍军人相比，维生素 D 状况是导致非裔美国退伍军人医疗保健费用增加的主要因素。对退伍军人综合服务网络 9（美国东南部）的医疗数据进行了回顾性分析，确定了 14148 名男性退伍军人。根据患者指定的种族，并评估其与维生素 D 水平/状况和成本的关系。非裔美国退伍军人的维生素 D 水平明显较低，维生素 D 缺乏症患者的比例明显更高。这种差异与纬度和季节性无关。与非裔美国退伍军人相比，白种美国退伍军人进行维生素 D 检测的比例明显更高（5.4%对 3.8%）。如果发现患者维生素 D 缺乏，进行后续检测的可能性增加 42%，但白种美国退伍军人进行至少 1 次后续 25-羟维生素 D 检测的可能性比非裔美国退伍军人高 34%。非裔美国退伍军人的医疗保健费用明显更高，这与维生素 D 水平较低有关；然而，即使在调整了维生素 D 状况后，成本差异仍然存在。维生素 D 缺乏在非裔美国退伍军人中非常普遍，需要在退伍军人事务管理局系统中进行更好的管理。维生素 D 状况似乎不是导致非裔美国退伍军人医疗保健费用增加的唯一因素。
