title: Assessment criteria for vitamin D deficiency/insufficiency in Japan: proposal by an expert panel supported by the Research Program of Intractable Diseases, Ministry of Health, Labour and Welfare, Japan, the Japanese Society for Bone and Mineral Research and the Japan Endocrine Society [Opinion].
abstract: Vitamin D is indispensable for the maintenance of bone and mineral health. Inadequate vitamin D action increases the risk for various musculoskeletal/mineral events including fracture, fall, secondary hyperparathyroidism, diminished response to antiresorptives, rickets/osteomalacia, and hypocalcemia. Its most common cause in recent years is vitamin D deficiency/insufficiency, clinically defined by a low serum 25-hydroxyvitamin D [25(OH)D] level. Guidelines for vitamin D insufficiency/deficiency defined by serum 25(OH)D concentrations have been published all over the world. In Japan, however, the information on the associations between serum 25(OH)D and bone and mineral disorders has not been widely shared among healthcare providers, partly because its measurement had not been reimbursed with national medical insurance policy until August 2016. We have set out to collect and analyze Japanese data on the relationship between serum 25(OH)D concentration and bone and mineral events. Integrating these domestic data and published guidelines worldwide, here, we present the following assessment criteria for vitamin D sufficiency/insufficiency/deficiency using serum 25(OH)D level in Japan. (1) Serum 25(OH)D level equal to or above 30 ng/ml is considered to be vitamin D sufficient. (2) Serum 25(OH)D level less than 30 ng/ml but not less than 20 ng/ml is considered to be vitamin D insufficient. (3) Serum 25(OH)D level less than 20 ng/ml is considered to be vitamin D deficient. We believe that these criteria will be clinically helpful in the assessment of serum 25(OH)D concentrations and further expect that they will form a basis for the future development of guidelines for the management of vitamin D deficiency/insufficiency.
authors.affiliation: Third Department of Medicine, Teikyo University Chiba Medical Center, Ichihara, 299-0111, Japan. rokazaki@med.teikyo-u.ac.jp.
authors.forename: Ryo
authors.identifier: http://orcid.org/0000-0003-3313-469X
authors.initials: R
authors.lastname: Okazaki
authors.affiliation: Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ozono
authors.affiliation: Fujii Memorial Institute of Medical Sciences, Tokushima University, Tokushima, 770-8503, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Fukumoto
authors.affiliation: Third Department of Medicine, Teikyo University Chiba Medical Center, Ichihara, 299-0111, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Inoue
authors.affiliation: Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, 693-8501, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Yamauchi
authors.affiliation: Department of Endocrinology, Chiba Children's Hospital, Chiba, 266-0007, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Minagawa
authors.affiliation: Department of Bone and Mineral Research, Research Institute, Osaka Medical Center for Maternal and Child Health, Izumi, 594-1101, Japan.
authors.forename: Toshimi
authors.initials: T
authors.lastname: Michigami
authors.affiliation: Division of Endocrinology, Toranomon Hospital Endocrine Center, Tokyo, 105-8470, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takeuchi
authors.affiliation: Fujii Memorial Institute of Medical Sciences, Tokushima University, Tokushima, 770-8503, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Matsumoto
authors.affiliation: Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, 693-8501, Japan.
authors.forename: Toshitsugu
authors.initials: T
authors.lastname: Sugimoto
mesh_terms: D044466:Asian People; D035843:Biomedical Research; D015519:Bone Density; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D012955:Societies, Medical; D012958:Societies, Scientific; D014808:Vitamin D Deficiency
keywords: 25-Hydroxyvitamin D; Fracture; Parathyroid hormone; Vitamin D; Vitamin D deficiency