title: Assessment criteria for vitamin D deficiency/insufficiency in Japan - proposal by an expert panel supported by 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 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.
authors.forename: Ryo
authors.initials: R
authors.lastname: Okazaki
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ozono
authors.forename: Seiji
authors.initials: S
authors.lastname: Fukumoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Inoue
authors.forename: Mika
authors.initials: M
authors.lastname: Yamauchi
authors.forename: Masanori
authors.initials: M
authors.lastname: Minagawa
authors.forename: Toshimi
authors.initials: T
authors.lastname: Michigami
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takeuchi
authors.forename: Toshio
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Toshitsugu
authors.initials: T
authors.lastname: Sugimoto
mesh_terms: D035843:Biomedical Research / Q000458:organization & administration / Q000592:standards; D001842:Bone and Bones / Q000502:physiology; D003940:Diagnostic Techniques, Endocrine / Q000592:standards*; D004704:Endocrinology / Q000458:organization & administration / Q000592:standards; D050723:Fractures, Bone / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007564:Japan; D008903:Minerals / Q000378:metabolism; D012955:Societies, Medical / Q000458:organization & administration / Q000592:standards; D009626:Terminology as Topic; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000145:classification / Q000150:complications / Q000175:diagnosis*
chemical_list: D008903:Minerals; D014807:Vitamin D; C104450:25-hydroxyvitamin D