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

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. [1][2][3][4][5]. In Japan, however, the information

Decrement in bone mineral density after parathyroidectomy in a pediatric patient with primary hyperparathyroidism

“…PHT may have caused the lack of BMD gain in the patient, probably due to vitamin D deficiency, which is typically present in patients with PHT ( 9 ). The finding of a low 25(OH) vitamin D level in our patient (19 ng/mL) is consistent with vitamin D deficiency ( 10 ). Although cinacalcet was administered to decrease serum intact-PTH levels, vitamin D supplementation, to achieve the same outcome, should have been administered prior to cinacalcet.…”

Changes in vitamin D status considering hemodilution factors in Japanese pregnant women according to trimester: A longitudinal survey

“…For the general Japanese population, the assessment criteria for vitamin D deficiency/insufficiency was proposed in 2017 by an expert panel supported by the Research Program of Intractable Diseases of the Japanese Ministry of Health, Labour and Welfare, Japanese Society for Bone and Mineral Research, and the Japan Endocrine Society [ 16 ]. The assessment criteria for vitamin D deficiency/insufficiency proposed by the expert panel was as follows: 25(OH)D equal to or above 30 ng/mL was considered to be vitamin D sufficient; 25(OH)D less than 30 ng/mL but not less than 20 ng/mL was considered to be vitamin D insufficient; 25(OH)D less than 20 ng/mL was considered to be vitamin D deficient.…”

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“…Recently a guideline was published regarding its judgement as below. (5) Sufficiency: Serum 25(OH) level, equal to or higher than 30 ng/ml Insufficiency: Serum 25(OH) level, between 20 and 30 ng/ml Deficiency: Serum 25(OH)D level, less than 20 ng/ml Recently, other reference values for serum 25(OH)D levels have been described as below: sufficiency being defined as 25(OH)D >20 ng/ml (>50 nmol/L), insufficiency when the 25(OH)D are between 12 and 20 ng/ml (30-50 nmol/L), and deficiency when the 25(OH)D is <12 ng/ml (30 nmol/L). (6) Vitamin D Insufficiency and the Risks for Fracture and Falling…”