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Japanese need at least 30 ng of Vitamin D, test costs are now reimbursed – Nov 2016

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].

J Bone Miner Metab. 2016 Nov 23. [Epub ahead of print]

Okazaki R1, Ozono K2, Fukumoto S3, Inoue D4, Yamauchi M5, Minagawa M6, Michigami T7, Takeuchi Y8, Matsumoto T3, Sugimoto T5.
1Third Department of Medicine, Teikyo University Chiba Medical Center, Ichihara, 299-0111, Japan. rokazaki at med.teikyo-u.ac.jp.
2Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan.
3Fujii Memorial Institute of Medical Sciences, Tokushima University, Tokushima, 770-8503, Japan.
4Third Department of Medicine, Teikyo University Chiba Medical Center, Ichihara, 299-0111, Japan.
5Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, 693-8501, Japan.
6Department of Endocrinology, Chiba Children's Hospital, Chiba, 266-0007, Japan.
7Department of Bone and Mineral Research, Research Institute, Osaka Medical Center for Maternal and Child Health, Izumi, 594-1101, Japan.
8Division of Endocrinology, Toranomon Hospital Endocrine Center, Tokyo, 105-8470, Japan.

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.

PMID: 27882481 DOI: 10.1007/s00774-016-0805-4

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