Journal of Bone and Mineral Metabolism

, Volume 35, Issue 1, pp 1–5 | Cite as

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]

  • Ryo OkazakiEmail author
  • Keiichi Ozono
  • Seiji Fukumoto
  • Daisuke Inoue
  • Mika Yamauchi
  • Masanori Minagawa
  • Toshimi Michigami
  • Yasuhiro Takeuchi
  • Toshio Matsumoto
  • Toshitsugu Sugimoto


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.


Vitamin D Vitamin D deficiency 25-Hydroxyvitamin D Fracture Parathyroid hormone 



Funding was provided by the Research Program of Intractable Diseases, Ministry of Health, Labour and Welfare, Japan.

Compliance with ethical standards

Conflict of interest

All authors have no conflicts of interest.


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Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan 2016

Authors and Affiliations

  • Ryo Okazaki
    • 1
    Email author
  • Keiichi Ozono
    • 2
  • Seiji Fukumoto
    • 3
  • Daisuke Inoue
    • 1
  • Mika Yamauchi
    • 4
  • Masanori Minagawa
    • 5
  • Toshimi Michigami
    • 6
  • Yasuhiro Takeuchi
    • 7
  • Toshio Matsumoto
    • 3
  • Toshitsugu Sugimoto
    • 4
  1. 1.Third Department of MedicineTeikyo University Chiba Medical CenterIchiharaJapan
  2. 2.Department of PediatricsOsaka University Graduate School of MedicineSuitaJapan
  3. 3.Fujii Memorial Institute of Medical SciencesTokushima UniversityTokushimaJapan
  4. 4.Internal Medicine 1Shimane University Faculty of MedicineIzumoJapan
  5. 5.Department of EndocrinologyChiba Children’s HospitalChibaJapan
  6. 6.Department of Bone and Mineral Research, Research InstituteOsaka Medical Center for Maternal and Child HealthIzumiJapan
  7. 7.Division of EndocrinologyToranomon Hospital Endocrine CenterTokyoJapan

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