Reference values of 25-hydroxyvitamin D revisited: a position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society of Clinical Pathology/ Laboratory Medicine (SBPC) (2020)

Carolina Aguiar Moreira1,2,3
Carlos Eduardo dos S. Ferreira4,5,6
Miguel Madeira1,7
Barbara Campolina Carvalho Silva1,8,9
Sergio Setsuo Maeda1,10
Marcelo Cidade Batista4,5
Francisco Bandeira1,11
Victória Z. Cochenski Borba1,2
Marise Lazaretti-Castro1,10

1 Departamento de Metabolismo
Ósseo, Sociedade Brasileira
de Endocrinologia e
Metabologia (SBEM), Brasil
2 Serviço de Endocrinologia e
Metabologia do Hospital de Clínicas
da Universidade Federal do Paraná
(SEMPR), Curitiba, PR, Brasil
3 Laboratório PRO, Unidade de
Histomorfometria Óssea, Fundação
Pró-Renal, Curitiba, PR, Brasil
4 Sociedade Brasileira de
Patologia Clínica/Medicina
Laboratorial (SBPC/ML)
5 Medicina Diagnóstica
e Ambulatorial (MDA),
Departamento de Patologia
Clínica, Hospital Israelita Albert
Einstein, São Paulo, SP, Brasil
6 Disciplina de Medicina
Laboratorial, Laboratório Central,
Escola Paulista de Medicina,
Universidade Federal de São Paulo
(EPM-Unifesp), São Paulo, SP, Brasil
7 Unidade de Endocrinologia,
Universidade Federal do
Rio de Janeiro (UFRJ), Rio
de Janeiro, RJ, Brasil
8 Unidade de Endocrinologia,
Hospital Felício Rocho e Santa
Casa de Belo Horizonte, Belo
Horizonte, MG, Brasil
9 Disciplina de Endocrinologia,
Centro Universitário de Belo
Horizonte (UNI-BH), Belo
Horizonte, MG, Brasil
10 Disciplina de Endocrinologia,
Escola Paulista de Medicina,
Universidade Federal de São Paulo
(EPM-Unifesp), São Paulo, SP, Brasil
11 Divisão de Endocrinologia e
Diabetes, Faculdade de Medicina,
Universidade de Pernambuco
(UPE), Recife, PE, Brasil

ABSTRACT
Hypovitaminosis D is a common condition with a negative impact on health. This statement, prepared
by experts from the Brazilian Society of Endocrinology and Metabolism and the Brazilian Society
of Clinical Pathology/Laboratory Medicine, includes methodological aspects and limitations of the
measurement of 25-hydroxyvitamin D [25(OH)D] for identification of vitamin D status, and identifies
individuals at increased risk for deficiency of this vitamin in whom 25(OH)D measurement is
recommended. For the general population, 25(OH)D levels between 20 and 60 ng/mL are considered
normal, while individuals with levels below 20 ng/mL are considered to be vitamin D deficient.
This statement identifies potential benefits of maintaining 25(OH)D levels > 30 ng/mL in specific
conditions, including patients aged > 65 years or pregnant, those with recurrent falls, fragility
fractures, osteoporosis, secondary hyperparathyroidism, chronic kidney disease, or cancer, and
individuals using drugs with the potential to affect the vitamin D metabolism. This statement also
calls attention to the risk of vitamin D intoxication, a life-threatening condition that occurs at 25(OH)
D levels above 100 ng/mL. Arch Endocrinol Metab. 2020;64(4):462-78
Keywords
Vitamin D; 25-hydroxyvitamin D; reference range; vitamin D intoxication

https://www.aem-sbem.com/media/uploads/2019-0153_fiXqxfd.pdf

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