{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T22:28:56Z","timestamp":1790202536330,"version":"4.1.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T00:00:00Z","timestamp":1737763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T00:00:00Z","timestamp":1737763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Biochem"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>International guidelines give greatly varying definitions of 25-hydroxyvitamin D (25OHD) insufficiency and deficiency. Vitamin D testing is increasing despite 2016 UK guidance for adults advising routine vitamin D supplementation October-March and year-round for high risk groups. A service evaluation of vitamin D testing and biochemical osteomalacia in the North-East of Scotland (57\u201358\u00b0N) could inform definitions and testing guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified adult 25OHD requests 8\/7\/2008\u201329\/2\/2020 and albumin-adjusted serum calcium (aCa), parathyroid hormone (PTH) and alkaline phosphatase (ALP) within 6\u00a0months of 25OHD testing. After excluding renal impairment and liver disease, we defined biochemical osteomalacia as ALP &gt;130\u00a0IU\/L and aCa &lt;2.0\u00a0mmol\/L and elevated PTH &gt;9.2 or &gt;6.8\u00a0pmol\/L, depending on the assay. Possible biochemical osteomalacia was defined as 2 of these abnormalities in the absence of the third measurement. From these cases anonymised clinical data were then examined to confirm the diagnosis of osteomalacia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>25,379 eligible patients had 25OHD measured: 25% were &lt;25\u00a0nmol\/L (6,258\/25,379) and 18% &lt;20\u00a0nmol\/L (4,536\/25,379). 0.5% (126\/25,379) of eligible patients had biochemical or possible biochemical osteomalacia. After reviewing clinical records, only 0.1% (29\/25,379) had clinically confirmed osteomalacia, equivalent to 2\u20133 cases\/y for a population of 0.5 million, none of the untreated cases of clinically confirmed osteomalacia had 25OHD &gt;25\u00a0nmol\/L. For the entire tested population, when 25OHD was &lt;25\u00a0nmol\/L untreated osteomalacia confirmed by clinical records was rare (0.4%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Osteomalacia is rare in North-East Scotland. Our data call into question designating 25OHD 25\u201350\u00a0nmol\/L \u2018insufficiency\u2019. The risk of osteomalacia even when 25OHD is &lt;25\u00a0nmol\/L is very low.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00045632251315671","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T21:17:23Z","timestamp":1738012643000},"page":"303-311","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Biochemical osteomalacia in adults undergoing vitamin D testing in the North-East of Scotland"],"prefix":"10.1177","volume":"62","author":[{"given":"Angus D","family":"Macleod","sequence":"first","affiliation":[{"name":"University of Aberdeen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J","family":"Bolland","sequence":"additional","affiliation":[{"name":"University of Auckland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Balfour","sequence":"additional","affiliation":[{"name":"NHS Grampian"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Grey","sequence":"additional","affiliation":[{"name":"University of Auckland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh","family":"Newmark","sequence":"additional","affiliation":[{"name":"NHS Grampian"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4813-5628","authenticated-orcid":false,"given":"Alison","family":"Avenell","sequence":"additional","affiliation":[{"name":"NHS Grampian"},{"name":"University of Aberdeen"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,1,25]]},"reference":[{"key":"e_1_3_5_2_2","unstructured":"NICE (National Institute for Health and Care Excellence). Vitamin D deficiency in adults. https:\/\/cks.nice.org.uk\/topics\/vitamin-d-deficiency-in-adults\/ (updated 2022) (accessed 10\/10\/2024)."},{"key":"e_1_3_5_3_2","unstructured":"Scientific Advisory Committee on Nutrition. Vitamin D and health. https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/537616\/SACN_Vitamin_D_and_Health_report.pdf (2016 accessed 10 10 2024)."},{"key":"e_1_3_5_4_2","unstructured":"Institute of Medicine. In: Ross AC et al. (eds) Dietary reference intakes for calcium and vitamin D. Washington DC: National Academies Press. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK56070\/ (2011 accessed 10 10 2024)."},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgae322"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n484"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(18)30265-1"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14483"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/dtb.2020.000060"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsbmb.2023.106328"},{"key":"e_1_3_5_11_2","unstructured":"Scottish Government. Older people in care homes in Scotland prescribing advice. https:\/\/www.gov.scot\/publications\/guidance-support-adoption-existing-recommendations-vitamin-d-supplementation-eligible-people-living-adult-care-homes-equality-impact-assessment-results\/ (accessed 10 10 2024)."},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.35.6.625"},{"key":"e_1_3_5_13_2","unstructured":"NHS Inform. Scotland use of Vitamin D general adult population. https:\/\/www.nhsinform.scot\/healthy-living\/food-and-nutrition\/eating-well\/vitamin-d (accessed 10\/10\/2024)."},{"key":"e_1_3_5_14_2","first-page":"CD013789","article-title":"Population-based interventions for preventing falls and fall-related injuries in older people","volume":"1","author":"Lewis SR","year":"2024","unstructured":"Lewis SR, McGarrigle L, Pritchard MW, et al. Population-based interventions for preventing falls and fall-related injuries in older people. Cochrane Database Syst Rev 2024; 1: CD013789.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_5_15_2","first-page":"CD005465","article-title":"Interventions for preventing falls in older people in care facilities and hospitals","volume":"9","author":"Cameron ID","year":"2018","unstructured":"Cameron ID, Dyer SM, Panagoda CE, et al. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev 2018; 9: CD005465.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)63013-9"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afm091"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-1309"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2018-314826"},{"key":"e_1_3_5_20_2","unstructured":"Scientific Advisory Committee on Nutrition. Fortifying foods and drinks with vitamin D: main report. https:\/\/www.gov.uk\/government\/publications\/fortifying-food-and-drink-with-vitamin-d-a-sacn-rapid-review\/fortifying-foods-and-drinks-with-vitamin-d-main-report (accessed 11 10 2024)."},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.116.151415"}],"container-title":["Annals of Clinical Biochemistry: International Journal of Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00045632251315671","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00045632251315671","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00045632251315671","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T10:40:05Z","timestamp":1786012805000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00045632251315671"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,25]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1177\/00045632251315671"],"URL":"https:\/\/doi.org\/10.1177\/00045632251315671","relation":{},"ISSN":["0004-5632","1758-1001"],"issn-type":[{"value":"0004-5632","type":"print"},{"value":"1758-1001","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,25]]}}}