{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T14:14:30Z","timestamp":1774880070411,"version":"3.50.1"},"reference-count":39,"publisher":"Walter de Gruyter GmbH","issue":"5","funder":[{"name":"National Key Technologies R&D Program of the People's Republic of China","award":["Sub-project Grant # 2022YFC3602302"],"award-info":[{"award-number":["Sub-project Grant # 2022YFC3602302"]}]},{"name":"National Key Technologies R&D Program of the People's Republic of China","award":["Project Grant # 2022YFC3602300"],"award-info":[{"award-number":["Project Grant # 2022YFC3602300"]}]},{"DOI":"10.13039\/501100010031","name":"China postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["Grant # 2024T171044"],"award-info":[{"award-number":["Grant # 2024T171044"]}],"id":[{"id":"10.13039\/501100010031","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010031","name":"China postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["Grant # 2022YFC3602300"],"award-info":[{"award-number":["Grant # 2022YFC3602300"]}],"id":[{"id":"10.13039\/501100010031","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_cclm-2025-1138_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The clinical utility of serum bone turnover markers (BTMs) in managing osteoporosis in the elderly is constrained by the absence of personalized reference intervals (prRI) based on biological variation\u00a0(BV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-1138_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This longitudinal study tracked monthly serum levels of \u03b2-CTX (C-terminal cross-linking telopeptide of type I collagen), procollagen type I N-propeptide (PINP), osteocalcin (OC), parathyroid hormone (PTH), and 25-hydroxyvitamin D (25(OH)D) over six months in 40 healthy elderly participants aged 60\u201375\u00a0years (16 males and 24 females). The study calculated estimates of within-subject BV (CV\n                      <jats:sub>I<\/jats:sub>\n                      ), between-subject BV (CV\n                      <jats:sub>G<\/jats:sub>\n                      ), within-person BV (CV\n                      <jats:sub>P<\/jats:sub>\n                      ), analytical variation (CV\n                      <jats:sub>A<\/jats:sub>\n                      ), and reference change values (RCVs).These parameters were subsequently used to establish the personalized reference interval (prRI).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-1138_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Considerable variability in CV\n                      <jats:sub>I<\/jats:sub>\n                      , CV\n                      <jats:sub>P<\/jats:sub>\n                      , and CV\n                      <jats:sub>G<\/jats:sub>\n                      was observed for BTMs in older adults. Gender differences in baseline concentrations were observed for PINP, OC, and 25(OH)D (p&lt;0.05), but no significant differences were found in BV parameters. Among the markers, OC exhibited the lowest CV\n                      <jats:sub>I<\/jats:sub>\n                      (7.9\u202f%), while \u03b2-CTX had the highest (14.8\u202f%). Other markers had CV\n                      <jats:sub>I<\/jats:sub>\n                      values ranging from 11.0 to 14.2\u202f%. RCVs ranged from\u00a0\u221219.8 to\u00a0\u221233.7\u202f% and 24.6 to 50.8\u202f%. For all five BTMs, the CV\n                      <jats:sub>I<\/jats:sub>\n                      -based prRI ranges were narrower than the popRI, whereas the CV\n                      <jats:sub>P<\/jats:sub>\n                      -based prRIs showed wide inter-individual variation, reflecting substantial heterogeneity in prRIs among older adults.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-1138_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study establishes BV-based prRI for BTMs in older adults, which offers a more clinically relevant interpretation of individual-level data than popRI and facilitates more accurate clinical decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/cclm-2025-1138","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T13:06:49Z","timestamp":1771247209000},"page":"1109-1116","source":"Crossref","is-referenced-by-count":0,"title":["Personalized reference intervals based on biological variation for serum bone turnover markers in healthy older adults"],"prefix":"10.1515","volume":"64","author":[{"given":"Ye","family":"Qin","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine , National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, China Medical University , Shenyang , P.R. 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China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine , National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, China Medical University , Shenyang , P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zihan","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine , National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, China Medical University , Shenyang , P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine , National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, China Medical University , Shenyang , P.R. 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