{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T11:28:25Z","timestamp":1793618905349,"version":"4.5.0"},"reference-count":81,"publisher":"Walter de Gruyter GmbH","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,11,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_cclm-2026-0511_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to establish a comprehensive panel of dried blood spot (DBS)-specific reference intervals (RIs) for vitamins, essential elements, and potentially toxic elements (PTEs) in Chinese adults, and to introduce a hierarchical decision framework for selecting between healthy- and general-population-derived intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2026-0511_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In a cohort of 857 adults (aged 20\u201380 years) recruited in Shiyan, Hubei Province, central China, a healthy reference subpopulation (n=217) was defined based on the CLSI C28-A3c criteria. RIs were established for 17 analytes\u00a0\u2013\u00a0vitamins (A, D, E, B\n                      <jats:sub>1<\/jats:sub>\n                      , B\n                      <jats:sub>2<\/jats:sub>\n                      , B\n                      <jats:sub>3<\/jats:sub>\n                      , B\n                      <jats:sub>5<\/jats:sub>\n                      , B\n                      <jats:sub>6<\/jats:sub>\n                      , and B\n                      <jats:sub>9<\/jats:sub>\n                      ), essential macro- and trace elements (Mg, Fe, Cu, Zn, and Se), and PTEs (Pb, Hg, As)\u00a0\u2013\u00a0quantified from venous whole-blood-derived DBSs using LC-MS\/MS and ICP-MS. Bootstrap-based nonparametric estimation was applied following CLSI guidelines. A hierarchical decision framework was applied to select the optimal RI source.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2026-0511_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sex-specific partitioning was supported for seven analytes, yielding 14\u00a0sex-specific RIs and 10\u00a0combined-sex RIs. Application of the hierarchical decision framework identified significant distributional differences for VA, VD, VB\n                      <jats:sub>5<\/jats:sub>\n                      , VB\n                      <jats:sub>6<\/jats:sub>\n                      , VB\n                      <jats:sub>9<\/jats:sub>\n                      , Cu, and Hg, warranting retention of healthy-subpopulation-derived RIs. Healthy-population RIs were retained for all female sex-specific intervals to prioritize biological specificity, whereas general-population RIs were adopted for 6 of 7 male intervals given sub-threshold healthy male sample\u00a0sizes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2026-0511_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study established a comprehensive DBS-specific RI panel for 17 analytes in Chinese adults, with primary applicability to individuals aged 20\u201359 years. The hierarchical decision framework provides a transparent, evidence-driven approach to balancing biological specificity against statistical precision in RI establishment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/cclm-2026-0511","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T02:56:31Z","timestamp":1784170591000},"page":"2878-2894","source":"Crossref","is-referenced-by-count":0,"title":["Establishment of DBS-based reference intervals for vitamins, essential elements, and potentially toxic elements in Chinese adults from Hubei Province"],"prefix":"10.1515","volume":"64","author":[{"given":"Mengtong","family":"Yang","sequence":"first","affiliation":[{"name":"BYHEALTH Institute of Nutrition & Health , Guangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenghua","family":"Huang","sequence":"additional","affiliation":[{"name":"BYHEALTH Institute of Nutrition & Health , Guangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limiao","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) , School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruikun","family":"He","sequence":"additional","affiliation":[{"name":"BYHEALTH Institute of Nutrition & Health , Guangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"An","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating) , School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongxia","family":"Li","sequence":"additional","affiliation":[{"name":"BYHEALTH Institute of Nutrition & Health , Guangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"2026110211032932152_j_cclm-2026-0511_ref_001","doi-asserted-by":"crossref","unstructured":"Passarelli, S, Free, CM, Shepon, A, Beal, T, Batis, C, Golden, CD. Global estimation of dietary micronutrient inadequacies: a modelling analysis. Lancet Global Health 2024;12:e1590\u20139. https:\/\/doi.org\/10.1016\/s2214-109x(24)00276-6.","DOI":"10.1016\/S2214-109X(24)00276-6"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_002","doi-asserted-by":"crossref","unstructured":"Huang, L, Wang, Z, Wang, H, Zhao, L, Jiang, H, Zhang, B, et al.. Nutrition transition and related health challenges over decades in China. Eur J Clin Nutr 2021;75:247\u201352. https:\/\/doi.org\/10.1038\/s41430-020-0674-8.","DOI":"10.1038\/s41430-020-0674-8"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_003","doi-asserted-by":"crossref","unstructured":"Wei, X, Zhao, L, Fang, H, Chen, M, Piao, W, Ju, L, et al.. Deficiency of energy and nutrient and gender differences among Chinese adults: China nutrition and health survey (2015-2017). Nutrients 2024;16. https:\/\/doi.org\/10.3390\/nu16142371.","DOI":"10.3390\/nu16142371"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_004","doi-asserted-by":"crossref","unstructured":"Bailey, RL, West, KPJr, Black, RE. The epidemiology of global micronutrient deficiencies. Ann Nutr Metab 2015;66:22\u201333.","DOI":"10.1159\/000371618"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_005","doi-asserted-by":"crossref","unstructured":"De Kesel, PM, Sadones, N, Capiau, S, Lambert, WE, Stove, CP. Hemato-critical issues in quantitative analysis of dried blood spots: challenges and solutions. Bioanalysis 2013;5:2023\u201341. https:\/\/doi.org\/10.4155\/bio.13.156.","DOI":"10.4155\/bio.13.156"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_006","doi-asserted-by":"crossref","unstructured":"Guthrie, R, Susi, A. A simple phenylalanine method for detecting phenylketonuria in large populations of newborn infants. Pediatrics 1963;32:338\u201343. https:\/\/doi.org\/10.1542\/peds.32.3.338.","DOI":"10.1542\/peds.32.3.338"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_007","doi-asserted-by":"crossref","unstructured":"Li, W, Tse, FL. Dried blood spot sampling in combination with LC-MS\/MS for quantitative analysis of small molecules. Biomed Chromatogr 2010;24:49\u201365. https:\/\/doi.org\/10.1002\/bmc.1367.","DOI":"10.1002\/bmc.1367"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_008","doi-asserted-by":"crossref","unstructured":"McDade, TW, Williams, S, Snodgrass, JJ. What a drop can do: dried blood spots as a minimally invasive method for integrating biomarkers into population-based research. Demography 2007;44:899\u2013925. https:\/\/doi.org\/10.1353\/dem.2007.0038.","DOI":"10.1353\/dem.2007.0038"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_009","doi-asserted-by":"crossref","unstructured":"Mei, JV, Alexander, JR, Adam, BW, Hannon, WH. Use of filter paper for the collection and analysis of human whole blood specimens. J\u00a0Nutr 2001;131:1631s\u20136s. https:\/\/doi.org\/10.1093\/jn\/131.5.1631s.","DOI":"10.1093\/jn\/131.5.1631S"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_010","doi-asserted-by":"crossref","unstructured":"Yetley, EA, Pfeiffer, CM, Phinney, KW, Bailey, RL, Blackmore, S, Bock, JL, et al.. Biomarkers of vitamin B-12 status in NHANES: a roundtable summary. Am J Clin Nutr 2011;94:313s\u201321s. https:\/\/doi.org\/10.3945\/ajcn.111.013243.","DOI":"10.3945\/ajcn.111.013243"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_011","doi-asserted-by":"crossref","unstructured":"Demirev, PA. Dried blood spots: analysis and applications. Anal Chem 2013;85:779\u201389. https:\/\/doi.org\/10.1021\/ac303205m.","DOI":"10.1021\/ac303205m"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_012","doi-asserted-by":"crossref","unstructured":"Lange, B, Cohn, J, Roberts, T, Camp, J, Chauffour, J, Gummadi, N, et al.. Diagnostic accuracy of serological diagnosis of hepatitis C and B using dried blood spot samples (DBS): two systematic reviews and meta-analyses. BMC Infect Dis 2017;17:700. https:\/\/doi.org\/10.1186\/s12879-017-2777-y.","DOI":"10.1186\/s12879-017-2777-y"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_013","doi-asserted-by":"crossref","unstructured":"Lim, MD. Dried blood spots for global health diagnostics and surveillance: opportunities and challenges. Am J Trop Med Hyg 2018;99:256\u201365. https:\/\/doi.org\/10.4269\/ajtmh.17-0889.","DOI":"10.4269\/ajtmh.17-0889"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_014","doi-asserted-by":"crossref","unstructured":"Vialaret, J, Vignon, M, Hirtz, C, Badiou, S, Baptista, G, Fichter, L, et al.. Use of dried blood spots for monitoring inflammatory and nutritional biomarkers in the elderly. Clin Chem Lab Med 2024;62:881\u201390. https:\/\/doi.org\/10.1515\/cclm-2023-0312.","DOI":"10.1515\/cclm-2023-0312"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_015","doi-asserted-by":"crossref","unstructured":"Ranjan, J, Ponnuvel, S, Fletcher, GJ, Anantharam, R, Radhakrishnan, K, Jeyaseelan, V, et al.. Evaluation of dried blood spots as a feasible alternative to plasma for the detection and quantification of hepatitis C virus in a tropical setting: a pilot study. Indian J Med Microbiol 2019;37:60\u20136. https:\/\/doi.org\/10.4103\/ijmm.ijmm_19_12.","DOI":"10.4103\/ijmm.IJMM_19_12"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_016","doi-asserted-by":"crossref","unstructured":"Edelbroek, PM, van der Heijden, J, Stolk, LM. Dried blood spot methods in therapeutic drug monitoring: methods, assays, and pitfalls. 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Dried blood microsample-assisted determination of vitamins: recent developments and challenges. TrAC, Trends Anal Chem 2020;132:116057. https:\/\/doi.org\/10.1016\/j.trac.2020.116057.","DOI":"10.1016\/j.trac.2020.116057"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_034","doi-asserted-by":"crossref","unstructured":"Farag, MA, Hamouda, S, Gomaa, S, Agboluaje, AA, Hariri, MLM, Yousof, SM. Dietary micronutrients from zygote to senility: updated review of minerals\u2019 role and orchestration in human nutrition throughout life cycle with sex differences. Nutrients 2021;13. https:\/\/doi.org\/10.3390\/nu13113740.","DOI":"10.3390\/nu13113740"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_035","doi-asserted-by":"crossref","unstructured":"Huang, D, He, J, Zhang, R, Zhong, S, Lai, S, Jia, Y. Sex differences in serum trace elements and minerals levels in unmedicated patients with major depressive episode: the role of suicidal ideation. J\u00a0Affect Disord 2024;348:26\u201334. https:\/\/doi.org\/10.1016\/j.jad.2023.12.024.","DOI":"10.1016\/j.jad.2023.12.024"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_036","doi-asserted-by":"crossref","unstructured":"Ryan, BJ, Charkoudian, N, McClung, JP. Consider iron status when making sex comparisons in human physiology. J\u00a0Appl Physiol 1985)2022;132:699\u2013702. https:\/\/doi.org\/10.1152\/japplphysiol.00582.2021.","DOI":"10.1152\/japplphysiol.00582.2021"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_037","doi-asserted-by":"crossref","unstructured":"Mehta, SW, Eikum, R. Effect of estrogen on serum and tissue levels of copper and zinc. Adv Exp Med Biol 1989;258:155\u201362.","DOI":"10.1007\/978-1-4613-0537-8_13"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_038","doi-asserted-by":"crossref","unstructured":"Jung, US, Jeong, KJ, Kang, JK, Yi, K, Shin, JH, Seo, HS, et al.. Effects of estrogen receptor \u03b1 and \u03b2 on the expression of visfatin and retinol-binding protein 4 in 3T3-L1 adipocytes. Int J Mol Med 2013;32:723\u20138. https:\/\/doi.org\/10.3892\/ijmm.2013.1440.","DOI":"10.3892\/ijmm.2013.1440"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_039","doi-asserted-by":"crossref","unstructured":"McInnes, KJ, Smith, LB, Hunger, NI, Saunders, PT, Andrew, R, Walker, BR. Deletion of the androgen receptor in adipose tissue in male mice elevates retinol binding protein 4 and reveals independent effects on visceral fat mass and on glucose homeostasis. Diabetes 2012;61:1072\u201381. https:\/\/doi.org\/10.2337\/db11-1136.","DOI":"10.2337\/db11-1136"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_040","unstructured":"Organization, WH. 10 Chemicals of public health concern. Geneva: World Health Organization; 2020. https:\/\/www.who.int\/news-room\/photo-story\/detail\/10-chemicals-of-public-health-concern [Accessed 1 June 2020]."},{"key":"2026110211032932152_j_cclm-2026-0511_ref_041","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-Lado, L, Sun, G, Berg, M, Zhang, Q, Xue, H, Zheng, Q, et al.. Groundwater arsenic contamination throughout China. Science 2013;341:866\u20138. https:\/\/doi.org\/10.1126\/science.1237484.","DOI":"10.1126\/science.1237484"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_042","doi-asserted-by":"crossref","unstructured":"Zhao, D. Arsenic bioaccessibility in rice and its application to derive health-based limits in China. Foods 2024;13:2741. https:\/\/doi.org\/10.3390\/foods13172741.","DOI":"10.3390\/foods13172741"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_043","doi-asserted-by":"crossref","unstructured":"Wu, M, Wu, X, Saiz-Lopez, A, Blanchfield, PJ, Ren, H, Zhong, H. Climate change amplifies neurotoxic methylmercury threat to Asian fish consumers. Proc Natl Acad Sci U S A 2025;122:e2421921122. https:\/\/doi.org\/10.1073\/pnas.2421921122.","DOI":"10.1073\/pnas.2421921122"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_044","doi-asserted-by":"crossref","unstructured":"Zhang, Y, Hou, D, O\u2019Connor, D, Shen, Z, Shi, P, Ok, YS, et al.. Lead contamination in Chinese surface soils: source identification, spatial-temporal distribution and associated health risks. Crit Rev Environ Sci Technol 2019;49:1386\u2013423. https:\/\/doi.org\/10.1080\/10643389.2019.1571354.","DOI":"10.1080\/10643389.2019.1571354"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_045","doi-asserted-by":"crossref","unstructured":"Martinez-Morata, I, Sobel, M, Tellez-Plaza, M, Navas-Acien, A, Howe, CG, Sanchez, TR. A state-of-the-science review on metal biomarkers. 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Nutritional modulation of age-related changes in the immune system and risk of infection. Nutr Res 2017;41:14\u201335. https:\/\/doi.org\/10.1016\/j.nutres.2017.02.001.","DOI":"10.1016\/j.nutres.2017.02.001"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_051","doi-asserted-by":"crossref","unstructured":"Giacconi, R, Costarelli, L, Piacenza, F, Basso, A, Rink, L, Mariani, E, et al.. Main biomarkers associated with age-related plasma zinc decrease and copper\/zinc ratio in healthy elderly from ZincAge study. Eur J Nutr 2017;56:2457\u201366. https:\/\/doi.org\/10.1007\/s00394-016-1281-2.","DOI":"10.1007\/s00394-016-1281-2"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_052","doi-asserted-by":"crossref","unstructured":"Giacconi, R, Piacenza, F, Aversano, V, Zampieri, M, B\u00fcrkle, A, Villanueva, MM, et al.. 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Blood lead levels and their associated risk factors in Chinese adults from 1980 to 2018. Ecotoxicol Environ Saf 2021;218:112294. https:\/\/doi.org\/10.1016\/j.ecoenv.2021.112294.","DOI":"10.1016\/j.ecoenv.2021.112294"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_060","doi-asserted-by":"crossref","unstructured":"Nie, M, Du, H, Xie, T, Zheng, B, Zou, X, Sun, G, et al.. Reference intervals for lead, arsenic, Mercury, and cadmium in the population of Southwest China: a comparative Study of direct and indirect sampling techniques. J\u00a0Clin Lab Anal 2025;39:e70096. https:\/\/doi.org\/10.1002\/jcla.70096.","DOI":"10.1002\/jcla.70096"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_061","doi-asserted-by":"crossref","unstructured":"Xu, X, Dong, C-Y, Lu, A-X, Wang, S-S, Harvey, P, Yan, C-H. Mercury levels in freshwater aquatic products across China: spatial distribution, species differences, and health risk assessment. 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Biochem Med 2024;34:020706. https:\/\/doi.org\/10.11613\/bm.2024.020706.","DOI":"10.11613\/BM.2024.020706"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_066","doi-asserted-by":"crossref","unstructured":"Luan, Y, Li, T, Lin, F, Li, X, Yang, J. Development and validation of age- and sex-specific reference intervals for serum vitamin B5 in Henan pediatric population by LC-MS\/MS. Front Nutr 2025;12:1698679. https:\/\/doi.org\/10.3389\/fnut.2025.1698679.","DOI":"10.3389\/fnut.2025.1698679"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_067","doi-asserted-by":"crossref","unstructured":"Luan, Y, Chen, N, Wang, X, Li, X, Yang, J, Li, T. Establishment of age-stratified serum vitamin B6 pyridoxal and pyridoxic acid reference intervals among children aged 1-16\u00a0years in Henan, China. Front Nutr 2025;9:1592045. https:\/\/doi.org\/10.3389\/fnut.2025.1592045.","DOI":"10.3389\/fnut.2025.1592045"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_068","doi-asserted-by":"crossref","unstructured":"Stidsen, NM, Bjerg, LN, Sandfeld-Paulsen, B. Establishing reference intervals for thiamine pyrophosphate and pyridoxal 5\u2019-phosphate in whole blood in a Danish cohort using liquid chromatography tandem-mass spectrometry (LC-ms\/ms). Scand J Clin Lab Invest 2024;84:311\u20136. https:\/\/doi.org\/10.1080\/00365513.2024.2392126.","DOI":"10.1080\/00365513.2024.2392126"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_069","doi-asserted-by":"crossref","unstructured":"Vos, MJ, Joost van Pelt, L, Kok, MB, Dijck-Brouwer, DAJ, Heiner-Fokkema, MR, Dikkeschei, LD, et al.. Folate reference interval estimation in the Dutch general population. Pract Lab Med 2019;16:e00127. https:\/\/doi.org\/10.1016\/j.plabm.2019.e00127.","DOI":"10.1016\/j.plabm.2019.e00127"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_070","doi-asserted-by":"crossref","unstructured":"Yang, J, Cao, Y, Shan, X, Zhang, H, Feng, J, Lu, J, et al.. The magnesium status and suggested reference ranges of plasma magnesium, calcium, and calcium\/magnesium ratio in Chinese adults over 45\u00a0years old. Nutrients 2023;15. https:\/\/doi.org\/10.3390\/nu15040886.","DOI":"10.3390\/nu15040886"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_071","doi-asserted-by":"crossref","unstructured":"Zhang, H, Cao, Y, Song, P, Man, Q, Mao, D, Hu, Y, et al.. Suggested reference ranges of blood Mg and Ca level in childbearing women of China: analysis of China adult chronic disease and nutrition surveillance (2015). 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Age- and sex-specific reference intervals for trace elements in infants and children: a multi-center study in Lincang, China. Front Pediatr 2025;13:1547429. https:\/\/doi.org\/10.3389\/fped.2025.1547429.","DOI":"10.3389\/fped.2025.1547429"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_075","doi-asserted-by":"crossref","unstructured":"Zhai, R, Zhang, M, Liu, J, Guang, H, Li, B, Chen, D, et al.. Reference intervals of and relationships among essential trace elements in whole blood of children aged 0-14\u00a0years. J\u00a0Clin Lab Anal 2017;31. https:\/\/doi.org\/10.1002\/jcla.22043.","DOI":"10.1002\/jcla.22043"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_076","doi-asserted-by":"crossref","unstructured":"Zhang, H, Cao, Y, Man, Q, Li, Y, Lu, J, Yang, L. Study on reference range of zinc, copper and copper\/zinc ratio in childbearing women of China. Nutrients 2021;13. https:\/\/doi.org\/10.3390\/nu13030946.","DOI":"10.3390\/nu13030946"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_077","doi-asserted-by":"crossref","unstructured":"Kim, HJ, Lim, HS, Lee, KR, Choi, MH, Kang, NM, Lee, CH, et al.. Determination of trace metal levels in the general population of Korea. Int J Environ Res Publ Health 2017;14. https:\/\/doi.org\/10.3390\/ijerph14070702.","DOI":"10.3390\/ijerph14070702"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_078","doi-asserted-by":"crossref","unstructured":"Cao, Y, Zhang, H, Yang, J, Man, Q, Song, P, Mao, D, et al.. Reference ranges of selenium in plasma and whole blood for child-bearing-aged women in China. Int J Environ Res Publ Health 2022;19. https:\/\/doi.org\/10.3390\/ijerph19084908.","DOI":"10.3390\/ijerph19084908"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_079","doi-asserted-by":"crossref","unstructured":"France \u0160tiglic, A, Falnoga, I, Bri\u0161ki, AS, \u017davbi, M, Osredkar, J, Skitek, M, et al.. Reference intervals of 24 trace elements in blood, plasma and erythrocytes for the Slovenian adult population. Clin Chem Lab Med 2024;62:946\u201357. https:\/\/doi.org\/10.1515\/cclm-2023-0731.","DOI":"10.1515\/cclm-2023-0731"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_080","doi-asserted-by":"crossref","unstructured":"Rivas, I, Miranda, M, Herrero-Latorre, C, Monte-Secades, R, L\u00f3pez-Alonso, M. Serum reference intervals for essential and toxic trace elements in a healthy population: a basis for nutritional monitoring and clinical intervention. Clin Nutr ESPEN 2025;70:227\u201339. https:\/\/doi.org\/10.1016\/j.clnesp.2025.09.031.","DOI":"10.1016\/j.clnesp.2025.09.031"},{"key":"2026110211032932152_j_cclm-2026-0511_ref_081","doi-asserted-by":"crossref","unstructured":"Stojsavljevi\u0107, A, Borkovi\u0107-Miti\u0107, S, Vujoti\u0107, L, Gruji\u010di\u0107, D, Gavrovi\u0107-Jankulovi\u0107, M, Manojlovi\u0107, D. The human biomonitoring study in Serbia: background levels for arsenic, cadmium, lead, thorium and uranium in the whole blood of adult Serbian population. 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