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Magdalena Lech Faculty of Life Sciences and Medicine, School of Life Course Sciences, King’s College London, London, UK

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Ruvini Ranasinghe Department of Clinical Biochemistry, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, UK

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Royce P Vincent Department of Clinical Biochemistry, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, UK
Faculty of Life Sciences and Medicine, School of Life Course Sciences, King’s College London, London, UK

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David R Taylor Department of Clinical Biochemistry, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, UK

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Lea Ghataore Department of Clinical Biochemistry, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, UK

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James Luxton Department of Clinical Biochemistry, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, UK

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Fannie Lajeunesse-Trempe Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK
Quebec Heart and Lung Institute, Laval University, Quebec, Canada

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Pia Roser Department of Endocrinology and Diabetes, University Medical Centre Hamburg Eppendorf, Hamburg, Germany

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Eftychia E Drakou Department of Clinical Oncology, Guy's Cancer Centre - Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, UK

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Ling Ling Chuah Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK

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Ashley B Grossman Green Templeton College, University of Oxford, Oxford, UK
Barts and the London School of Medicine, Centre for Endocrinology, William Harvey Institute, London, UK
Neuroendocrine Tumour Unit, Royal Free Hospital, London, UK

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Simon J B Aylwin Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK

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Georgios K Dimitriadis Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK
Obesity, Type 2 Diabetes and Immunometabolism Research Group, School of Cardiovascular and Metabolic Medicine & Sciences, Faculty of Life Course Sciences, King’s College London, London, UK
Division of Reproductive Health, Warwick Medical School, University of Warwick, Coventry, UK

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serum cortisol may not accurately reflect the glucocorticoid status of the patient and may lead to unrecognised adrenal insufficiency. Consequently, the altered binding protein profile and heightened risk of adrenal insufficiency lead to patients on

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Göran Oleröd Department of Clinical Chemistry and Transfusion Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden

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Lillemor Mattsson Hultén Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden

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Ola Hammarsten Department of Clinical Chemistry and Transfusion Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden

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Eva Klingberg Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden

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winter ( Fig. 1 ). Figure 1 Boxplot diagram showing the variation in the vitamin D metabolites over the months of the year. (A) Directly measured free 25(OH)D. (B) Calculated free 25(OH)D. (C) Total serum 25(OH)D. (D) Vitamin D-binding protein. (E

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Jiayang Lin Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China

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Peizhen Zhang Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China

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Yan Huang Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China

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Xueyun Wei Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China

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Dan Guo Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China

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Jianfang Liu Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China

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Deying Liu Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China

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Yajuan Deng Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China

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Bingyan Xu Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China

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Chensihan Huang Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China

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Xiaoyu Yang Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China

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Yan Lu Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China

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Lijing Jia Department of Endocrinology, Shenzhen People’s Hospital, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China

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Huijie Zhang Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China

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) were measured using standard enzymatic methods. Total bilirubin (TBIL) and direct bilirubin (DBIL) were measured by diazotization method. Serum insulin, free triiodothyronine (T3), total T3, free thyroxine (T4), total T4, and TSH thyroid peroxide

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Leqi He Department of Clinical Laboratory Medicine, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Xiaoying Li Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Zaoping Chen Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Wei Wang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Kai Wang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Xinmei Huang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Qian Yang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Wencai Ke Department of Clinical Laboratory Medicine, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Jun Liu Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Bingbing Zha Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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.193 0.000 0.007 0.016 0.000 0.829 Model 4 (E2, age, BMI, ALT, SCR) –0.190 0.000 0.008 0.016 0.000 0.824 ALT, alanine aminotransferase; E2, estradiol; FT4, free thyroxine; SCR, serum creatinine; TSH, thyroid

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Angela Köninger
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Philippos Edimiris
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Laura Koch
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Antje Enekwe
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Claudia Lamina Department of Gynecology and Obstetrics, Division of Genetic Epidemiology, Vitateq Biotechnology GmbH, University of Duisburg-Essen, D-45122 Essen, Germany

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Sabine Kasimir-Bauer
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Rainer Kimmig
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Hans Dieplinger Department of Gynecology and Obstetrics, Division of Genetic Epidemiology, Vitateq Biotechnology GmbH, University of Duisburg-Essen, D-45122 Essen, Germany
Department of Gynecology and Obstetrics, Division of Genetic Epidemiology, Vitateq Biotechnology GmbH, University of Duisburg-Essen, D-45122 Essen, Germany

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)-inhibiting parameter (11) . The previously described vitamin E-binding protein afamin may play a role in oxidative stress-related anti-apoptotic cellular processes (12) . Vitamin E is an important anti-oxidant and protects from oxidative stress. Afamin was

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Shatha Alharazy Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

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M Denise Robertson Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK

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Susan Lanham-New Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK

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Muhammad Imran Naseer Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia

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Adeel G Chaudhary Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
Centre for Innovation in Personalized Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

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Eman Alissa Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

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, 27 ). Free 25(OH)D can be measured either by means of a direct method, using a recently developed immunoassay, or estimated by calculation using the levels of albumin, vitamin D-binding protein and total 25(OH)D ( 20 , 28 ). However, although

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M P Schuijt Department of Laboratory Medicine, Slingeland Hospital, Doetinchem, The Netherlands
Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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C G J Sweep Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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R van der Steen Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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A J Olthaar Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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N M M L Stikkelbroeck Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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H A Ross Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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A E van Herwaarden Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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chromatography tandem mass spectrometry (ED-LC-MS/MS). LC-MS/MS enables the accurate, specific and matrix-independent measurement of testosterone with direct calibration. Equilibrium dialysis enables to separate the free- from protein-bound testosterone with

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Stine A Holmboe Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Ravi Jasuja Research Program in Men’s Health: Aging and Metabolism, Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts, USA

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Brian Lawney Research Program in Men’s Health: Aging and Metabolism, Brigham and Womens Hospital, Harvard Medical School, Boston, Massachusetts, USA

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Lærke Priskorn Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Niels Joergensen Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Allan Linneberg Centre for Clinical Research and Prevention, Frederiksberg Hospital, Copenhagen, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Tina Kold Jensen Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark

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Niels Erik Skakkebæk Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Anders Juul Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Anna-Maria Andersson Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
The International Research Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Introduction Testosterone in serum is primarily bound to proteins with only a minor fraction circulating as free unbound testosterone. The major high-affinity binding protein is sex hormone-binding globulin (SHBG) ( 1 ). Because of the short

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Johanna Öberg Tromso Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway

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Rolf Jorde Tromso Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway

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Yngve Figenschau Tromso Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
Diagnostic Clinic, University Hospital of North Norway, Tromso, Norway

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Per Medbøe Thorsby Hormone Laboratory, Department of Medical Biochemistry and Biochemical Endocrinology and Metabolism Research Group, Oslo University Hospital, Aker, Oslo, Norway

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Sandra Rinne Dahl Hormone Laboratory, Department of Medical Biochemistry and Biochemical Endocrinology and Metabolism Research Group, Oslo University Hospital, Aker, Oslo, Norway

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Anne Winther Division of Neurosciences, Orthopedics and Rehabilitation Services, University Hospital of North Norway, Tromso, Norway

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Guri Grimnes Tromso Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromso, Norway
Division of Internal Medicine, University Hospital of North Norway, Tromso, Norway

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accounted for in existing guidelines ( 6 , 7 , 8 , 9 ). In contrary to 25(OH)D (free and protein bound), free 25(OH)D has not differed according to HC use in the adult population ( 3 , 10 ). It has been raised concern that the vitamin D status in HC

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W N H Koek Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands

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N Campos-Obando Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands

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B C J van der Eerden Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands

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Y B de Rijke Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, the Netherlands

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M A Ikram Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands

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A G Uitterlinden Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands

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J P T M van Leeuwen Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands

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M C Zillikens Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands

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albumin, calcium bound to other proteins and ionized calcium. Moreover, serum albumin levels are lower in critical ill patients and are correlated with disease status. Therefore, data were adjusted for age and serum albumin levels. As a sensitivity

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