A 27-year-old woman complains of pain in her left shin. X-rays of the leg reveal a stress fracture of the tibia, decreased cortical bone density, and increased radiolucency. She is suspected of having osteomalacia (impaired mineralization of bone matrix). Which of the following is the most common biochemical manifestation of osteomalacia?
hyperphosphatemia hypoparathyroidism decreased vitamin D hypercalcemia