Bone alkaline phosphatase measured with a new immunoradiometric assay in patients with metabolic bone diseases

Abstract

We have investigated the clinical utility of a new quantitative two-site radioimmunometric assay specific for bone alkaline phosphatase (B-ALP) in 219 healthy control subjects and in 264 patients with various metabolic bone diseases. B-ALP was compared with total alkaline phosphatase (T-ALP) and with osteocalcin (BGP). B-ALP increased linearly with age in both sexes. In postmenopausal normal women B-ALP increased by 82% compared with premenopausal normal women, whereas the differences between pre- and postmenopausal women for T-ALP and BGP were 18% and 30% respectively. As assessed by Z-score, the highest values of B-ALP were found in patients with Paget's disease of bone, bone metastases or hyperparathyroidism and in patients on maintenance haemodialysis. In osteoporotic patients, B-ALP< but not T-ALP, showed a slight but significant (P < 0.05) difference compared with normal women. On the basis of bone turnover, osteoporotic patients were divided into two groups: high turnover and low turnover; B-ALP, like BGP, was significantly (P < 0.01) higher in patients with high turnover. In conclusion, B-ALP, measured by this new method, can be considered a sensitive marker of bone turnover and could be especially useful in identifying women at risk of developing osteoporosis.

High alkaline phosphatase levels in hemodialysis patients are associated with higher risk of hospitalization and death

“…In female postmenopausal HD patients, previous studies have shown mild elevations in serum total AP and large increases in bonespecific AP levels compared with premenopausal or menopausal women. 14,15 In our study, perimenopausal women had higher OR of elevated AP than premenopausal patients or HD patients 460 years old. As elevated AP levels are a marker for higher bone turnover rates, 16 these findings suggest that female HD patients between the ages of 45 and 60 may have a higher risk of increased bone turnover.…”

Use of Bone Alkaline Phosphatase to Monitor Alendronate Therapy in Individual Postmenopausal Osteoporotic Women

“…This is as expected considering that total ALP measurements are less specific to bone than measurements of the bone isoenzyme. In conditions such as osteoporosis and renal osteodystrophy and in other conditions in which bone metabolic changes are often subtle, the use of the more bone-specific test confers clinical advantages (45)(46)(47). However, for patients with conditions that typically produce more marked bone metabolic changes, including bone metastases and Paget disease, the two assays have been shown to provide similar clinical discrimination (48 -50 ).…”

Graphs for Research in Counseling Psychology

“…Fig ure 7 is a first step in the direc tion of fit ting a more appro pri ate model than the sin gle regres sion line of Gon nelli et al (1996). I have fit two sepa rate regres sions: one for women younger than 45 and one for women older than Fig ure 7.…”