Association between serum alkaline phosphatase and C-reactive protein in the United States National Health and Nutrition Examination Survey 2005–2006
-
Matthew Webber
Abstract
Background: Alkaline phosphatase (ALP) is a widely used marker for skeletal and hepatobiliary disorders, but its activity is also increased in atherosclerosis and peripheral vascular disease. It is an inflammatory marker like C-reactive protein (CRP). We therefore analyzed its relationship with CRP in the United States National Health and Nutrition Examination Survey (NHANES) 2005–2006.
Methods: The analysis included 4155 men and non-pregnant women over the age of 20 years. The relationship between log-transformed ALP and plasma CRP was analyzed using univariate and multivariate models.
Results: ALP activity was significantly correlated with age, waist circumference, body mass index, blood pressure, exercise, alcohol, triglycerides, and other liver enzymes after adjusting for age, gender and ethnicity (p<0.001). ALP was significantly associated with a higher frequency of cardiovascular disease (p=0.02), hypertension (p=0.01) hypercholesterolemia (p=0.04), and diabetes (p=0.02). Compared to the lowest quartile of ALP, the adjusted odds ratio (OR) associated with the highest quartile were 1.9 [95% confidence intervals (CI) 1.1–3.5], 1.6 (95% CI 1.0–2.5), 1.5 (95% CI 1.1–2.1) and 1.7 (95% CI 1.0–2.4) for cardiovascular disease, hypertension, hypercholesterolemia, and diabetes, respectively. In multivariate analysis, log ALP was an independent predictor of log CRP (p=1.0×10−6). A multivariate model that included log ALP, ethnicity, glycohemoglobin, waist circumference, albumin, apolipoprotein B, γ-glutamyltransferase and uric acid explained 40% of the variance in log CRP.
Conclusions: ALP is a marker of cardiometabolic risk, but it needs to be tested as part of a multivariate model in prospective studies.
Clin Chem Lab Med 2010;48:167–73.
©2010 by Walter de Gruyter Berlin New York
Articles in the same Issue
- Review
- Elevated serum γ-glutamyltransferase activity is associated with increased risk of mortality, incident type 2 diabetes, cardiovascular events, chronic kidney disease and cancer – a narrative review
- Minireview
- Artificial intelligence for diagnostic purposes: principles, procedures and limitations
- General Clinical Chemistry and Laboratory Medicine
- Association between serum alkaline phosphatase and C-reactive protein in the United States National Health and Nutrition Examination Survey 2005–2006
- Association between serum uric acid and non-alcoholic fatty liver disease in Korean adults
- Plasma osteopontin concentrations in preeclampsia – is there an association with endothelial injury?
- Determination of globotriaosylceramide in plasma and urine by mass spectrometry
- Effect of inflammation induced by prolonged exercise on circulating erythroid progenitors and markers of erythropoiesis
- The Beckman DxI 800 prolactin assay demonstrates superior specificity for monomeric prolactin
- Stability of cerebrospinal fluid/serum glucose ratio and cerebrospinal fluid lactate concentrations over 24 h: analysis of repeated measurements
- O-β-N-acetyl-D-glucosaminidase in erythrocytes of Italian air force acrobatic pilots
- Validation and Outcome Studies
- Experimental validation of specificity of the squamous cell carcinoma antigen-immunoglobulin M (SCCA-IgM) assay in patients with cirrhosis
- Performance analysis of the ARCHITECT anti-cyclic citrullinated peptide antibody in the diagnosis of rheumatoid arthritis
- Reference Values and Biological Variations
- Applicability of common reference intervals for serum creatinine concentrations to the Croatian population
- Laboratory reference intervals during pregnancy, delivery and the early postpartum period
- Determination of serum holotranscobalamin concentrations with the AxSYM active B12 assay: cut-off point evaluation in the clinical laboratory
- Definition of reference ranges for the platelet distribution width (PDW): a local need
- Cancer Diagnostics
- Mean leukocyte telomere length and risk of incident colorectal carcinoma in women: a prospective, nested case-control study
- Heat shock protein 27 is over-expressed in tumor tissues and increased in sera of patients with gastric adenocarcinoma
- Soluble mesothelin related peptides (SMRP) and osteopontin as protein biomarkers for malignant mesothelioma: analytical validation of ELISA based assays and characterization at mRNA and protein levels
- A novel sensitive immunoassay by nucleic acid barcode dot and its application in the detection of prostate-specific antigen
- Prostate cancer screening: clinical impact of WHO calibration of Beckman Coulter Access® prostate-specific antigen assays
- Infectious Diseases
- Use of flow cytometry (Sysmex® UF-100) to screen for positive urine cultures: in search for the ideal cut-off
- Letters to the Editor
- Improving laboratory efficiencies through significant time reduction in the preanalytical phase
- Comparison of the Vitek 2 system with the CLSI broth microdilution, disk diffusion, and sterol quantitation methods for determining fluconazole susceptibility against Candida spp.
Articles in the same Issue
- Review
- Elevated serum γ-glutamyltransferase activity is associated with increased risk of mortality, incident type 2 diabetes, cardiovascular events, chronic kidney disease and cancer – a narrative review
- Minireview
- Artificial intelligence for diagnostic purposes: principles, procedures and limitations
- General Clinical Chemistry and Laboratory Medicine
- Association between serum alkaline phosphatase and C-reactive protein in the United States National Health and Nutrition Examination Survey 2005–2006
- Association between serum uric acid and non-alcoholic fatty liver disease in Korean adults
- Plasma osteopontin concentrations in preeclampsia – is there an association with endothelial injury?
- Determination of globotriaosylceramide in plasma and urine by mass spectrometry
- Effect of inflammation induced by prolonged exercise on circulating erythroid progenitors and markers of erythropoiesis
- The Beckman DxI 800 prolactin assay demonstrates superior specificity for monomeric prolactin
- Stability of cerebrospinal fluid/serum glucose ratio and cerebrospinal fluid lactate concentrations over 24 h: analysis of repeated measurements
- O-β-N-acetyl-D-glucosaminidase in erythrocytes of Italian air force acrobatic pilots
- Validation and Outcome Studies
- Experimental validation of specificity of the squamous cell carcinoma antigen-immunoglobulin M (SCCA-IgM) assay in patients with cirrhosis
- Performance analysis of the ARCHITECT anti-cyclic citrullinated peptide antibody in the diagnosis of rheumatoid arthritis
- Reference Values and Biological Variations
- Applicability of common reference intervals for serum creatinine concentrations to the Croatian population
- Laboratory reference intervals during pregnancy, delivery and the early postpartum period
- Determination of serum holotranscobalamin concentrations with the AxSYM active B12 assay: cut-off point evaluation in the clinical laboratory
- Definition of reference ranges for the platelet distribution width (PDW): a local need
- Cancer Diagnostics
- Mean leukocyte telomere length and risk of incident colorectal carcinoma in women: a prospective, nested case-control study
- Heat shock protein 27 is over-expressed in tumor tissues and increased in sera of patients with gastric adenocarcinoma
- Soluble mesothelin related peptides (SMRP) and osteopontin as protein biomarkers for malignant mesothelioma: analytical validation of ELISA based assays and characterization at mRNA and protein levels
- A novel sensitive immunoassay by nucleic acid barcode dot and its application in the detection of prostate-specific antigen
- Prostate cancer screening: clinical impact of WHO calibration of Beckman Coulter Access® prostate-specific antigen assays
- Infectious Diseases
- Use of flow cytometry (Sysmex® UF-100) to screen for positive urine cultures: in search for the ideal cut-off
- Letters to the Editor
- Improving laboratory efficiencies through significant time reduction in the preanalytical phase
- Comparison of the Vitek 2 system with the CLSI broth microdilution, disk diffusion, and sterol quantitation methods for determining fluconazole susceptibility against Candida spp.
