An Update on Alkaline Phosphatase

The ODX Range for Alkaline Phosphatase was recently updated from 70 – 100 IU/L to 45 – 100 IU/L. We are in the process of auditing every biomarker currently in the ODX platform and made this change based on an extensive review of the literature that suggests the following:

• Significantly increased alkaline phosphatase is associated with bone disorders, bone growth, and hepatobiliary disorders, especially cholestasis and choledocholithiasis, a condition associated with a 2.5-fold increase in ALP above the standard range.
• The combination of increasing alkaline phosphatase and increasing inflammation should be investigated further to best determine cerebrovascular risk. Moderately increased ALP above 63 IU/L and elevated CRP above 5 mg/L have been observed with an increased risk of cerebral infarction. 
• An increasing ALP, especially above 97 IU/L, was associated with more severe adverse outcomes following hemorrhagic and ischemic stroke in high-risk patients.
• In high-risk patients, an ALP above 80 IU/L was associated with increased coronary artery calcium and plaque burden and should be evaluated further.
• In stable angina patients, an ALP of 105.4 IU/L was significantly associated with more advanced cardiovascular disease than an ALP of 78.4 IU/L.
• An ALP below 45 IU/L is associated with insufficient zinc or magnesium, minerals essential to alkaline phosphatase function. An alkaline phosphatase at the low end of optimal, along with signs or symptoms of zinc or magnesium insufficiency, should be followed up with an evaluation of serum or RBC levels of zinc and magnesium.

For more information on specific research and recommendations, please CLICK HERE to visit the ODX Research Blog entry for Alkaline Phosphatase.