Alkaline phosphatase (alkaline phosphatase) is an enzyme that belongs to the group of hydrolase molecules. It is necessary for the reaction in the body of dephosphorylation.
The success of this degradation of phosphorus occurs due to alkaline phosphatase.
The division of phosphorus molecules and organic substances occurs when the phosphatase is moved through the cell membrane of phosphorus ions.
The concentration of alkaline phosphatase in the blood plasma has a constant coefficient, which indicates the normal metabolism of phosphorus in the body. The alkaline phosphatase manifests most actively at the average pH of 8.60 to 10.10.
What is alkaline phosphatase?
Alkaline phosphatase is the most abundant enzyme in the body, but its functional responsibilities are not fully understood.
The alkaline phosphatase is present in all the cells of all the organs of the body and has its own variety:
Type of renal enzyme
- Intestinal phosphatase
- Type of placental phosphatase
- Hepatic type enzyme
- Bone type of alkaline phosphatase.
In serum, alkaline phosphatase is present in isoenzymes.
They are in almost the same percentage:
- Bone enzyme represented in osteoblasts.
- Liver enzyme – in hepatocytes.
If the balance is disturbed and the destruction of molecules in the cells (with a bone fracture) or pathology in the liver occurs, an alkaline phosphatase index in the blood plasma is produced.
There are enzymes that, when the biochemical analysis is included in the indications of alkaline phosphatase, in the body has certain functional responsibilities.
The duties of many enzymes include the decomposition of phosphoric acid into essential organic compounds, which leads to the normalization of phosphorus and calcium metabolism.
The activity of this enzyme.
The activity of this enzyme in serum has properties to change depending on the exchange process. This activity is a marker for the detection of bone disease (osteoporosis) at an early stage of the development of the pathology, and this coefficient is used for screening studies of the blood composition in serum.
The processes in the female genital organs lead to an increase in placental phosphatase, and in the biochemical analysis it will be reflected as an increase in the activity of the general phosphatase index which is alkaline.
By placental change, the neoplasms can be identified in the female genitalia (malignant tumor of the cervix).
Phosphatase activity in the child’s body.
The activity of the enzyme alkaline phosphatase in the child’s body is normally higher than in the body of an adult between 1.5 and 2 times. It depends on the physiological processes that occur in children’s bodies: this is the intensive training of all systems and organs, their intensive growth.
During the period of intensive growth, the alkaline phosphatase index may be 800 U / l.
This indicator in children is not a pathology, but a rule, since both enzymes, the type of liver and bone, are involved in the maturation process of the body.
When skeletal bone growth is complete, the bone enzyme stops showing its activity and only the hepatic isoenzyme affects the activity of alkaline phosphatase.
The isoenzyme phosphatase increases in women during the fertile period, and especially in the third trimester of fetal development. It is also a very high enzymatic activity in children who were born prematurely, because they have to catch up with their peers in development.
These indicators are physiological and are not considered deviations from the regulatory indicators.
There are results of biochemistry, if alkaline phosphatase is underestimated, this is an indicator of underdevelopment of the placenta and is an indicator during pregnancy.
What is the study of the enzyme phosphatase?
Phosphatase tests will be prescribed to identify at an early stage the development of pathology in the liver, as well as for diseases of the skeletal system.
In addition, there is an increase in the rate of alkaline phosphatase with changes in the gallbladder, during blockage of the bile ducts, as well as stones found in the bladder and ducts.
The activity of alkaline phosphatase also increases with malignant neoplasms in the organs of the endocrine system, in the pancreas.
The gamma-glutamyl transferase test together with the ALP test is performed during the diagnostic tests of a disease that causes pathologies in the process of removal of bile to the body: biliary cirrhosis (primary form), as well as sclerosing cholangitis of nature primary.
A biochemical analysis of the alkaline phosphorus factor is performed to identify pathologists in the bone cells, because any change in the bones increases the activity of the alkaline phosphatase.
At this point, malignancies can be detected and help ensure that this oncology center does not go beyond the bones.
The biochemical supply is repeated to track the activity of alkaline phosphatase and the development of the pathology, as well as to adjust the therapeutic or surgical treatment of the drug.
Under what circumstances is the study prescribed?
Laboratory tests for alkaline phosphatase are standard in biochemical analysis and are used to prepare surgery in the body. This test is also done on liver tests.
The analysis of alkaline phosphatase is prescribed when the patient has pronounced symptoms:
- General weakness of the body.
- Reduced appetite
- Nausea that goes into vomiting.
- Pain in the upper part of the abdomen, which bounces to the right side below the ribs.
- Yellowing of the skin with jaundice.
- Darkening of urine
- Change in fecal color.
- Skin itch
- Bone pain
- Joint pain
They also always perform alkaline phosphatase tests with frequent bone fractures.
The regulatory index of the enzyme in the blood.
The standard alkaline phosphatase coefficient has a fairly wide range of coefficients. Its range is 44.0 IU / L at an index of 147 IU / L.
When determining the standards, the gender of the person, as well as the age category, is of great importance.
Women who have a child have an overestimated alkaline anthrax index, as well as a slightly higher coefficient in adolescents in the puberty phase. These high indications of the index are not considered pathologies in the body, but are physiological deviations from the standard coefficients.
In addition, the indicators may vary in different directions, depending on the reagents used by the laboratory, because the standard scheme for the use of drugs in biochemistry is currently not available.
Table of standard indicators in the composition of blood alkaline phosphatase:
The activity of the enzyme is determined by several methods, as well as at different temperature conditions. The standard given in the table is calculated at a laboratory study temperature of 37 degrees.
To avoid confusion when deciphering the discrepancies in different clinical laboratories, there are reference values in the laboratory results in the alkaline phosphatase test. Using these values, it is possible to determine if the coefficient of the blood to be examined is within the regulatory range, or if there are deviations from the norm.
Table of reference values standards:
To be sure of the normal index of the results of your tests, you should consult your results in the clinical laboratory or at the reception of the attending physician.
What diseases increase the index?
In addition to the physiological etiology of the increase in alkaline phosphatase, the pathologies in the body affect the increase in the activity of this enzyme:
- Hepatic diseases – Necrosis of the hepatic parenchyma, jaundice (hepatitis), neoplasms in the organ of a malignant nature, metastasis in the liver, as a result of oncology of neighboring organs. In addition, the enzymatic activity is caused by infectious diseases of the liver, organ damage by toxins and drug intoxication. Parasites, which enter and destroy liver cells, affect the rate of enzymes. Hepatitis, which is caused by viruses, does not give high activity of isoenzymes. The enzyme coefficients can not be higher than normal. The result of the analysis of aminotransferase – an increased rate of ALT and AST
- Inflammatory process in the gallbladder and ducts. – They are diseases of cholecystitis or cholangitis. It can also be caused by an increase in jaundice caused by mechanical phosphatase, which was caused by a stone that blocked the exit of the biliary bladder. The closing of the bile ducts can cause adhesions of the ducts and tumors caused by the cancer. This pathology causes a sudden jump in the AP index.
- Oral contraceptives, Progesterone, as well as estrogen, can lead to drug-induced jaundice (cholestatic), which causes an increase in the rate of phosphatase in women.
- Chronic alcohol poisoning
- Vitamin D deficiency caused by rickets in a baby. Rickets caused by renal pathology has a congenital etiology.
- Infectious pathology due to cytomegalovirus in a child
- Neoplasms of the excretory vesicles.
- Pathologies that lead to the destructive processes of bone tissue: bone sarcoma, metastasis, which have penetrated from the oncology of neighboring organs. In addition, abnormalities in the enzyme index do not properly accumulate bone after a fracture.
- Pathology osteomalacia – deficiency of minerals in bone tissue
- Paget’s disease – osteitis of deforming character. Index increase 20 times normal
- Infectious etiology mononucleosis: the enzyme rises in the initial stage of infectious inflammation
- Myeloma disease
- Muscular pathology
- Increased production of hormones by the thyroid gland (a toxic goiter disease)
- Hyperparathyroidism – Parathyroid hyperactivity
- Oncology of the head of the pancreatic organ.
- Sarcoidosis of Beck
- Breast cancer
- Endometritis of the genital organs in women.
- New growths of oncological character in the cervix.
- Ovarian cancer
- Endometrial disease
- Myocardial infarction in the acute phase of the disease.
- Ulcerative colitis
- Intestinal perforation
- Deficiency of calcium in the body.
- Phosphorus deficiency.
How to reduce alkaline phosphatase?
The treatment to reduce the activity of the enzyme is carried out with the help of medications and a balanced nutrition of the patient:
- Azathioprine drug
- Clofibrated Drug
- Oral contraceptives
- Medications that normalize the functioning of the liver.
- Use herbal medicine infusions that have a positive effect on the liver.
- Diet with foods rich in calcium.
- Diet, that with the maximum presence in phosphorus products – fish, seafood, dairy products, meat, beef liver.
Foods rich in phosphorus
Low blood phosphatase index
A lower release of isoenzymes in serum causes a decrease in the alkaline phosphatase index.
The alkaline phosphatase is reduced, which means that the following pathologies occur in the body:
- Osteoporosis of advanced age
- Thyroid myxedema
- A surplus of isotopes that have a radioactive nature in the bone tissue.
- Severe anemia
- Deficiency of scurvy or vitamin C
- The excess in the body of vitamin D. This indicator is the consequence of non-compliance with the dose of drugs for rickets.
It can increase the presence of serum alkaline phosphatase in the blood serum using a diet that is able to saturate the body with essential vitamins:
- Foods high in vitamin C: citrus fruits (especially lemon), onions, garlic, blackcurrants, rose hips
- Products with the vitamin B group content: meat, vegetables, beef liver, fatty fish, garden vegetables.
- Foods rich in magnesium molecules: seeds, legumes, soybeans, nuts of all kinds.
Foods rich in magnesium molecules.
Do not confuse alkaline phosphatase with acid phosphatase.
In addition to alkaline phosphatase, in the analysis of blood biochemistry, there is also an indicator: acid phosphatase. This index shows the state of the prostate gland in men.
An increase in the level of the acidic enzyme suggests that a tumor is present in the gland or that the metastases have sprouted in other organs.
Acid phosphatase is a specific antigen of the prostate, as well as a marker of neoplasm in the prostate gland (PSA).
Conclusion of alkaline phosphatase
To identify the pathology in the body, the results of the study of the composition of the blood on the concentration of alkaline phosphatase are not enough. Since the regulatory range of this enzyme is quite broad, and depends on the age category.
For an accurate diagnosis, you must undergo a series of additional diagnostic tests.
Based on the alkaline phosphatase index and the results of additional studies, the physician sees a complete picture of the pathology and can establish the correct diagnosis.
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