Alkaline phosphatase is normal. What values ​​are considered low? What can influence the result

The results of blood tests allow us to determine malfunctions in the body even before any symptoms appear. If during the examination it turns out that alkaline phosphatase is elevated, the doctor will help you figure out whether this condition is a sign of a disease or whether it is normal and treatment is not required.

One of the most informative diagnostic studies is biochemical analysis. The material for this test is blood serum. During the research, the level of content is determined various substances, one of them is alkaline phosphatase (for brevity, this substance is often referred to as ALP). If a biochemical analysis shows that alkaline phosphatase is elevated, then it will be necessary to find out the reasons for this condition.

What is it?

First of all, it is worth finding out what the substance is. This is a protein compound that acts as a catalyst in metabolic processes involving calcium and phosphorus. This enzyme is located in the cell membranes of a wide variety of tissues. Therefore, several fractions of alkaline phosphate are distinguished:

• bone;
• hepatic;
• placental;
• intestinal, etc.

The substance molecule is a dimeric compound; it consists of two parts, each of which has several (most often three) active nuclei.

Advice! In the blood, the substance is contained mainly in two forms - bone and liver. The ratio of these isoenzymes is approximately one to one. The content of other isoforms is insignificant.

Indications

Blood tests for alkaline phosphatase levels are ordered during the diagnostic process. various diseases, most often, such an analysis is prescribed for suspected pathology bone tissue and liver diseases. Thus, the doctor can refer the patient for analysis if he complains of digestive disorders, itchy skin, pain in the right side, etc.

In addition, analysis is assigned in the process:

• medical examination of people working in hazardous industries;
• preparing the patient for surgery.

How is the procedure carried out?

To conduct the study, you need to donate blood samples. In order for the analysis to show objective results, it is necessary that the patient is ready for the examination. Analysis is submitted to morning time, and at least 12 hours must have passed since the last meal. The day before, you should not drink alcohol or eat fatty foods.

Norms and deviations

Normal levels of alkaline phosphatase activity for adults are 40-130 U/l. However, exceeding this indicator does not always mean the presence of pathology. In some cases, this is a variant of the norm.

Advice! Specific numbers for normal ALP levels can be seen on the laboratory form. The fact is that different laboratories can use different techniques analysis, therefore the values normal indicators may differ significantly.

Physiological norm

The normal level of alkaline phosphatase depends on the age of the patient. So, in a child the level of the substance in the blood is significantly higher than in adults. This is due to the fact that during growth more bone isoenzyme alkaline phosphatase is synthesized, so the level of total phosphatase in the child’s blood is high. With age, the child’s growth process stops, and the concentration of the bone isoform of the enzyme in the blood also decreases.

Advice! In girls, the level of alkaline phosphatase is compared with the indicators characteristic of adult patients by adulthood. In guys, the bone-forming processes that cause the production of alkaline phosphatase last longer. Their indicators are equal to “adult” standards by the age of 20-25.

In addition, elevated ALP levels are physiological norm for pregnant women. In the period up to the 16th week of pregnancy, enzyme activity increases due to increased output of this substance by the placenta.

Thus, an increased level of alkaline phosphatase is a physiological norm:

• for a child during the period of growth;
• for girls up to 18 years old and for guys up to 25 years old;
• for pregnant women in the first trimester of pregnancy;
• for women taking hormonal contraceptives;
• for patients undergoing antibiotic treatment taking aspirin;
• during the rehabilitation period after fractures, at this time a callus, therefore the level of bone isoenzyme is slightly higher than normal.

Pathology

However, an increase in alkaline phosphatase activity is not always a physiological norm; often the reasons for changes in the level of activity lie in pathological processes. Most often, the analysis allows us to identify pathologies of the liver, gall bladder, and bone tissue. An increase in the level of liver isoenzyme can be caused by the following reasons:

In addition, the reasons for the increase in enzyme levels are due to dysfunction of the gallbladder:

• at stagnation, cholestasis may be caused by blockage of the duct with a stone or compression of the gallbladder by a tumor;
• with neoplasms in the biliary tract;
• with biliary cirrhosis.

An increase in the level of the bone fraction of the enzyme is caused by damage skeletal system. Possible reasons:

• rickets in a child;
• osteomalacia (pathology associated with impaired mineralization);
• bone sarcoma or bone metastases;
• osteoporosis.

Increased placental fraction of the enzyme in non-pregnant women may indicate the presence of a tumor in the internal genital organs (cervix, endometrium, etc.)

Advice! An increase in the level of alkaline phosphatase enzyme by 2-3 times is observed with inert pathology. With damage to the liver and biliary system, a more significant increase in enzyme activity is observed; its level can be 3-10 times higher than normal.

If the level of alkaline phosphatase in the blood is elevated, this does not mean that the patient has the pathology listed above. The analysis is not specific; diagnosis will require additional research.

What to do?

What to do if the analysis shows that alkaline phosphatase activity is increased? First of all, do not panic and do not try to diagnose yourself. There is no need to try to lower the level of the enzyme by self-medicating.

You need to see a therapist. The doctor will also not be able to immediately make a diagnosis, since it is impossible to determine the nature of the pathology based on the results of only one analysis. The doctor will examine the patient, ask about his health, and prescribe additional tests and examinations.

If necessary, he will issue a referral to a specialized doctor. You may need to consult a hepatologist, endocrinologist, surgeon, or oncologist. Only after it has been carried out full examination, it will be possible to install accurate diagnosis and prescribe appropriate treatment to the patient.

Assessing the results of a biochemical blood test is a matter for specialists. However, patients cannot help but be concerned if they see obvious deviations from the norm in the analysis form. So, many people ask what does it mean if alkaline phosphatase is elevated? Unfortunately, the results of such an examination cannot make a diagnosis.

Moreover, in some cases, an increase in the level of the hormone is a variant of the norm. Therefore, you will need additional examinations and possibly consultations narrow specialists. Only after the cause of the change in alkaline phosphatase activity has been established, treatment can be prescribed.

Especially important role in the human body has phosphorus-calcium exchange. Proper work this exchange affects the work of almost everyone vitally important systems human body - from musculoskeletal tissue, to the liver. For normal exchange substances require the work of enzymes. These enzymes are called alkaline phosphatase (ALP). To diagnose diseases, patients undergo a blood test, which determines the level of alkaline phosphatase.

What is alkaline phosphatase in the test? In a biochemical blood test, alkaline phosphatase helps to timely determine not only serious illnesses systems of human life, but also oncological tumors. In order to conduct the study, the patient must donate blood for general analysis and biochemistry. A blood test will show what concentration the enzyme is in.

How enzymes work

WITH various products nutrition, phosphoric acid enters the human body. IN in full force it is not absorbed by the body. ALP enzymes come into action. They separate phosphoric acid from other elements and break it down.

Then, ALP in the blood acts as a catalyst. Enzymes deliver phosphorus to the tissues of all internal systems body. Phosphorus provides cells with the necessary level of metabolism.

If pathology or neoplasms appear in the tissues, the process of phosphorus absorption slows down. Enzyme levels deviate from normal and metabolic disorders occur. A blood test at this moment shows a jump in the level of alkaline phosphatase. Biochemistry allows you to accurately determine the pathology of human internal organs.

What does a blood test show?

Most often, a biochemical blood test for alkaline phosphatase and its norm is used in comprehensive study, together with the determination of other substances. Blood biochemistry helps diagnose:

• Metabolic disorders during pregnancy.
• The appearance of stones in the gall bladder.
• Damage to inert tissue.
• Oncological disease.
• Development of infectious mononucleosis.
• The appearance of liver and kidney pathologies.

Deviations in normal alkaline phosphatase levels may indicate the effectiveness of therapy. Most often, this test is prescribed before complex operation. It will be directly affected by taking certain medications. For example: Phenobarbital, Ranitidine, Papaverine, Furosemide and others.

ALP in a biochemical analysis can have a value higher than normal even in the analysis of a healthy person. This may mean that the patient's body high level metabolism. Elevated alkaline phosphatase usually occurs:

• In athletes during periods of high sports loads.
• In expectant mothers and women during lactation.
• In a child during the period of bone development and formation
• In adults during generous intake food.

The situation is much worse if the alkaline phosphatase in the blood is below normal. This means that pathological processes occur in the body:

• Thyroid dysfunction.
• Imbalance in microelements.
• Excess vitamin D in tissues.
• Vitamin deficiency, with deficiency of vitamins B and C.

Low alkaline phosphatase levels may be caused by medications that include statins and sulfonamides.

How to get tested correctly

To receive accurate results, it is necessary to ensure a high-quality analysis. Blood is drawn from a vein. You need to take the test in the morning, on an empty stomach. It is best not to eat food at least 10-12 hours before the test.

Before analysis, it will be necessary to exclude severe physical activity. It is recommended to cancel at least 2 days in advance. active image life and physical labor. Alkaline phosphatase increased during sports activities. Therefore, any physical activity, will distort the analysis result. Children are especially active during walks.

Therefore, it is necessary to exclude outdoor games the day before blood sampling.

When preparing for analysis, you should completely avoid using any alcoholic drinks. Taking medications must be limited if they are not vital - important function. Before carrying out the analysis, it is better not to undergo physiotherapeutic procedures and hardware tests (X-rays, fluorography, etc.).

How to evaluate the analysis result

The level of alkaline phosphatase in the blood varies depending on a person's age and gender. Minor deviations from the norm are a natural error in the analysis. What deviation is considered insignificant? Only the attending physician can answer this question.

To navigate the issue, it is enough to know the approximate norms of alkaline phosphatase:

• In adult men, the normal level of alkaline phosphatase is from 30 to 130 units/l.
• In adult women, the normal level of alkaline phosphatase in the blood is from 30 to 120 units/l.
• In children in adolescence, the norm is from 150 to 280 units/l.
• In newborns and children under 9 years of age, the norm is from 250 to 350 units/l.

In some laboratories the result may be calculated in µmol/l. If your blood test says micromoles, only a doctor can convert the result to generally accepted units. The high level of alkaline phosphatase in the blood of children should correspond to the characteristics of their age. IN childhood in the human body, bone tissue develops, internal organs grow, and high motor activity. For these processes, a high concentration of enzymes responsible for metabolism is vital.

Why is the ALP level elevated?

This result of an ALP test occurs much more often than reduced level alkaline phosphatase. If it can be ruled out that the increase in level occurred as a result of playing sports or after eating a heavy meal, then the decoding may indicate the presence of serious diseases.

Most probable reasons Increased alkaline phosphatase in the blood will lead to liver diseases:

• Obstructive pancreatitis.
• Hepatitis C.
• Mononucleosis.
• Fatty liver degeneration.
• Cholestasis.
• Malignant tumor.
• Bacterial and viral infections.

Another group of diseases that are diagnosed with elevated level ALP are pathologies of bone tissue:

• Rickets.
• Paget's disease.
• Acromegaly.
• Myelofibrosis.
• Leukemia.
• Myeloma.

Changes hormonal levels, also lead to disruption of the functioning of internal organs and the development dangerous diseases. As a result of the development of diseases caused by hormones, the level of enzyme concentration also increases. Therefore, an analysis result that is significantly higher than normal may indicate the presence of diseases:

• Hyperthyroidism, hyperparathyroidism.
• Osteomalacia.
• Rickets.
• Osteogenic sarcoma.
• Shingles.
• Hyperfunction of the adrenal glands.

Reception contraceptive drugs at a constant level, may lead to exacerbation of liver diseases. If the medication is taken for a long time (more than 3 years), then the analysis to determine the level of enzymes will be overestimated.

A high alkaline phosphatase level can occur after a bone fracture. During this period, there is active fusion of bone tissue and wound healing. All metabolic processes are increased.

Therefore, a result above the norm will be a natural phenomenon.

Extremely high rate The level of enzymes during examination absolutely clearly indicates the presence of bone cancer. But such a result requires expanding the analysis in order to accurately diagnose the lesion and the degree of cancer development.

Long-term use of alcoholic beverages during alcoholism contributes to the destruction of liver cells. Any enzyme tests in such patients will be elevated.

Why is the ALP level low?

A reduced level of alkaline phosphatase in a biochemical blood test may be due to lack of nutrition. If a person's diet is not balanced, or the amount of food is not enough, this leads to a slowdown in the metabolic process. Cells and tissues cease to function in a stable manner. In internal organs begin irreversible consequences, and outbreaks of disease appear. Such consequences are difficult to treat with medication.

If the patient does not complain of lack of food, then low level alkaline phosphatase often demonstrates the presence of serious diseases:

• Hypophosphatasia (lack of phosphorus in the body).
• Low protein content.
• Dysfunction of the parathyroid glands.
• Pernicious anemia.
• Deficiency of vitamins and microelements.

Low enzyme levels occur in donors during the period of donating large volumes of blood. At the same time, to support normal functioning The donor's body is prescribed vitamins and dietary supplements.

During menopause, women usually experience a slowdown in all processes in the body. Metabolism also slows down. Therefore, enzyme activity is slightly reduced. This is considered normal.

Alkaline phosphatase is found in small amounts in all tissues human body. It plays a leading role in phosphorus-calcium metabolism; the greatest activity of the enzyme is manifested in the tissues of the kidneys, liver, intestines and bones.

In diagnostics, it is used to obtain information about the functioning of various systems, for example, digestive or musculoskeletal. The analysis also helps to identify oncological diseases. What kind of enzyme is it and what are its features?

What is alkaline phosphatase?

What is alkaline phosphatase? This is a set of 11 isoenzymes belonging to the group of hydrolases (enzymes that hydrolyze covalent bonds). The following localizations are used more often than other types of isoenzymes in diagnostics:

Hepatic;

Gall;

Bone tissue;

Intestines;

Tumors and neoplasms;

Placenta.

Alkaline phosphatase is a protein with complex chemical structure. It contains two zinc atoms. This enzyme is very active in an alkaline environment with a pH of 9-10. IN biochemical processes it has the function of a catalyst.

The main sources of “natural catalyst” are:

Kidneys;

Spleen;

Placenta,

Mucous membranes.

Its purpose in our body is to separate phosphoric acid from food and enrichment of tissues with it. All this has a direct impact on metabolism.

If a person is healthy, then the concentration of alkaline phosphatase in the blood is equally divided into the liver and bone fractions. It should be noted that the source of the liver fraction is hepatocytes, and the bone fraction is formed in osteoblasts. Other types are also included in the blood, but their content is minimal. In pathology and a number of physiological changes the ratio of isoenzymes changes. This process has been successfully used in diagnostics.

Normal values ​​of alkaline phosphatase in the blood by age and gender

Alkaline phosphatase levels depend on both a person’s gender and age. The values ​​are wide and depend on the research methodology. The referral form indicates the current standards for the chosen method.

Alkaline phosphatase levels are normally much higher in children than in adults. The difference is approximately 150%. This is considered normal, since they are in the stage active growth and development, which means metabolic processes proceed more intensely. In the table you can track these changes in ALP.

Age category	Maximum permissible limit of reference value, U/l
Up to 5 days	550
From 5 days to 6 months.	1000
6-12 months	1100
1-3 years	670
3-6 years	650
6-12 years	720

IN adolescence the body is rebuilt, then it happens puberty. The hormonal “explosion” affects the functioning of all life support systems, and as a result, the concentration of alkaline phosphatase increases (table below).

High alkaline phosphatase is considered normal in women during pregnancy (in the third trimester), as well as in premature newborns (the body is trying to “catch up”).

The enzyme content in the blood of women is slightly lower than that of men. Male concentrations of alkaline phosphatase are determined by the activity of bone isoenzymes until approximately 30 years of age. Then the situation changes and it is observed sharp decline enzyme level due to the bone fraction (after all, the skeleton is fully formed, and enzyme activity decreases). Below is a table showing the norm for men according to age categories compared to women's.

As you can see, the difference is on average 20-25 units. Studying the table, you can notice another pattern. The older a person is, the higher his alkaline phosphatase level. This is explained by the fact that bone tissue in older people becomes fragile and light, which provokes additional release of enzymes and their entry into the blood. And since the bone type of isoenzymes is one of the leading ones, their concentration increases with age.

In what cases is a study prescribed?

Alkaline phosphatase testing is required for all patients suffering from kidney, liver, endocrine system and disruptions in the gastrointestinal tract.

The analysis can be carried out fractionally. This is a more informative study than a biochemical blood test, but at a budget price medical institutions It is “biochemistry” that is used. This is due to the need to use expensive equipment that only specialized laboratories can afford.

Alkaline phosphatase test

A biochemical blood test for alkaline phosphatase is a test that involves taking venous blood in an amount of 5-10 ml. It is carried out only on an empty stomach, so that the breakfast eaten does not provoke an increase in concentration. Smoking less than half an hour before visiting the laboratory is also excluded.

The biochemical blood test uses the colorimetry technique. This means that reagents will be gradually added to the sample, and then indicators will be obtained using specialized equipment.

Increased concentration of alkaline phosphatase

Inflammatory, mechanical, neoplastic and degenerative nature cause the release of enzymes into the blood, thereby causing a jump in the level of alkaline phosphatase.

By the way, a completely healthy person can have high alkaline phosphatase. The reasons for the increase in this case are as follows:

Physical activity;

Fast digestibility of food;

Pregnancy period (last trimester) and lactation;

Intensive bone growth in a child.

A jump in concentration can be caused artificially:

The blood was refrigerated after collection until the study was performed;

Taking medications - antibiotics, hormonals, contraceptives, phenobarbital, papaverine, ranitidine. List similar drugs consists of 250 items.

If a high level is considered as a symptom, then the following diseases are possible:

Liver disorders. List possible options very big. They can be grouped into groups: diseases of the pancreas or biliary tract, hepatitis, cirrhosis, infections;

Changes in bone structure. During illness, the tissue may soften due to calcium deficiency in the body (osteomalacia). Other injuries include rickets, fractures, bone cancer, osteosarcoma, abnormal bone growth, myeloma;

Amyloidosis;

Inflammatory process in the gastrointestinal tract;

Alcoholism;

Granulation of affected areas in the wound;

Gilbert's syndrome;

Tumors.

In addition to increasing the level of phosphatase in the blood test, other indicators also change:

Glucose levels decrease;

Cholesterol increases;

Urea decreases;

Low total protein;

High triglycerides;

Low albumin level;

Quite often the alkaline phosphatase indicator is ignored. During a biochemical blood test, this enzyme is simply rarely examined, giving preference to more significant indicators, For example, total protein, bilirubin, urea. However, the level of alkaline phosphatase in the blood, the norm for healthy people need to know. There are several enzymes of this group; they are specific markers of damage.

An indicator such as alkaline phosphatase cannot be ignored. This enzyme, or more precisely, a group of them, is present in various organs, therefore it can be called a specific marker, the change of which indicates the location of the lesion.

The following types of enzyme are distinguished depending on the tissue or organ of their location:

• intestinal;
• renal;
• hepatic;
• bone;
• placental;
• tumor.

On the biochemical blood test form you can see the following letters indicating alkaline phosphatase: ALP or alkaline phosphatase. If ALPL is identified, then it is a nonspecific form that is predominantly active in the liver, bones, and kidneys. Abbreviation ALPI - intestinal, ALPP - placental. But these isoforms are separately determined only at the time of diagnosis.

Normally, enzymes of bone and liver origin predominate in the blood. In a simple biochemical analysis, ALP refers to the total amount of all isoforms.

There is also acid phosphatase, which in men serves as a marker of prostate tumors - PSA, or prostate-specific antigen. This is a completely different enzyme and has nothing to do with alkaline phosphatase and they should not be confused.

Functions and place in the body

The function of ALP is to exchange phosphorus and calcium during alkaline reaction environment (optimal pH 10). It is located on cell membranes and processes phosphates - carries out hydrolysis, as a result of which phosphorus enters the tissues, phospholipids are formed - structural components biological membranes.

Despite several isoforms of ALP, the concentration in the blood characterizes the state of the skeletal system, liver and biliary tract.

Bone

ALP is responsible for calcium metabolism. On the surface of osteoblasts - bone cells - it carries out hydrolysis, thereby supplying the tissues with minerals and phosphates. Blood alkaline phosphatase activity may jump when significant growth or regeneration of the skeletal system occurs. Therefore, children have increased enzyme values.

Hepatic

The fraction in the liver is localized in bile ducts near the central and portal veins. As elsewhere, it breaks down organic acids, producing phosphorus residues. Participates in the synthesis of bile.

Intestinal

This isoform of the ALPI enzyme is produced by enterocytes into the intestinal lumen. This fraction is normally small; only with heavy food consumption does it increase in people with blood groups 1 and 3; its rise accompanies diarrhea.

Renal

There is almost none in the blood; almost all of it is excreted in the urine, with the exception of renal pathology.

Neutrophilic

Neutrophils also contain alkaline phosphatase, but its nature is not completely clear. Significantly increases in neutrophils in lymphocytic leukemia and mononucleosis.

Placental

This form of ALP can be attributed to both normal blood components and tumor enzymes. In women, the appearance of this fraction is associated with pregnancy. Begins to enter the blood after 12 weeks of gestation from 1 to 40 U/l.

As pregnancy progresses, placental alkaline phosphatase increases and this growth can be used to judge the viability of the placenta’s development. If a pregnant woman has a decreased placental alkaline phosphatase, placental insufficiency can be assumed. A decrease in alkaline phosphatase was noted with:

• gestosis;
• disturbances in the metabolism of calcium, magnesium, phosphorus;
• threat of miscarriage.

In non-pregnant women and men, this enzyme indicates an oncological process.

Tumor

There are 3 tumor isoforms:

• placental, or Regan's isoenzyme;
• testicular, placental-like, Nagao form;
• germinal intestinal, Kasahara.

These enzymes are “indicators” of cancer in the body. Although placental phosphatase is present in the blood after 12 weeks of pregnancy is normal. But in non-pregnant women and men, the appearance of tumor isoenzymes may be characteristic lung cancer, hepatoma, pancreatic, renal cell, seminoma, stomach, ovary.

ALP norms

Alkaline phosphatase concentrations correlate with age and gender. In a child it is 2 times higher than in adults, which is due to active osteogenesis. In the elderly, bone destruction processes associated with changes in the alkaline phosphatase level predominate.

In men

In men, the level of alkaline phosphatase in the blood changes with age. These changes arise as a result at different speeds synthesis or lysis of bone tissue in an adult.

Table 1. Alkaline phosphatase norms in men by age.

In women

In the blood of women, the level of alkaline phosphatase is approximately 10 units lower than that of men.

Table 2. Alkaline phosphatase norms in women by age.

During pregnancy

During pregnancy, the level of alkaline phosphatase can change dynamically due to both the liver and placental fractions.

In children and adolescents

Blood alkaline phosphatase standards in children are slightly higher than in adults. The reasons for this are discussed above.

Table 3. Alkaline phosphatase norms in children by age.

It is important to note that normal values ​​depend on the reagents and devices used to study the phosphatase enzyme!

For the INVITRO laboratory, the ALP standards are somewhat different from the test systems in HELIX.

Table 4. Comparison of reference values ​​of ALP in INVITRO and HELIX.

Causes of increased alkaline phosphatase in the blood

Conditional physiological processes An increase in the level of enzyme activity occurs in the following conditions:

• pregnancy after 12 weeks;
• children during the period of active skeletal growth;
• healing of bone fractures;
• menopause;
• taking combined contraceptives;
• lack of calcium in food.

An increase in alkaline phosphatase in the blood occurs during congestion in the bile ducts. This occurs due to mechanical obstructions of the bile outflow. In case of damage to hepatocytes - liver cells, the increase in the enzyme will not be as pronounced or may be absent altogether.

If obstruction of the bile ducts occurs outside the liver, then the alkaline phosphatase level increases by more than 10 times, while intrahepatic obstruction does not lead to such a pronounced jump in alkaline phosphatase - 2-3 times.

There is an increase in alkaline phosphatase in liver pathologies:

• cholelithiasis (GSD);
• cholangitis;
• cholecystitis;
• tumors of the biliary tract;
• neoplasm of the head of the pancreas;
• hepatitis of any etiology with signs of bile stagnation;
• cirrhosis and cancer;
• benign and malignant formations, metastases;
• infectious mononucleosis;
• liver failure with cholestasis.

If diseases of the bone skeleton develop, alkaline phosphatase is increased. This occurs with nosologies:

There are a number of other pathologies that provoke an increase in blood alkaline phosphatase:

• Gaucher disease is congenital, affecting the liver, bones and other organs;
• tuberculosis;
• myocardial infarction, kidney, lung;
• intestinal diseases - cancer, ulcerative colitis, food poisoning and others;
• kidney, lung cancer;
• hyperparathyroidism;
• hyperthyroidism;
• malignant tumors of the testicles, breast, stomach, ovaries;
• implant calcification;
• sepsis.

Medicines, the use of which is associated with stagnation of bile, provoke an increase in the level of alp in biochemical research. Such means include:

• magnesium sulfate;
• anticonvulsants – carbamazepine and others;
• antidepressants;
• excess synthetic vitamin WITH;
• hormonal (contraceptives);
• antibiotics;
• non-steroidal anti-inflammatory drugs;
• sulfonamides.

In some heart nosologies, deviations from normal alkaline phosphatase levels also develop, but these changes are not specific. Therefore, diagnosing heart diseases requires other research methods.

Why is ALP low in the blood?

There is a pathology with congenitally reduced alkaline phosphatase in the blood - hypophosphatasia. As a result of a decrease in the enzyme, fractures occur with long consolidation, developmental delay, muscle weakness, seizures, kidney calcification and others.

Conditions occur when alkaline phosphatase is low. The reasons for the decrease in ALP are related to:

• lack of vitamin C, B6 in food;
• excessive intake of vitamin D in the prevention of rickets in children;
• anemia;
• starvation;
• hypothyroidism

Indications for analysis

To study phosphatase activity, a conventional biochemical assay is used. To identify enzyme fractions, separate tests are prescribed. ALP is not specific, but its individual isoforms help make the diagnosis.

You should not drink alcohol the day before the test. medicines without the need to eat 8 hours before the date of delivery.

Indications for its use are:

• chronic diseases of the liver, pancreas;
• cholecystitis;
• “acute abdomen” for the diagnosis of cholestasis;
• identification of specific oncological process forms;
• measurements during pregnancy.

How to reduce ALP levels

If alkaline phosphatase increases, then it is necessary to look for the reasons for this increase. Additional studies are carried out to identify the underlying pathology. With correctly prescribed therapy, no measures to specifically reduce ALP are required. Upon recovery, the enzyme will return to normal.

Video about ShchF

Alkaline phosphatase is a hydrolysis enzyme that removes phosphate from various types molecules. Such molecules can be nucleotides, proteins, and alkaloids. This enzyme is most active in an alkaline environment.

The enzyme ensures the transport of phosphorus through the thickness cell membranes cellular structures. The amount and activity of the enzyme is an indicator of the activity of phosphorus and calcium metabolism. Alkaline phosphatase is contained in bone tissue, gastrointestinal mucosa, liver hepatocytes, renal tubule cells; in addition, this enzyme is synthesized in the cells that make up the tissues of the placenta during the period of gestation. The main amount of phosphatase in the human body is found in the small intestine. For example, the concentration of a compound in the mucosa small intestine 30-40 times higher than in liver tissue cells. The compound is synthesized surface layer mucosa of the small intestine, however, the role of phosphatase in the processes of digestion is secondary. The main functions of this compound are to ensure the processes of general metabolism.

For diagnosis various ailments An examination is carried out for the presence and amount of enzyme in body fluids, which are:

• blood serum;
• urine;
• gastric juice.

Additionally, phosphatase isoenzymes are determined:

• hepatic;
• bone;
• intestinal;
• placental and some others.

Chemically, the enzyme is an isoenzyme, monoester phosphohydrolase phosphoric acid. These monoesters have molecular weights ranging from 70 to 120 kDa.

1 Isoenzyme content in blood serum

Serum alkaline phosphatase levels can vary widely. These indicators range from 44 to 147 IU/l. In this case, when determining the amount of phosphatase in the blood, attention should be paid to the gender of the patient from whom blood was taken for research, and additional attention should be paid to the age of the person being examined. In pregnant women, as a rule, the concentration of alkaline phosphatase in the blood is elevated. Adolescent children who are going through puberty also have a slightly higher rate. An increase in enzyme concentration during this period is not an indication of the presence of any disorders or abnormalities in the body. The reasons for the increase in the level of alkaline phosphatase in the blood during this period are the passage of rapid processes of restructuring in the body, which are associated with various systems life support and growth of bone tissue and placenta.

As a rule, the content of alkaline phosphatase may fluctuate depending on the reagents used in the research process. On modern stage standardized laboratory medical technique There is no definition of an enzyme. The norm in women and men, depending on the determination method, may fluctuate, but the range of discrepancies in the indicators is insignificant. Alkaline phosphatase is elevated if its concentration exceeds:

• in children under 10 years of age the rate is 150-350;
• in adolescents from 10 to 19 years of age the indicator is from 155 to 500;
• for an adult under 50 years of age, the figure is from 85 to 120;
• at the age from 50 to 75 years the indicator is 110 -135;
• for a person over 75 years old the figure is 165-190.

To determine the number of this type of connection, any specialist carries out a series of clinical trials. However, the limits of normal phosphatase levels are wide and depend on large quantity factors, therefore it is impossible to judge the presence or absence of a particular disease in a person by only one indicator of the amount of this compound in body fluids. This indicator is used as additional feature diagnosing body ailments.

2 Increasing the concentration of the enzyme in the body

A decrease or increase in alkaline phosphatase is carried out according to certain medical indications. This indication could be:

Blood is taken for analysis during liver function tests and to assess the functional capacity of the liver.

Very often, the patient is examined for abnormalities in the amount of enzyme in the blood, if the patient complains of fatigue, loss of appetite, nausea and pain in the right hypochondrium. As an additional diagnostic sign To detect the presence of a disease, the amount of enzyme in the blood serum is determined if there is a suspicion of the development in the body of diseases associated with damage to bones and bone tissue.

An increased level of phosphatase in the serum always signals possible defeat or involvement in pathological process in the body's bones, liver or biliary tract. An additional set of examinations can be used to clarify the results of the examination. So, for example, if, along with an increase in the concentration of alkaline phosphatase, it is detected, then this signals the presence of ailments associated with disturbances in the functioning of the liver. If an increase in the amount of the enzyme occurs in conjunction with an increase in the level of calcium and phosphorus, this indicates the presence of damage to the bone tissue.

3 Reasons for increased phosphatase concentrations

Today, medicine knows many reasons that contribute to an increase in the concentration of the enzyme in the patient’s body. The whole range of reasons can be divided into four main groups.

The first group is causes associated with the occurrence of disturbances in the functioning of the kidneys or diseases affecting these organs. Such ailments may be obstructive jaundice, which is caused by obstruction of the bile ducts, the formation of stones in the bile ducts. This disease can be caused by the formation of scars after surgical intervention. Additionally, an increase in the concentration of the enzyme can provoke the development of cancer of the head of the pancreas, stomach, or the formation of cancer metastases in the liver tissue. With hepatitis and cirrhosis of any origin, an increase in phosphatase is detected in the human body. Infectious mononucleosis may be immediate cause disturbances in the functioning of the liver and can provoke an increase in the amount of enzyme in the blood serum.

The reasons belonging to the second group are disorders associated with the functioning of the bone tissue of the body. These disorders can be provoked by diseases such as osteomalacia, which is a process of softening of bone tissue resulting from a lack of calcium in the body, osteosarcoma, metastases of cancerous lesions that affect the bone tissue of the body, the occurrence of fractures, the development of rickets and myeloma.

The third group represents other reasons not listed in the first two groups. An upward change in the amount of enzyme in the blood may be associated with the occurrence and development of myocardial infarction, ulcerative colitis and the occurrence of intestinal perforation. Additionally, this group includes hyperparathyroidism, which is a hormonal disease that promotes the leaching of calcium from bone tissue.

The causes included in the fourth group are not a consequence of the development of diseases in the body, but are caused by a whole complex various factors. This group includes the following condition: female body, as the period of bearing a child, adolescence, women under 20 years of age and men under 30 years of age.

4 Reasons for decreased phosphatase concentration

• carrying out large-volume blood transfusions;
• decline functionality thyroid glands;
• severe anemia;
• lack of microelements such as zinc and magnesium in the body;
• hypophosphatasia, which promotes softening of bone tissue.

If a decrease in the volume of phosphatase in the blood serum of a pregnant woman is detected, this may indicate insufficient functioning of the placenta.

In order to qualitatively evaluate the result obtained during quantitative research for alkaline phosphatase, the specialist conducting an examination of the patient’s body needs to conduct a number of studies that can confirm or refute the alleged diagnosis. Quantitative indicators of the enzyme can vary depending on wide range, therefore, it is impossible to establish an accurate diagnosis only based on the results of studying the amount of enzyme in the blood serum. This indicator can be used in diagnostics to obtain complete information about the patient’s disease.

5 Analysis of small intestinal juice for alkaline phosphatase and the development of hypophosphatasia in the body

Determination of enzyme activity in intestinal juice used in assessment functional state Gastrointestinal tract and intestinal mucosa. When conducting a study, enzyme activity is determined separately in duodenum and skinny. The concentration of the enzyme in duodenal juice can range from 10 to 30 units/ml. People living in southern regions have higher enzyme activity than people living in northern latitudes. Enzyme activity in jejunal juice ranges from 11 to 28 units/ml.

Normal phosphatase activity is considered to be between 10 and 45 U/mL. An increase in enzyme activity to values ​​from 46 to 100 units/ml is classified by doctors as weak. An increase in activity from 101 to 337 units/ml is considered significant. At values ​​exceeding 337 units/ml, this increase in activity is sharp. Enzyme activity depends largely on the type of nutrition, which makes this indicator less informative.

Hypophosphatasia is a rarely progressive metabolic disorder of hereditary origin. Develops due to alkaline phosphatase deficiency. The deficiency occurs as a result of mutation of the gene that encodes a nonspecific tissue enzyme. The lack of activity of a nonspecific enzyme in the patient’s blood serum provokes the development of hypomineralization and extensive disturbances in the body’s processes. mineral metabolism in bone tissue; in addition, such an anomaly provokes the development of multiple organ complications in the patient’s body.

IN present moment methods of treating this disease in medical science does not exist, and the only medicine that can stop the development of the disease in the human body is the promising enzyme-containing drug Phosphatase alpha.