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  • Title: Comparison of bone and total alkaline phosphatase activity on bone turnover during menopause and in patients with established osteoporosis.
    Author: Takahashi M, Kushida K, Hoshino H, Miura M, Ohishi T, Inoue T.
    Journal: Clin Endocrinol (Oxf); 1997 Aug; 47(2):177-83. PubMed ID: 9302392.
    Abstract:
    OBJECTIVE: Recently, a bone alkaline phosphatase (AP) enzyme immunoassay (EIA) was developed for measurement of bone AP activity with a monoclonal antibody. We compared the clinical performance of bone AP (bAP) measured by EIA and total AP (tAP) to examine if bAP is preferable to tAP as a bone formation marker in the post-menopause and established osteoporosis. DESIGN AND PATIENTS: Serum was obtained from 50 pre- and 93 post-menopausal healthy women, and 54 osteoporotic patients with vertebral fractures and 57 patients with hip fracture. MEASUREMENTS: Total AP was measured spectrophotometrically with p-nitrophenyl phosphate as substrate. The intra- and inter-assay coefficients of variation were 0.7-1.8% and 0.6-1.1%, respectively. Bone AP activity (bAP) was measured by EIA kit, ALKPHASE-B (Metra Biosystems, Inc.) using a monoclonal antibody against human bone AP. The intra- and inter-assay CVs were 4.0-8.3% and 6.2-7.9%, respectively. RESULTS: The percentage mean increase of bAP (54.9%) in post-menopausal subjects over premenopausal subjects was higher than that of tAP (40.1%). In age-matched comparison, % mean increases were 57.5% for bAP and 35.3% for tAP. Z-score for bAP in post-menopausal subjects was significantly higher than that for tAP. However, there was no significant difference in Z-scores between tAP and bAP in osteoporotic patients with vertebral fractures or with hip fracture. The correlation coefficient of bAP with age (r = 0.316) was similar to that of tAP with age (r = 0.319). In post-menopausal subjects, there was no difference in the concentrations of tAP nor bAP among the groups in whom times since the menopause was 0-9 years, 10-19 years and more than 20 years. Bone AP was highly correlated to tAP in the normal subjects, the patients and the total study group. CONCLUSION: Preference can be given to bone AP by enzymatic immunoassay over total AP based on their clinical utility during the menopause; however, no preference can be given to bone AP over total AP in established osteoporosis.
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