Alkaline phosphatase in the blood of women. What is alkaline phosphatase in a biochemical blood test. The specifics of determining the level of alkaline phosphatase

Drugs that cause an increase in alkaline phosphatase activity

A wide variety of drugs have been reported to increase serum ALP (Table 162).

Table 162. Drugs that cause an increase in the level of alkaline phosphatase

Some drugs have a "mixed" effect. In individual cases, the specific effect of a particular drug is not always noted.

Diseases in which there is an increase in the activity of alkaline phosphatase are listed in Table. 163.

Diseases of the liver and biliary tract

Traditionally, liver function tests are divided into those indicating either hepatocellular pathology or a "cholestatic" process. The former are also referred to as indicators of a "non-obstructive" process. It is indicated by an increase in the levels of gminotransferases and unconjugated bilirubin with a normal or slightly elevated level of alkaline phosphatase. Indicators of an obstructive or cholestatic process are normal levels of aminotransferases and elevated levels of alkaline phosphatase, GTP, and conjugated bilirubin.

Complete obstruction of the biliary tract leads to an increase in the level of alkaline phosphatase up to 3-10 x GRP. The most common cause is blockage of the common bile duct by a stone; less common causes include tumors of the pancreas, bile ducts, or gallbladder, primary biliary cirrhosis, acute pancreatitis, and chronic recurrent pancreatitis. With complete obstruction, there is usually an increase in bilirubin levels.

Incomplete obstruction of the biliary tract leads to an increase in the level of alkaline phosphatase at a normal concentration of bilirubin, since under conditions of obstruction, hepatocytes produce an increased amount of alkaline phosphatase, which enters the bloodstream, and the exchange of bilirubin is carried out by the unaffected part of the liver, so its serum level does not increase. Incomplete obstruction can be caused by a hepatic duct stone or a pathological process affecting part of the liver tissue, for example, in a primary liver tumor, liver metastasis, or abscess.

An increase in the level of alkaline phosphatase may be due to some infectious diseases. With viral hepatitis, it usually rises to 2-3 x GRP. A significant increase, equal to an increase in the level of serum aminotransferases, is uncharacteristic. Infectious mononucleosis, if there is liver damage, usually results in an increase in ALP levels; the level of bilirubin in this disease remains normal. In addition, an increase in the level of alkaline phosphatase can cause cytomegalovirus infection.

Liver diseases such as sarcoidosis and amyloidosis can lead to elevated levels of alkaline phosphatase. If these processes do not capture the liver, the level of alkaline phosphatase remains normal.

In most patients, the intake of even large doses of alcohol has little effect on the level of alkaline phosphatase. In cases of acute alcoholic hepatitis, a transient increase in enzyme activity up to 3 x GRP may be observed. Most patients with alcoholic liver cirrhosis have normal levels of alkaline phosphatase. Even in the terminal stage of cirrhosis and in a state of hepatic coma, an increase in the level of alkaline phosphatase is observed only up to 2-3 x VRP. In addition to alcohol, an increase in ALP activity is caused by a number of drugs and hepatotoxic substances (see Table 162).

In patients with cholelithiasis without obstruction of the biliary tract, ALP activity is normal. Also in cases of acute and chronic cholecystitis, ALP levels remain normal until biliary obstruction occurs.

Skeletal pathology

The level of serum alkaline phosphatase increases during pathological processes that occur with an increase in osteoblastic activity, i.e. in the formation of new bone tissue. The prototype, which increases osteoblastic activity, is Paget's disease; 90% of patients with this disease have elevated levels of alkaline phosphatase.

In Paget's disease, ALP activity increases in parallel with increased urinary excretion of hydroxyproline and radiological signs of the disease. In some individuals, ALP levels may be normal, but in most patients with an active process, it rises to 3-20 x GRP.

Another disease that occurs with an increase in the level of alkaline phosphatase is osteomalacia. The disease is caused by insufficient calcification of the bones and leads to the formation of non-calcified osteoid. For unknown reasons, osteomalacia is accompanied by an increase in osteoblastic activity and, consequently, an increase in ALP activity. Osteomalacia occurs in specific clinical situations, such as phosphorus depletion from abuse of the antacid aluminum hydroxide, gastrectomy, long-term use of anticonvulsants, renal failure, and vitamin D deficiency. and not to be observed.

Thus, this study is not informative enough to assess osteomalacia in patients with pre-existing risk factors for this disease. It is important to note that patients with osteoporosis have normal or slightly elevated ALP levels.

Primary hyperparathyroidism can lead to an increase in the level of alkaline phosphatase, but in most patients it is within the normal range. In patients with an increase in the level of alkaline phosphatase, radiological signs of parathyroid osteopathy are also found.

Benign tumors of bone tissue, such as chondroma and osteoma, proceed with the preservation of normal levels of ALP activity. An increase in ALP levels has been observed in some patients with osteogenic sarcoma, and this subgroup has a less favorable prognosis than the subgroup with normal ALP activity. Malignant tumors with bone metastasis can lead to some increase in ALP activity, but this test is much less sensitive than bone scans to detect metastases.

Bone fractures sometimes result in minimal and transient increases in ALP levels.

Other diseases

Congestive heart failure. Between 10 and 46% of patients with congestive heart failure have elevated ALP levels. It is believed that this increase, rarely exceeding 2 x GRP, is due to passive stagnation of blood in the liver.

Mammary cancer. An increase in ALP activity in patients with breast cancer is most likely due to metastases to the liver and bones. In rare cases, cancer cells themselves can produce ALP isoenzymes, which can be distinguished from ordinary ALP isoenzymes using electrophoresis.

Lymphoma and leukemia. There are reports of elevated ALP levels in these diseases. The cause may be infiltration by tumor cells of the liver and bones.

Lung cancer. Most lung cancer patients have normal ALP levels. The increase is most likely due to metastases to the liver or bones.

Hypernephroma. Patients with a kidney tumor may have increased ALP activity, which is believed to be associated with ectopic ALP production by tumor cells.

Renal failure. In most patients with end-stage renal disease, ALP levels are within the normal range. An increase is usually a sign of azotemic osteodystrophy.

Prostate cancer. The percentage of patients with prostate cancer and bone metastases who have elevated ALP levels is high. During metastasis, the level of alkaline phosphatase may rise earlier than that of acid phosphatase.

Hyperthyroidism. The activity of alkaline phosphatase is increased in 30% of patients with hyperthyroidism. This increase is due to the bone isoenzyme of alkaline phosphatase.

Diabetes. Some studies have found a slight increase in ALP activity in diabetes mellitus, which is likely due to diabetes-related liver damage.

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

The enzyme ensures the transport of phosphorus through the thickness of the cell membranes of cell structures. The amount and activity of the enzyme is an indicator of the activity of phosphorus and calcium metabolism. Alkaline phosphatase contains bone tissue, gastrointestinal mucosa, hepatocytes of the liver, cells of the renal tubules, in addition, this enzyme is synthesized in the cells that make up the tissues of the placenta during the period of bearing a child. The main amount of phosphatase in the human body is found in the small intestine. So, for example, the concentration of the compound in the mucosa of the small intestine is 30-40 times higher than in the cells of the liver tissues. The compound is synthesized by the surface layer of the small intestine mucosa, but 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.

To diagnose various ailments, an examination is carried out for the presence and amount of the 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, a phosphohydrolase of orthophosphoric acid monoesters. These monoesters have molecular weights from 70 to 120 kDa.

The content of the isoenzyme in the blood serum

The rate of alkaline phosphatase in serum can vary widely. These figures range from 44 to 147 IU / l. At the same time, 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, in addition, 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 overestimated. They have a slightly overestimated rate, as well as adolescent children who are in puberty. An increase in the concentration of the enzyme during this period is not an indication of the presence of any disorders and abnormalities in the body. The reasons for the overestimation of the rate of alkaline phosphatase in the blood during this period are the rapid processes of its restructuring in the body, which are associated with various life support systems and the growth of bone tissue and placenta.

As a rule, the content of alkaline phosphatase can fluctuate depending on the reagents used in the research process. At the present stage, there is no standardized laboratory medical method for determining the enzyme. The norm for women and men, depending on the method of determination, may fluctuate, but the range of discrepancies in the indicators is insignificant. Alkaline phosphatase is increased if its concentration exceeds:

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

ARVE Error:

To determine the amount of this type of compounds, any specialist conducts a number of clinical studies. However, the boundaries of normal phosphatase values ​​are extensive and depend on a large number of factors, therefore it is impossible to judge the presence or absence of a particular disease in a person only by one indicator of the amount of this compound in body fluids. This indicator is used as an additional sign of diagnosing ailments of the body.

Increasing the concentration of the enzyme in the body

A blood test for a decrease or increase in alkaline phosphatase is performed according to certain medical indications. This indication could be:

Blood sampling is carried out for analysis during the study of liver samples and to assess the functional ability of the liver.

Very often, the patient is examined for abnormalities in the amount of the enzyme in the blood, if the patient complains of fatigue, loss of appetite, nausea and pain in the right hypochondrium. As an additional diagnostic feature that allows you to identify the presence of an ailment, the amount of the enzyme in the blood serum is determined, if there are suspicions of the development of diseases in the body associated with damage to bones and bone tissue.

An elevated serum phosphatase always signals a possible lesion or involvement in the pathological process in the body of the bones, liver or biliary tract. To clarify the results of the survey allows an additional set of surveys. So, for example, if, along with an increase in the concentration of alkaline phosphatase, an increase in the amount of ALT and AST is detected, then this indicates the presence of ailments associated with disorders 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, then this indicates the presence of damage to the bone tissue.

ARVE Error: id and provider shortcodes attributes are mandatory for old shortcodes. It is recommended to switch to new shortcodes that need only url

Reasons for increasing the concentration of phosphatase

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

The first group is the causes associated with the occurrence of disorders in the functioning of the kidneys or diseases affecting these organs. Such ailments can be obstructive jaundice, which causes the occurrence of obstruction of the bile ducts, the formation of stones in the bile ducts. This ailment can be triggered by the formation of scars after surgery. 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 in the human body, an increase in phosphatase is detected. Infectious mononucleosis can be a direct cause of disorders in the functioning of the liver and can provoke an increase in the amount of the enzyme in the blood serum.

The causes belonging to the second group are disorders associated with the functioning of the body's bone tissue. These disorders can be triggered 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 foci that affect the bone tissue of the body, the occurrence of fractures, the development of rickets and myeloma.

The third group represents other causes not listed in the first two groups. An upward change in the amount of the 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 contributes to the leaching of calcium from the bone tissue.

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

Causes of a decrease in the concentration of phosphatase

• carrying out a blood transfusion in a large volume;
• decreased functionality of the thyroid gland;
• severe anemia;
• deficiency in the body of trace elements such as zinc and magnesium;
• hypophosphatasia, which contributes to the 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 a lack of functioning of the placenta.

In order to qualitatively evaluate the result obtained when conducting a quantitative study on alkaline phosphatase, a 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 over a wide range, therefore, it is impossible to establish an accurate diagnosis only on the basis of the results of a study of the amount of enzyme in the blood serum. This indicator can be used in diagnostics to obtain complete information about the patient's disease.

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

Determination of enzyme activity in intestinal juice is used when assessing the functional state of the gastrointestinal tract and intestinal mucosa. When conducting a study, the determination of enzyme activity is carried out separately in the duodenum and jejunum. The concentration of the enzyme in the composition of the duodenal juice can range from 10 to 30 U / 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 activity ranging from 10 to 45 units / ml. An increase in enzyme activity to values ​​​​from 46 to 100 units / ml is classified by physicians as weak. An increase in activity from 101 to 337 units/ml is considered to be significant. At values ​​greater than 337 U/ml, this increase in activity is dramatic. Enzyme activity depends largely on the type of food, which makes this indicator less informative.

ARVE Error: id and provider shortcodes attributes are mandatory for old shortcodes. It is recommended to switch to new shortcodes that need only url

Hypophosphatasia is a rarely progressive metabolic disease of hereditary origin. It develops as a result of an alkaline phosphatase deficiency. Deficiency occurs as a result of mutation of a gene that encodes a non-specific tissue enzyme. The lack of activity of a nonspecific enzyme in the patient's blood serum provokes the development of hypomineralization in the body and extensive disturbances in the processes of mineral metabolism in bone tissue, in addition, such an anomaly provokes the development of multiple organ complications in the patient's body.

At the moment, there is no method of treating this disease in medical science, and the only drug that can stop the development of the disease in the human body is the promising enzyme-containing drug Phosphatase alfa.

Alkaline phosphatase is a specific enzyme belonging to the group of hydrolases. It is necessary for the dephosphorylation reactions to successfully take place in the body, namely: the elimination of phosphate from organic substances, which occurs at the molecular level. Carrying phosphorus through the cell membrane, phosphatase has a certain constant concentration in the blood and is an indicator of the norm of phosphorus-calcium metabolism. The name "alkaline" enzyme was received because it exhibits the greatest activity in the presence of a pH of the medium in the range from 8.6 to 10.1.

Although alkaline phosphatase is one of the most common enzymes, its mechanism of action is not fully understood. It should be noted that in the human body it is present almost everywhere, in all tissues, but it is presented in several varieties: renal, intestinal, placental, hepatic and bone. As for blood serum, in adults, phosphatase is represented by the last two isoenzymes, in relatively equal amounts. In the bones, the enzyme is formed in osteoblasts, and in the liver in hepatocytes. The higher the activity of certain cells, for example, during or during the destruction of liver cells, the higher the level of phosphatase in the blood becomes.

The norm of alkaline phosphatase in the blood

As for the normal level of alkaline phosphatase in the blood, these indications fluctuate in a fairly wide range, they can range from 44 to 147 IU / l. In this case, it is worth paying attention to the gender of the person from whom blood was taken for research, as well as to his age. In pregnant women, this indicator may be slightly overestimated, as well as in adolescents who are in the stage of puberty, but will not indicate any abnormalities in their body. This is simply due to the restructuring of some life support systems, as well as the growth of bone tissue or the placenta.

In addition, the norm indicators may vary depending on the reagents used for its study in various laboratories, since there is no standardized methodology at the moment. Specific figures change, but the range of their fluctuations, nevertheless, remains insignificant, therefore, when determining the norm, one can rely on the following average indicators:

for children under 10 years old - from 150 to 350

for children from 10 to 19 - from 155 to 500

for adults under the age of 50 - from 30 to 120

for people over 75 years old - from 165 to 190

These reference values ​​are in international units per litre.

A study of an increase or decrease in the level of phosphatase in the blood is carried out according to some indications. This may be preparation for surgery, as well as a routine examination of the patient. They take blood to determine the level of this enzyme and during "liver tests" to assess the functional ability of the organ.

Often, when patients complain of fatigue, loss of appetite, nausea, or pain in the right hypochondrium, the level of alkaline phosphatase in the blood is studied. The result is also indicative for the diagnosis of various lesions of bones and bone tissue.

When alkaline phosphatase is elevated, it almost always means either damage or involvement in any pathological process of either the bones, or the liver, or the biliary tract. Additional studies help to distinguish and clarify the results, so if along with this enzyme there is an overestimation of and, then this clearly indicates liver disease. If, in combination with alkaline phosphatase, the level of calcium and phosphorus is increased, then bone tissue damage is evident.

Causes of an increase in alkaline phosphatase

As one or another reason, four main subgroups can be distinguished that lead to an increase in the blood level of this enzyme:

The first group is disorders associated with changes or diseases of the liver. This may be obstructive jaundice, which is caused by obstruction of the biliary tract, stones located in the bile ducts, as well as the occurrence in them after operations. Cancer of either the head of the pancreas, or the stomach, or the liver with metastases. With hepatitis of any origin, an increase in phosphatase is observed, as well as with cirrhosis. Another viral infection, namely an infectious one, can cause liver dysfunction, and as a result, an increase in this enzyme in the blood.

The second group is disorders associated with changes in bone tissue. These include diseases such as osteomalacia (softening of the bone tissue due to calcium deficiency), osteosarcoma affecting bone tissue, Paget's disease (abnormal growth of bones with a change in their structure), fractures, rickets and multiple myeloma.

The third group is other reasons. A jump in alkaline phosphatase levels can be associated with myocardial infarction, with ulcerative colitis and intestinal perforation, as well as with hyperparathyroidism (a hormonal disease characterized by calcium leaching from the bones).

The fourth group is conditions that are not associated with diseases, but are caused by a number of factors. This includes pregnancy, adolescence, healthy women under 20 and healthy men under 30, as well as the use of antibiotics and hormonal drugs for contraception and a number of other drugs that are included in a rather extensive list and contains up to 250 items. Also, if the blood was refrigerated after it was taken for analysis, the level of alkaline phosphatase will be too high.

It should be noted that an increase in the level of this enzyme is not in all cases without exception an indicator of a particular disease. Sometimes it can exceed the norm even in absolutely healthy people. Therefore, in order to judge the presence of a particular pathological process, it is necessary to conduct additional studies and study the results obtained as a whole.

Attention should be paid to a decrease in this enzyme in the blood, since such an indicator can serve as signs of a number of diseases that are no less dangerous than with an increase in the level of phosphatase.

Possible reasons that lead to a decrease in the level of the enzyme:

Massive blood transfusions.

Reduced functionality.

Alkaline photophase is a specific enzyme, it is found in some tissue compounds in the human body (the bones of the cells of the biliary tract, as well as the liver and placenta contain this phase). The alkaline phase has the ability to activate the reaction, which is associated with the process of phosphate cleavage from the organic compound.

These enzymes are hydrolases, they have the ability to transform the biochemical substrate by adding elements of water. In this case, there is an unhindered movement of phosphorus in the body. When a very active alkaline phase, then its level in an alkaline environment. An indicator of the state of enzymes can reflect the state in which the bones and hepatobiliary systems are located. From what content of it in the blood means the correspondence in the phosphorus-calcium metabolism and the needs in the body of the norm of alkaline phosphatase in the blood.

With an increased content of enzymes in the body, it means the fact that a physiological state has formed in the system, as well as a severe pathological process. Alkaline phosphatase increased causes: the change in the indicator manifests itself in different ways, and the causes are always different. This can be influenced by various external factors, but often this is due to a malfunction in the body. Symptoms with an increase in the alkaline phase are manifested, as a rule:

• general malaise;
• pain in the hypochondria;
• loss of appetite;
• nausea vomiting;
• pain in bones and joints.

Increased alkaline phosphatase in the blood: when such manifestations are formed, this means that the body is in an unhealthy state of the system. This manifestation is characterized by the formation of various diseases. Analysis for alkaline phosphatase: to determine the exact diagnosis and cause of formation, a thorough examination is carried out in the composition of the blood, blood biochemistry of alkaline phosphatase is performed. The result of the examination is deciphered and information material is provided about the content of enzymes in the patient's body. Alkaline phosphatase rate is determined by the doctor.

With an increased level of photophase, as a rule, this is due to some reason. Alkaline phosphatase, the norm, if the patient is healthy, and such a manifestation is found, then this means that the person has been poisoned by alcohol, or has been taking medications for a long time, and not just one, but several different groups of potent drugs.

Alkaline phosphatase is lowered: dangerous drugs are drugs that have a property in the form of a hepatotoxic effect. Thus, with prolonged use, they disrupt the structure and functionality in the liver.

Alkaline phosphatase is increased with an increase in enzyme levels, which means the process of pathological effects in the body. Often, this indicates that a complex disease is developing, in which bone tissue and other organs are damaged. A pathological change occurs in the bone tissues and a disease develops in the form of Paget's disease. As well as a chronic and complex form of the disease. Alkaline phosphatase in the blood: with it, the entire mechanism is damaged in the process of restoring bone tissue, while there is an increased destruction of deformation, as well as weakening.

The manifestation of an increase in the norm

The progression of osteomalacia is a systemic disease in the skeleton, in which softening and deformation of the bone tissue occurs. With this disease, mineral metabolism is disturbed, the body loses phosphoric acid, calcium salt, as well as vitamins and minerals. Osteogenic sarcoma is a malignant primary tumor in the bones. With it, the origin and development takes place in the very core of the system. This has a very detrimental effect on the entire body as a whole, since there is a complete destruction of bone tissue. The formation of metastases can also occur when the norm is violated, and they proceed into bone structures, as a rule, from another organ.

The formation of increased metabolism in bone tissue: this occurs when the process of healing a fracture through trauma to the tissue. With the formation of primary hyperparathyroidism, this disease of the endocrine systems occurs when there is increased activity in the parathyroid gland. With this disease, there is a pronounced violation in the exchanges of phosphorus and calcium. As well as the formation of ulcerative infarction, colitis, as well as perforation in the intestine. All these diseases can occur with an increase in the rate of the norm. According to medical statistics, it is obvious that basically all patients, if the indicator is exceeded, suffer from liver pathology.

The male sex has certain features in which the norm is exceeded, this is, as a rule, after excessive and intense physical exertion. With beriberi, as well as malnutrition, sometimes the reason is leaning only on protein products, protein. In women, the increase occurs especially often when they are carrying their child, especially when the third trimester of pregnancy, while breastfeeding, when menopause has come. Alkaline photosphatase can often manifest itself in a child, as a rule, this manifestation has its own peculiarities of education.

It has been scientifically proven that the enzyme in its quantity and activity exceeds the level compared to an adult. This happens until the time when the child begins puberty. This process is a natural phenomenon, and this means that children have such a physiological feature of the body. Due to this, rapid growth is formed in the bone tissues of the child's body. In addition, the content of this phase allows you to make a diagnosis of the pathological process in the liver. The levels of the enzyme during the formation of various pathologies in the body grow, and also become high in the normal value.

Revealing the exact result

If it is revealed that the indicator of this phase in a child is increased, then this means that a serious illness may develop. Such failures in the system appear in the form of rickets, hyperparathyroidism, infectious mononucleosis, intestinal infections, and also in malignant tumors. You should not self-medicate, you need to consult an experienced specialist, as well as timely seeking medical help. It also takes into account the fact that at an increased level of the phase, a natural nature occurs. As is known, the formation of excess activity in the level of enzymes is manifested both in a sick person and in a healthy person.

Progression occurs due to the physiological characteristics of the body process in the patient (when the increased or decreased phase). Shchf: only the attending physician in the field of this branch of medicine can reveal the real reason for the manifestation of the formation of an increase from the norm. The specialist conducts a thorough examination, during which he can prescribe additional examinations, the result of which will be an accurate diagnosis, as well as the cause of the formation, and after which the necessary drug therapy will be prescribed. To normalize the level of the enzyme, the cause of the disease should initially be eliminated.

Only to establish the norm of the indicator due to the optimal boundaries will not work. When this indicator deviates from the norm, then this deviation occurs when there was a physiological state, as well as with the progression of a serious disease. It also occurs in the case of oncology. Alkaline phosphatase is general, when a reduced amount of the indicator, as well as an increased form of alkaline phosphatase, then in the first and second cases this will negatively affect the patient's body. Often, there are special types of enzymes that can activate a biochemical reaction by splitting off a phosphate molecule of a direct organic compound. Its location is on the surfaces of the liver cells of the mucous membranes in the intestine, as well as on the placenta.

Depending on the localization, several of the following forms in the enzyme are distinguished: bone, intestinal, hepatobiliary, temporary or passing into the placental form. When a standard biochemical study is carried out, the state of total alkaline phosphatase is determined, but there is another specialized technique in which the differentiation method is carried out with a separate form of enzymes. The norm in women is lowered by AP: they rarely resort to a narrow study, since specialists, as a rule, always look at the clinical picture, and at the same time make an assessment of the result according to the analysis obtained.

When there is a pronounced symptom from the liver organ, as well as the necessary confirmation that a violation has occurred in the hepatic system, where the alkaline phase. When the normal value in the alkaline phase is exceeded, this is detected by means of a biochemical examination in the blood. Patients require additional in-depth types of research, because by changing what activity is in this enzyme, it indicates what pathological process is in the system (alkaline phosphatase biochemical blood test).

After that, complex therapy for schf is prescribed. Initially, they turn to a therapist for advice. Increased alkaline phosphatase: after evaluating the result of the analysis of a thorough examination, as well as interviewing the patient, he is sent for a consultation with a narrower specialist (this is a hepatologist, oncologist, orthopedist, endocrinologist or surgeon). When a patient seeks help from a specialist in a timely manner, when the diagnosis is confirmed, the disease is surgically treated and eliminated, which does not endanger the body.

Alkaline phosphatase (ALP, ALP) is a parameter of a biochemical blood test, which patients usually indifferently ignore with their eyes due to its “incomprehensibility”. More attention goes to parameters with familiar, familiar names - total protein, urea, glucose, total choleste
rin. Meanwhile, ALP in biochemical analysis is a very important marker that can tell a lot about the patient's health status to a diagnostician.

What is alkaline phosphatase?

Alkaline phosphatase is an enzyme (a special substance, without which the course of biochemical reactions in the human body will become impossible, in inorganic chemistry another word is used in the same meaning - catalyst). ALP is an enzyme from the group of hydrolases. Hydrolases are a large family of enzymes, the distinguishing ability of which is the breaking of intramolecular bonds of various organic compounds with the help of water molecules. There are 6 large groups of hydrolases: phosphatases, glycosidases, esterases, lipases, peptidases, nucleases.

Phosphatase classification

In biochemistry, phosphatases are divided into two types - acidic and alkaline. The conditional middle of the hydrogen ion concentration index in “PH” solutions for a person will be 5.5 (the absolute value is 5.0). Less than 5.5 is an acidic environment, the location of acid phosphatase activity. More than 5.5 - alkaline environment, the location of the activity of alkaline phosphatases. Alkaline human phosphatases show the highest activity in the range of 8.5-10.0 pH index.

ALP is the most abundant enzyme in the human body and can be found in any tissue in the human body. Human alkaline phosphatase is not one homogeneous enzyme, but a group of biologically active substances, having a common generic affiliation, they at the same time differ from each other in their selective effect on a certain type of cell.

Subspecies (isoforms) of human alkaline phosphatase:

• ALPI - intestinal;
• ALPL - non-specific (located in the liver, bone and kidney tissues);
• ALPP - placental.

Although a biochemical blood test can detect any subtype of alkaline phosphatase, another alternative analysis method, the “kinetic colorimetric method”, can be used in clinical studies. Its undoubted advantage will be a clear differentiation of enzymes according to classes and isoforms. It is not worth opposing methods, each of the methods has its own advantages.

Functions of alkaline phosphatase in the human body

The main function of ALP is participation in phosphorus-calcium metabolism, the enzyme facilitates the transport of phosphorus to body tissues, thus regulating the calcium content in the human body.
The secondary functions of alkaline phosphatase are participation in the secretory work of the liver and the growth of bone tissue. The bile produced by liver cells contains molecules of phospholipids, alkaloids, proteins, nucleotides - organic compounds that have phosphatases in their composition. They got into the bile because the body did not have time to use and protect them. ALP helps to separate phosphatase from these compounds, breaks them down, performing a dual useful function - it neutralizes and utilizes these substances. Osteoblast cells, responsible for the “building” of bone tissue, contain the most alkaline phosphatase in the body after the liver. These cells need alkaline phosphatase to structure calcium molecules in bone tissue - phosphatase supplied by alkaline phosphatase acts as a catalyst for this process.

What role does phosphorus and calcium play in the human body?

Calcium and Phosphorus are two inseparable chemical elements in the human body. Their connection is dialectical in nature - one element determines the comprehensibility of the other. The mediator in this process is vitamin D, alkaline and acid phosphatases. The approximate ratio of phosphorus to calcium in the body is 1:3.5 (for an adult, it is 650 g of phosphorus and 2200 g of calcium).

This chemical element is the most important building material from which the human body builds itself. Calcium is part of bone, dental, muscle tissue. With the help of calcium, nails are formed, the smooth muscles of blood vessels are strengthened. In nature, there is a structural twin of calcium - strontium. This metal, in case of calcium deficiency, becomes its substitute. As a building material, strontium is significantly inferior to calcium, and therefore tissues consisting of strontium will be inferior to those made on the basis of calcium - blood vessels, nails, teeth will become brittle and brittle, muscles will lose some of their tone, various growths, processes will appear on the bones. It is not an excess of calcium that is to blame for the deposition of so-called “salts” in the bones, but, on the contrary, a deficiency - the body compensates for the missing calcium with strontium, which, as a rule, is always in excess.

Attention! Phosphorus is needed for the absorption of calcium, a lack of phosphorus leads to a decrease in the absorption of calcium and, accordingly, the level of this chemical element is rapidly falling in the body. For the assimilation of strontium, phosphorus is needed much less than for the assimilation of calcium. Therefore, the body, in case of a lack of phosphorus, switches to an economical mode, forming its tissues from what is, and not from what is needed.

Phosphorus

After calcium, phosphorus is the most important building material. This chemical element is part of the bones, teeth, fats (phospholipids), enzymes and proteins.

Phosphorus is the most important participant in energy metabolism in the human body. Such an organic compound as ATP, splitting into ADP, gives the human body the energy necessary for its existence.

DNA and RNA molecules responsible for the storage and transmission of temporal and hereditary information contain phosphate groups that ensure the stability of their structure.

Attention! The normal content of phosphorus in the body will reduce the risk of rheumatoid factor, reduce the likelihood of arthritis and arthrosis, provide clarity and purity of thinking, and reduce the pain threshold.

ALP norms in children and adults

To understand what the numbers mean in the values ​​of alkaline phosphatase in a biochemical blood test, you need to know the normal range, according to which it will be possible to determine the increased and decreased values ​​of the content of this enzyme.

• children from 8 to 10 years old - 150-355 U / l;
• children from 10 to 19 years old - 158-500 U / l;
• adults under the age of 50 years - 85-120 U / l;
• adults from 50 to 75 years old - 110-138 U / l;
• people over 75 years old - from 168-188 U / l.

Possible pathologies associated with a change in the norm of alkaline phosphatase in the results of a biochemical blood test

Before proceeding to a review of the possible pathological causes of changes in the level of ALP in biochemical analysis, we note several significant features that patients need to know.

Alkaline phosphatase is elevated in children. In the children's body, there are rapid metabolic processes associated with the growth of the body. Considering the role that ALP plays in the human body - the growth of bone tissue, the stabilization of the liver - it is not surprising that there is a lot of this enzyme in the blood of a child. Naturally, the younger the child, the more active such processes are. Upon completion of the hormonal restructuring of the body at 17-19 years (men) and 15-17 years (women), the level of alkaline phosphatase in the human body begins to decline. After 24-25 years, alkaline phosphatase in the human body is used not so much for tissue growth, but for maintaining their health.

Alkaline phosphatase is increased in women during gestation - the formation of a fetus in a woman's body requires a significant amount of various substances - trace elements, proteins, fats, which, accordingly, causes an increase in the number of enzymes responsible for their digestibility. Therefore, the level of alkaline phosphatase in the blood of a pregnant woman increases.

Important! A high level of alkaline phosphatase in children and pregnant women is completely natural, we are not talking about pathology in such cases.

Elevated alkaline phosphatase

Considering the fact that most alkaline phosphatase is found in bone and liver cells, an increased level of this enzyme will indicate a high probability that there are problems with the liver and bone tissue - the death of liver cells, the breakdown of bone tissue will release excess of this enzyme into the blood. All sorts of diseases of the liver (hepatitis of various etiologies, liver injuries) and bone tissue (osteitis of various etiologies, bone injuries and fractures) will become the main suspects in a diagnostician who sees a high level of alkaline phosphatase in the results of a patient's analysis. In addition to the indicated pathologies, a high level of alkaline phosphatase in the patient's blood can have quite banal reasons, for example, a lack of phosphorus and calcium in the diet.

Decreased alkaline phosphatase

A reduced level of alkaline phosphatase is most often associated with metabolic disorders and wear and tear of the body:

• osteoporosis;
• anemia;
• starvation;
• excess vitamin D (often observed in children due to the uncontrolled use of dietary supplements containing this coenzyme);
• violation of the secretory function of the thyroid gland;
• lack of vitamin C (scurvy).