Alkaline phosphatase blood test means. Alkaline phosphatase is elevated: symptoms, causes of increase in adults and children, treatment. Types of alkaline phosphatase

This disease is characterized by a disruption in the mother-placenta-fetus ligament. This deviation is extremely dangerous for the unborn child for obvious reasons - fetal hypoxia is likely ( oxygen starvation), which can lead to the death of the unborn child. Therefore, if you detect a level of thyroid hormone in the blood below normal, you should immediately consult a doctor for advice. Self-diagnosis during pregnancy is also extremely dangerous. Do not treat yourself and seek medical help in a timely manner.

Has a particularly important role in the human body phosphorus-calcium exchange. Proper work this exchange affects the work of almost everyone vitally important systems human body - from bone- muscle tissue, to the liver.

For normal metabolism the work of enzymes is necessary. 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 biochemical analysis blood 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 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 split it.

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 the intake of certain medicines. For example: Phenobarbital, Ranitidine, Papaverine, Furosemide and others.

ALP in biochemical analysis may have a value higher than normal even in the analysis healthy person. This may mean that the patient has a high metabolic rate. 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 due to medications that include statins and sulfonamides.

How to get tested correctly

For getting 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 exercise. It is recommended to cancel at least 2 days in advance. active image life and physical work. Alkaline phosphatase is elevated during sports. 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.

In preparation for the analysis, you should completely avoid drinking any alcoholic beverages. 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 alkaline phosphatase norm 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 physical activity. For these processes it is vital high concentration enzymes responsible for metabolism.

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 alkaline phosphatase levels are bone tissue pathologies:

• 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 enzyme levels during examination absolutely clearly indicate the presence cancer bones. But such a result requires expanding the analysis in order to accurately diagnose the lesion and the degree of cancer development.

Long-term consumption 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 Irreversible consequences begin, and foci 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 levels of enzymes occur in donors during the period of donating large volumes of blood. At the same time, to support the normal functioning of the donor’s body, vitamins and dietary supplements are prescribed.

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.

In contact with

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 a 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 it is?

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 bone tissue pathologies and liver disease. 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. The test is taken in the morning, and at least 12 hours must have passed since the last meal. Cannot be taken the day before alcoholic drinks and 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

Normal content ALP depends on the patient's age. 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.

Besides, increased level ALP is physiological norm for pregnant. 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.

An increase in the 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; additional studies will be required to make a diagnosis.

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 with narrow specialists. Only after the cause of the change in alkaline phosphatase activity has been established, treatment can be prescribed.

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

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 whose distinctive ability is to break the 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.

Classification of phosphatases

In biochemistry, phosphatases are divided into two types - acidic and alkaline. The conditional midpoint of the hydrogen ion concentration index in “PH” solutions for humans will be 5.5 ( absolute value– 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 alkaline phosphatase activity. Human alkaline phosphatases exhibit the greatest 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 of 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 selectivity of action on a certain type of cell.

Subtypes (isoforms) of human alkaline phosphatase:

• ALPI – intestinal;
• ALPL – nonspecific (located in liver, bone and kidney tissues);
• ALPP – placental.

Although a biochemical blood test can detect any subtype of alkaline phosphatase, clinical studies another one can be used, alternative method analysis – “kinetic colorimetric method”. Its undoubted advantage will be a clear differentiation of enzymes into classes and isoforms. There is no point in contrasting methods; each method has its own advantages.

Functions of ALP in the human body

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

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

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

This chemical element– the most important construction material, from which the human body builds itself. Calcium is part of bone, tooth, and muscle tissue. With the help of calcium, nails are formed and the smooth muscles of blood vessels are strengthened. In nature, there is a structural double 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 fragile and brittle, muscles will lose some of their tone, various growths and processes will appear on the bones. It is not the excess of calcium that is to blame for the deposition of so-called “salts” in the bones, but, on the contrary, the deficiency - the body compensates for the missing calcium with strontium, which, as a rule, is always in excess.

Attention! For the absorption of calcium, phosphorus is needed; a lack of phosphorus leads to a decrease in the absorption of calcium and, accordingly, the level of this chemical element rapidly decreases in the body. The absorption of strontium requires much less phosphorus than the absorption of calcium. Therefore, in case of a lack of phosphorus, the body switches to an economical mode, forming its tissues from what it has, and not from what it needs.

Phosphorus

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

Phosphorus is the most important participant in energy metabolism in the human body. This organic compound, like ATP, breaking down into ADP, gives the human body the energy necessary for its existence.

DNA and RNA molecules, which are responsible for storing and transmitting temporal and hereditary information, contain phosphate groups that ensure the stability of their structure.

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

ALP norms in children and adults

To understand what the numbers mean in alkaline phosphatase values ​​in a biochemical blood test, you need to know the normal range, according to which it will be possible to determine elevated and reduced value 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 50 years of age – 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 changes in the ALP norm in the results of a biochemical blood test

Before moving on to reviewing possible pathological reasons changes in ALP levels in biochemical analysis, we note several significant features that patients need to know.

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

Alkaline phosphatase is increased in women during gestation - the formation of the fetus in a woman’s body requires a significant amount of various substances - microelements, 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

Given the fact that alkaline phosphatase is found most abundantly in bone and liver cells, an elevated level of this enzyme will indicate high probability the fact that problems exist 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 kinds of liver diseases (hepatitis of various etiologies, liver injuries) and bone tissue (ostitis of various etiologies, bone injuries and fractures) will become the main suspects for a diagnostician who sees a high level of alkaline phosphatase in the patient’s test results. In addition to the indicated pathologies, high level ALP in the patient’s blood can be quite trivial reasons, for example, lack of phosphorus and calcium in the diet.