Measurement of skeletal specific alkaline phosphatase in disorders of calcium metabolism in childhood
Measurement of skeletal specific alkaline phosphatase in disorders of calcium metabolism in childhood
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DOI：
10.1007/s001120050054
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发表时间：
1996-09-01
影响因子：
0.4
通讯作者：
Kruse, K
中科院分区：
文献类型：
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作者：
Reiss, I;Inderrieden, D;Kruse, K
背景：人类碱性磷酸酶在碱性 pH 条件下催化磷酸酯的水解。血清中以骨骼和肝脏碱性磷酸酶同工酶为主。在儿童时期，60-90% 的总磷酸酶来自骨骼。放射免疫法测定成人骨骼碱性磷酸酶有助于代谢性骨病的诊断。因此，我们使用免疫放射测定法检查了儿童时期骨骼磷酸酶测定的诊断价值。 材料：我们检查了 155 名 0-27 岁健康儿童和成人的血清，以及 82 名患有以下疾病之一的患者的血清：维生素 D 缺乏性佝偻病、X 连锁低磷酸盐血症性佝偻病（磷酸盐糖尿病）、孤立性短暂性磷酸酯酶过多症、先天性磷酸酯酶缺乏症、体质性生长迟缓和方法：通过市售免疫放射测定法(Tandem(R)-R Ostase(TM))测定骨骼磷酸酶浓度。同时，通过光度法测定总碱性磷酸酶水平，通过麦芽凝集素沉淀法测定骨特异性碱性磷酸酶。数据以平均值的标准差表示。结果：正常对照组的碱性磷酸酶值与年龄有关，14 岁之前骨骼碱性磷酸酶水平升高，青春期后降低至成人水平较低。在患有维生素 D 缺乏性佝偻病、磷酸盐糖尿病以及短暂性磷酸酯酶过多和早产儿骨质减少的儿童中，骨骼磷酸酶值显着升高，高达平均值的 25 个标准差。感染后，麦芽碱性磷酸酶也升高，而骨骼磷酸酶在正常范围内，与生长加速儿童相比，骨骼碱性磷酸酶与总碱性磷酸酶以及麦芽凝集素沉淀测定的骨骼碱性磷酸酶的相关性非常显着（p < 0.01）。结论：由于发现两者之间存在高度显着相关性。骨骼碱性磷酸酶和总碱性磷酸酶 在健康儿童和患有各种骨代谢疾病的儿童中，在大多数情况下，测定总碱性磷酸酶足以确定骨转换。在不明原因总碱性磷酸酶升高的鉴别诊断中，测定骨骼碱性磷酸酶可能会有所帮助。
Background: Human alkaline phosphatases catalyze the hydrolysis of phosphate esters at an alkaline pH. Skeletal and liver alkaline phophatase isoenzymes predominate in serum. During childhood 60-90 % of total phosphatase are of skeletal origin. The radioimmunometric determination of skeletal alkaline phosphatase in the adult is helpful in the diagnosis of metabolic bone disease. We therefore examined the diagnostic value of skeletal phosphatase determination in childhood by using an immunoradiometric assay.Material: We examined the sera of 155 healthy children and adults aged 0-27 years in addition to 82 sera of patients with one of the following diseases: vitamin-D deficient rickets, X-linked hypophosphatemic rickets (phosphate diabetes), isolated transient hyperphosphatasia, congenital hypophosphatasia, constitutional delay of growth and puberty, pubertas praecox, osteopenia of the premature infant, hepatitis A.Method: The concentration of skeletal phosphatase was determined by a commercially available immunoradiometric assay (Tandem(R)-R Ostase(TM). Simultaneously, total alkaline phophatase levels were de termined by photometry and bone-specific alkaline phosphatase was determined by wheat germ agglutinine precipitation. Data were expressed as standard deviation of the mean.Results: In the normal control group alkaline phosphatase values were found to be age dependent with elevated levels of skeletal alkaline phosphatase before the age of 14 years decreasing to lower adult values after puberty. In children with vitamin D - deficient rickets, phosphate diabetes, as well as transient hyperphosphatasia and osteopenia of prematurity, skeletal phosphatase values were markedly increased up to 25 standard deviations of the mean. In two patients with elevated total alkaline phosphatase after a hepatitis A infection, wheat-germ alkaline phosphatase was also elevated while skeletal phosphatase was within the normal range. In children with growth retardation significantly levier values were found in comparision to children with growth accelaration. Correlation of skeletal alkaline phosphatase with total alkaline phosphatase and skeletal alkaline phosphatase assayed by wheat germ agglutinine precipitation was highly significant (p < 0.01).Conclusion: Due to the finding of a highly significant correlation between skeletal alkaline phosphatase and total alkaline phosphatase both in healthy children and in children with various disorders of bone metabolism, measurement of total alkaline phosphatase is sufficient in most cases to determine bone turnover. In the differential diagnosis of unexplained total alkaline phosphatase elevation, determination of skeletal alkaline phosphatase may be helpful.