Means a blood test alkaline phosphatase. What does an increase and decrease in alkaline pH in a biochemical blood test indicate?

Biochemical processes in living organisms occur with the help of enzymes. Latest play important role in the metabolism of cellular level. A change in their activity is a sign of a number of diseases. That is why it is so important to know what alkaline phosphatase in the blood (AP), what is the indicator of its norm.

The content of enzymes of this group is determined in tissues and fluids not only of humans, but also of animals, plants, and microorganisms.

What you need to know about HF

The group of the most studied enzymes includes phosphatases, alkaline and acid. They are widely distributed, but have differences in their properties.

Alkaline phosphatase is most active when the pH of the medium is between 8.4 and 9.4. This is characteristic of the epithelium small intestine, kidneys, liver, bones, white blood cells.

Bone tissue especially needs an enzyme, since it is necessary for it for metabolic processes, calcium saturation.

From those tissues that are involved in the transport of phosphorus, they secrete an alkaline phosphatase group. The level of the enzyme varies even in the same organ or fluid.

A group of phosphatases is synthesized by osteoblasts - cells that are involved in the construction of tissues of the bone apparatus. And for the synthesis of isoenzymes, phosphoric acid is necessary.

There is a lack of phosphatase in muscle tissue and mature connective, its minimum amount is in the cells of the walls of blood vessels and hyaline cartilage of the nose, larynx, trachea and bronchi.

The change in the activity of the phosphatase group depends on hormonal factors, stress. The enzyme level is different in people belonging to different sexes, having unequal ages.

In men, the rate is 20-30 percent higher than in women. But in the blood of pregnant women, an increase in phosphatase units is found. What does it mean? It's okay, it just goes normal development systems in the embryo.

The indicator of alkaline phosphatase is used in the diagnosis of diseases associated with the functions of the liver, bone apparatus.

Enzymes are active in rickets, osteogenic sarcoma, tuberculosis, diabetes, when phosphorus-calcium metabolism is disturbed.

At a low rate, they diagnose hereditary diseases accompanied by skeletal anomalies.

Indications for analysis and conduct

To determine the level of alkaline phosphatase activity, blood biochemistry must be assessed. The study is carried out in a laboratory. They are sent for an ALP blood test in cases where there is a suspicion of:

pathological process in the liver and kidneys;
cholelithiasis;
damage to bone tissue;
pathology of the lymphatic circulatory system caused by infections;
malignant education.

During pregnancy, blood tests for alkaline phosphatase are also needed.. Biochemical analysis is necessary to evaluate therapeutic measures and before surgery.

Before donating blood for analysis, the patient must:

refuse to eat eight hours before the procedure;
do not drink alcohol for two days;
suspend treatment with drugs and visits to physiotherapy sessions for a while;
not be subjected to x-ray examinations:
avoid heavy work physical work, sports.

Undergoing analysis, therefore, to assess the level of enzymes, five to ten milliliters of blood will be required. The fluid is taken in the morning from the cubital vein.

Research results and their interpretation

Enzyme activity is determined by colorimetry. By adding certain reagents to the blood serum, reliable data are obtained on the number of phosphatase units in the tissues of the liver, bones, and placenta.

To measure the level of isoenzymes, a system of international units is used, the calculation is per liter of biological fluid.

Norm

Assessment of the concentration of alkaline phosphatase in biochemical analysis blood occurs in accordance with the norm of its content:

in newborns - 250 units per liter;
in children from one to nine years old - 350;
from ten to fifteen - 280;
up to nineteen years, 150 units are considered the norm;
in adult males, the rate varies from 85 to 145;
the norm in women is lower by 20-25 units.

The norm in the blood of elderly men reaches 195 units. Differences among adults are due to the fact that the transition to normal concentration in the representatives of the stronger sex stretches up to 30 years. At this time, bone tissue already reduces the production of phosphatase.

For pregnant normal level ranges from 25 to 126 units. Experts interpret the results of the analysis, not the patient himself.

Sometimes high enzyme activity in women is associated not only with pregnancy, but also with the use of oral contraceptives.

An excessively high rate indicates complications during pregnancy in the second and third trimester - preeclampsia.

Toxicosis is accompanied by edema, disorders nervous system, arterial hypertension.

Relying on the result of the level of isoenzymes in diagnosis is not worth it. For exact definition pathological condition conduct additional testing.

Causes of increased phosphatase activity

More often, blood tests give an increase in the alkaline phosphatase. Rarely is it low.

The increase in units is due to:

presence oncological disease;
liver damage;
osteoporosis;
rickets;
chronic alcoholism;
sepsis;
kidney infarction;
infectious lesion lymph nodes, liver, spleen - mononucleosis;
disease bone structures- Paget's disease.

Increased activity of alkaline phosphatase in case of poisoning - both food and alcohol. After a fracture, when the bones begin to grow together, they also determine high level SHF. Many types of tumors in the human body affect the levels of enzymes in the blood.

Liver diseases cause both an increase in alkaline phosphatase and a low concentration of urea in the blood, an increase in cholesterol. And bone disease shows elevated levels of globulins and erythrocyte sedimentation rate. An additional study will give a complete picture of the disease, disorder.

The cause of many liver dysfunctions is heart failure. In this case, phosphatase will also be increased.

How to reduce the rate

Because increased content enzymes of the phosphatase group is associated with diseases of the bones, blood, organs excretory system, then treatment should be directed precisely at the elimination of pathological conditions.

If the process of increase is physiological, then special methods, allowing to lower alkaline phosphatase, do not apply.

You can reduce the activity of alkaline phosphatase:

giving up alcohol and cigarettes;
eating foods rich in phosphorus and calcium;
taking medications prescribed by a doctor;
passing timely preventive examinations.

Properly selected diet is useful for patients with increased level phosphatases. Menu without fatty foods, smoked products, sour fruits and vegetables, fried foods will lead to the fact that the content of enzymes in the blood will return to normal.

Why the activity of alkaline phosphatase is reduced, what to do

The reasons for the decrease in the level of enzymes in the blood lie in the deficiency of vitamins C and group B, and the lack of zinc. This is where anemia develops. They are cured with iron and ascorbic acid preparations.

Signs of beriberi and scurvy are easily identified by bleeding gums, tooth loss, and a hemorrhagic rash.

Diet plays a major role in treatment. It is based on sources of vitamin C.

Congenital disease (hypophosphatasia) is determined by bone deformities, flaccid and flabby skin. At the core pathological form lies low level alkaline phosphatase in the blood.

Often, newborns with this disease die, and adults suffer from various bone deformities. chest, stop. Patients bleed frequently.

Lack of protein kwashiorkor in the body leads to severe dystrophy. There is a pathology in children under five years of age, when they do not receive enough protein. They have low levels of glucose and cholesterol in their blood. Determine the lack of potassium, magnesium. Phosphatase activity is also strongly reduced.

Only nutrition correction will bring the child's condition back to normal. From the first days of therapy, drugs containing necessary elements, vitamins A and B.

Cottage cheese, foods rich in amino acids, protein are introduced into the diet. Of fats, preference is given to vegetable fats, which are better absorbed.

Hypothyroidism is a hormonal disorder associated with an underactive thyroid gland. It develops more often in women against the background of diseases of other organs and systems.

Therapy of hormonal failure is aimed at restoring the functioning of the thyroid gland.

To increase the level of iodine in the menu of patients include products such as sea kale, chicken meat, milk, cheese. The level of hormones is brought back to normal with thyroid preparations.

Low alkaline phosphatase in pregnant women: consequences and treatment

If a decrease in the rate is found in women in a position, then it is usually a symptom of placental insufficiency.

The danger of a pathological condition is that it leads to the death of a newborn or damage to the central nervous system of the fetus.

Placental insufficiency is considered a consequence of complications during pregnancy.

There are health problems due to infections of the genital organs, incompatibility between the mother and fetus according to the Rh factor.

If future mother suffers from diabetes, heart failure, pyelonephritis, then the alkaline phosphatase in the blood will be low. Biochemical analysis of blood changes under the influence of malnutrition, smoking.

When alkaline phosphatase in the blood is reduced during pregnancy, a comprehensive diagnosis is carried out. After identifying the causes of insufficiency, a pregnant woman is prescribed physiotherapy aimed at improving the blood supply to the placenta, electrorelaxation of the uterus.

If the patient has identified diseases of the heart and blood vessels, diabetes mellitus, then appropriate treatment is prescribed.

From drug therapy the emphasis is on reducing the concentration of homocysteine in the blood with Angiovit.

Vasodilators such as Trental reduce vascular resistance. In the presence of diabetes mellitus, Heparin, Fraxiparine, acetylsalicylic acid are used in the treatment.

Although pregnancy rarely occurs when a woman has hypothyroidism, a decrease in hormones produced thyroid gland, occurs during the period of bearing a baby.

And this is dangerous because irreversible processes can occur in the embryo, leading to deformities..

During pregnancy, it is important for women to do biochemical blood tests on time to determine the alkaline phosphatase index. Timely restoration of its level will help the child to be born healthy.

A biochemical blood test (BAC) or as it is also called "biochemistry" allows you to assess the quality of functioning internal organs, get the necessary information about the metabolism and the body's needs for trace elements. Special attention when studying laboratory data, phosphorus-calcium metabolism is given, since the lack of its components can lead to serious illnesses both in childhood and adulthood.

The first thing that a specialist involved in the interpretation of the results of the analysis draws attention to is alkaline phosphatase (AP) - an enzyme of the class of hydrolases (catalysts for the cleavage of chemical bonds in molecules with the participation of water). Using the obtained ALP values in a biochemical blood test, it is quite easy for the attending physician to detect a wide range of changes and recommend a further more specific examination to the patient.

The role of alkaline phosphatase in metabolic processes

Alkaline phosphatase is an enzyme of the hydrolase class, which is the most common of them. Without his participation, most of the biochemical processes in cellular structures do not take place. AP in varying degrees included in all tissues of the body. It is not a homogeneous (homogeneous) substance, but consists of a group of biologically active ingredients similar species. But each of them is characterized by a selective effect on different types of cells.

ALP has 11 isoforms (subspecies), however, in terms of importance for the adequate functioning of the body, the leading ones are intestinal, nonspecific (localized in bone, kidney and liver tissues) and placental. The latter type of isoenzyme actively increases during gestation, which is due to the formation and development of the placenta. The main task of alkaline phosphatase is to ensure phosphorus-calcium metabolism, namely, participation in the transfer of phosphorus to tissues, while maintaining a sufficient level of calcium.

The secondary task of this catalyst is to regulate the secretory activity of the liver and create conditions for the generation bone tissue. Bile produced by liver cells (hepatocytes) contains proteins, nucleotides, alkaloids and phospholipids - organic compounds that include phosphatase molecules in their biochemical formula. Since the tissues did not manage to dispose of them in time, they enter the bile.

ALP cleaves these compounds, extracting phosphatase from their molecules, simultaneously bringing double benefit- and uses them, and neutralizes them. The next most common in the body is considered to be a subspecies of bone alkaline phosphatase, which is responsible for the formation of bones and cartilage tissues. Isoenzymes of this type are predominantly found in osteoblast cells, and phosphatase serves as an indispensable catalyst for their forming function, structuring calcium molecules.

Norm indicators

The norm of alkaline phosphatase in the blood has differences - according to age categories and gender, and makes up a fairly wide range. Its boundaries can range from 30 to 500 IU / l. For example, in the blood of women who are in the process of bearing a child and in adolescent children, there is an increase in values. Moreover, such a phenomenon is not considered a deviation, and it is associated with perturbations in the body - pubertal maturation, the formation of bone structures or the development of the placenta.

Reference! Besides physiological fluctuations, ALP norms may be subject to changes depending on the characteristics of the reagents used to study this indicator in various diagnostic laboratories. It is not yet possible to come to well-defined values, since a strict standard methodology has not yet been developed at the moment.

ALP values characterizing the norm for different age categories

Specific values are periodically transformed, but their range remains approximately the same interval. Therefore, when determining the norm of alkaline phosphatase in a blood test, the medical staff involved in the interpretation of the study materials uses averaged indicators.

Causes of Alkaline Phosphatase Activity Changes

The alkaline phosphatase blood test is used in both adults and children. childhood. At the same time, in children, the activity of this catalyst is approximately 1.5 times higher. This is due to the intensive growth and development of the child, starting from the first days of life. Therefore, the APF index can reach such high numbers as 800-1000 IU / l, which will also be considered normal, provided that the decoding of other blood parameters does not cause suspicion of the presence of pathology.

Such an increase in enzyme activity is due to the presence of two subspecies at once - bone and liver, which are involved in the formation of hepatocytes and osteoblasts - liver and bone cells. In adults, when skeletal system completes its growth, mainly increases alkaline phosphatase in the blood due to the isoenzyme (enzyme) of the liver. A change in the activity of alkaline phosphatase in the blood serum occurs when the phosphorus-calcium metabolism is disturbed, which serves as a kind of marker in determining the common bone disease for the elderly - osteoporosis.

Screening biochemistry can detect this and other diseases of bone structures on initial stages. The activity of alkaline phosphatase increases markedly in pregnant women by the 3rd trimester and to childbirth, as well as in premature babies, since the child needs to intensively catch up with peers who have received sufficient development in the womb. Such an excess of normal parameters is considered physiological and corresponding to the conditions described.

Conversely, a decrease in the activity of alkaline phosphatase in women in position indicates an insufficient development of the placenta, which is a signal to the obstetrician-gynecologist to prescribe necessary therapy. With the development of neoplastic processes in the organs of the female reproductive system(tumors of the cervix), the placental fraction becomes high, which will be displayed in the BAC as increased alkaline phosphatase.

When is research needed?

Diagnosis of changes in the level of phosphatase in the blood - its decrease or increase is carried out according to certain indications. These include not only scheduled inspection, allowing to identify violations of the functioning of a particular organ. The concentration of phosphatase is checked in preparation for surgical operations, as well as to assess the functional ability of the liver, carried out using liver tests.

In addition, the level of this enzyme is determined to identify pathological conditions accompanied by:

causeless fatigue;
decrease or loss of appetite;
nausea and vomiting of unknown etiology;
pain in the right hypochondrium, etc.

Changes in alkaline phosphatase in blood results can show various extensive lesions of bone tissue or individual sections of bones. An increase in this enzyme almost always means that pathologies are developing in the bone or biliary system or liver. To distinguish and clarify the received materials are assigned additional research. If, in parallel with an increase in alkaline phosphorus, an increase in the concentration of phosphorus and calcium is observed, then this absolutely indicates the presence of damage to bone tissue, for example, fractures.

Nausea and vomiting, which do not have a specific explanation, are the reasons for the passage of the LHC with the determination of the parameters of alkaline phosphatase

Level up

The main reasons for the increase in the concentration of alkaline phosphatase in the blood can be concluded in 4 groups that have a relatively similar origin. These include diseases of the liver, bone structures, factors of a different origin and non-pathological conditions.

Diseases of the liver and gastrointestinal tract

The group includes disorders or changes in the functioning of the hepatobiliary system and other organs of the gastrointestinal tract caused by various factors, such as:

obstructive jaundice, which led to obstruction of the biliary tract, postoperative adhesions or stones that clog the lumen of the ducts;
tumor processes of the stomach, pancreas or liver with the formation of metastatic foci;
hepatitis of all kinds and cirrhosis of the liver;
obstructive pancreatitis, cholestasis;
Infectious mononucleosis;
fatty degeneration of the liver.

Diseases associated with bone loss

The list includes:

osteomalacia - softening of the bones caused by calcium deficiency;
bone cancer, bone metastases, multiple myeloma;
acromegaly - a pathology of the anterior pituitary gland, manifested by increased production of growth hormone - somatotropin;
Paget's disease - a violation of the structure of bones during their pathological growth;
fractures, rickets abnormal development bones in children due to vitamin D deficiency.

After a bone fracture, there is a significant increase in the isoenzyme in the blood. This is due to the active fusion of bone fragments and wound healing. Metabolism is responsible for such processes, so many indicators of its components will be increased. Such changes are considered normal. Ultra-high ALP values with big share probability indicates the development oncological processes skeletal system.

But such a result will require additional methods studies to clarify the degree of development of the disease and the location of the primary focus.

Several reasons for the increase in alkaline phosphatase in the blood

Reasons for a different origin

A marked jump in ALP may be due to myocardial infarction, adrenal hyperfunction, bowel disease such as ulcerative colitis, and its possible dangerous consequence- perforation (perforation). There is also an increase in this isoenzyme in hyperparathyroidism - hormonal disorder, in which calcium is washed out of bone structures.

Conditions that are not pathological

V this group includes conditions caused by a number of non-pathogenic factors. They include adolescence, pregnancy and youth of the body ( healthy women under 20 and men under 30). Also, similar conditions occur when receiving hormonal contraceptives, antibacterial drugs and others medicines from a list containing more than 250 items.

Attention! If the blood after taking it for analysis has undergone cooling, then there is high probability that the level of alkaline phosphatase will exceed normal levels.

V without fail It should be noted that an increase in alkaline phosphatase is not an absolute sign dysfunction of an organ. In some cases, it can be exceeded even for completely healthy people, for example, after a large meal or excessive physical activity. In such cases, detection of high levels of alkaline phosphatase to confirm or establish the presence of the disease will require additional diagnostics, and study the received materials in a complex.

Low level

It is necessary to pay no less attention to low alkaline phosphatase in the analysis of blood biochemistry than with an increase in its values, since its decrease can serve as a sign of the same dangerous diseases. There are enough reasons leading to conditions in the body in which the level of alkaline phosphatase is low. As one of the options, it may be an unbalanced or insufficient diet, which leads to a slowdown in metabolism.

Cells and organs lack the ability to maintain normal condition and function normally. As a result, irreversible changes occur in the tissues associated with a change in their functional structure. Such pathologies are difficult to treat and require long-term therapeutic exposure.

Insufficiency of the thyroid gland is one of the causes of low levels of alkaline phosphatase

If the patient does not complain about an insufficiently high-quality diet, then low phosphatase indicates the presence of serious pathologies, such as:

severe anemia;
an excess of vitamin D;
reduced protein content;
thyroid dysfunction;
beriberi - deficiency of magnesium, zinc, vitamins B and C;
hypophosphatosis (lack of phosphorus) - congenital disease leading to softening of the bone tissue;
when carrying a child, a decrease in alkaline phosphatase is a manifestation of placental insufficiency.

In addition to these factors, a low level of this enzyme can be observed when taking medicines containing beds or sulfonamides, as well as after frequent or volumetric blood transfusions. Therefore, donors who donate blood on a regular basis are periodically prescribed a course of vitamins and dietary supplements - dietary supplements.

With the onset of menopause, almost all women experience a physiological slowdown in all processes. Metabolism is also no exception to the rule, so there is a decrease in the level of all enzymes, including alkaline phosphatase. Such changes are not considered pathological, but are considered as the norm.

In the human body, alkaline phosphatase is responsible for transporting phosphorus to all cells and tissues. Its rate is more or less constant. If alkaline phosphatase is elevated, this indicates a violation of phosphorus-calcium metabolism, which, in turn, indicates the development of a pathological process in the body.

Functions

This substance is an enzyme. It belongs to the group of hydrolases. Alkaline phosphatase takes part in dephosphorylation processes. It separates the trace element from organic matter and transports it across cell membranes. As a result, all body tissues receive required amount phosphorus.

The enzyme is most active in an environment with a pH of 8.6 or more. It is thanks to this that the word “alkaline” is present in its name.

Where is contained

The highest level of the enzyme is observed in the intestinal mucosa, placenta (during pregnancy), mammary glands (during lactation), bone tissue. Almost all body tissues contain alkaline phosphatase. In this regard, it can be: intestinal, hepatic, renal, placental and bone. In addition, the enzyme is found in

Signs of an increase in the indicator

An increase in the level of alkaline phosphatase can occur against the background of both physiological processes and serious pathologies.

At the same time, a person has the following symptoms:

constant feeling fatigue;
decrease or total loss appetite
pain in the right hypochondrium;
episodes of nausea;
discomfort in the joints and bones.

The presence of such conditions is the basis for visiting the attending physician. The specialist will prescribe a study, according to the results of which he will be able to assess the composition of the blood. The conclusion also displays the concentration of alkaline phosphatase.

The natural nature of the indicator growth

The concentration of the enzyme can sometimes increase in healthy people. Information regarding what elevated alkaline phosphatase means in each case should be provided by the attending physician.

Nevertheless, it is important to know that an increase in the indicator can occur under the following conditions:

pregnancy;
lactation;
menopause;
beriberi;
unbalanced diet;
intoxication caused by the use of alcoholic beverages.

In addition, elevated blood alkaline phosphatase may be observed against the background of long-term use some medicines. The list of medicines that affect the growth of the indicator is extensive, it includes several hundred items. In this regard, it is necessary to strictly follow the treatment regimen drawn up by the doctor. An increase in dosage and duration of administration can lead to impaired liver function.

Reasons for the increase in adults

Most often, the level of the enzyme increases in the presence of pathologies, during the development of which bone tissue and liver are damaged.

All causes of elevated alkaline phosphatase are conditionally divided into several groups:

Diseases associated with damage or destruction of liver cells. This also includes ailments characterized by difficulty in the outflow of bile.
Pathology of bone tissue.
Other diseases.

The first group of causes includes the following pathologies:

Cirrhosis. This is a process characterized by inhibition of liver function. This is due to the replacement of normal scar tissue.
Hepatitis. Most often, alkaline phosphatase is elevated in autoimmune and viral forms diseases. At the same time, the level of the enzyme increases by 3 times.
Malignant neoplasms. The tumor may be primary, that is, localized in the liver. In addition, the cause of an increase in alkaline phosphatase may be the penetration of metastases into the organ (secondary cancer).
Cholangitis. This is a chronic liver disease. Against the background of its development, portal hypertension occurs and liver failure.
Biliary cirrhosis (primary). Pathology is a consequence of cholangitis. In its presence, alkaline phosphatase is increased significantly - 4 times. However, even after full recovery decreases over time.
Infectious mononucleosis. This is a viral pathology of an acute nature. It is characterized by damage to liver cells. In addition, the composition of the blood changes.
The formation of stones in bile ducts.
cholestasis. This pathological condition in which the bile produced by the liver stagnates.

If alkaline phosphatase is elevated in the blood, this may indicate damage to the bone tissue. The most common causes of an increase in the level of the enzyme are the following diseases:

Osteomalacia. This is a pathology of a systemic nature, characterized by softening of the bones, as well as their deformation. Against the background of its development, vital vitamins and microelements are washed out of the body.
Paget's disease. This is serious chronic illness. It is characterized by damage to the mechanism of restoration of bone tissue, as a result of which it becomes weak, prone to deformation and destruction.
Osteogenic sarcoma. This is a primary neoplasm of a malignant nature. The tumor forms and develops in the depth of the bone tissue.
Metastases from other organs.

In addition, alkaline phosphatase increases during bone healing after fractures.

Other diseases in which the rate is increased:

Hyperparathyroidism (primary).
Ulcerative colitis.
Myocardial infarction.
Perforation of the intestinal wall.

According to statistics, the most common cause elevated alkaline phosphatase are liver diseases.

Features of the growth rate in children

The level of the enzyme in the blood of a child is always higher than that of an adult. Similar situation persists until puberty. In these cases, it is customary to speak of physiological processes, in which there is an intensive growth of bone tissue.

An upward deviation of the indicator may also indicate the presence of the following pathologies:

Diagnostics

If alkaline phosphatase is elevated in a child, the pediatrician will issue a referral to a gastroenterologist. In adults, the initial diagnosis can be made by a therapist.

To detect pathology, the doctor prescribes the following studies:

Analysis of blood, feces and urine. The level of alkaline phosphatase is determined in the biomaterial.
Analysis of isoenzymes in the blood serum or amniotic fluid (in pregnant women).
Assessment of alkaline phosphatase activity in the juice of the small intestine.

The following values are normal (expressed in IU/L):

Children under the age of 10 years - 150-350.
Persons from 10 to 19 years old - 155-500.
Adults under the age of 50 - 30-120.
Persons from 50 to 75 years old - 110-135.
Elderly people (over 75 years old) - 165-190.

In order to understand which organ is involved in the pathological process, the doctor may prescribe additional studies. As a rule, this is an analysis for alanine aminotransferase and aspartate aminotransferase. If, against the background of an increase in alkaline phosphatase, they are also rejected upwards, this indicates liver damage. If the analysis of the patient's biomaterial showed an increase in phosphorus and calcium, it is customary to talk about diseases of the bone tissue.

Thus, according to the results complex diagnostics it will become clear which pathology development provoked an increase in the level of the enzyme.

Treatment

It is important to understand that the deviation of the alkaline phosphatase index in a large direction is not independent disease. This is just a symptom that indicates the development of a disease. In this regard, it is impossible to normalize the level of the enzyme in the blood without eliminating the underlying disease.

In most cases, an increase in alkaline phosphatase indicates liver damage. In diseases of this organ, it is necessary to strictly follow a diet in order to provide it with functional rest. To do this, you need to exclude from the diet fresh bread, flour products, sour fruits and berries legumes, fatty meat, carbonated and alcohol-containing drinks, spices, chocolate. All dishes must be boiled, stewed, baked or steamed. In addition, the patient is shown taking drugs intended to restore normal functioning liver (hepatoprotectors).

Regardless of what pathology caused the increase in the level of the enzyme, its treatment should be strictly under the supervision of a doctor. This will reduce the duration of therapy and significantly reduce the risk of complications. Based on the results of the diagnosis, the physician may refer the patient for further treatment to specialists of a narrow profile - gastroenterologist, orthopedist, oncologist, surgeon, cardiologist.

Prevention

specific measures to prevent the development of the pathological process does not exist. In order to minimize the risk of its occurrence, it is recommended:

Finally

Alkaline phosphatase is the enzyme responsible for delivering phosphorus to the body's cells. As a rule, its indicator changes only against the background of growing up. If the blood test indicates that alkaline phosphatase is elevated, what does this mean? This result is an warning sign, since an increase in the level of the enzyme in most cases indicates a pathology of the liver, bone tissue or bile ducts. To identify the underlying disease, a comprehensive diagnosis is required.

Alkaline phosphatase is an enzyme that provides metabolic processes of calcium and phosphorus in organism. Detection of this substance in the blood may indicate the presence of certain diseases. High performance are quite common, which indicates problems with the liver, kidneys and bones. There are much fewer situations in which alkaline phosphatase is lowered, but they also indicate the presence of health problems. In what situations can low rates and what to do with it, we will consider further.

This biochemical indicator used to assess the condition of certain organs, as well as metabolic processes calcium and phosphorus. Alkaline phosphatase in the blood is determined using an analysis, the accuracy of the results of which can be affected by factors such as:

Eating - the analysis should be taken on an empty stomach, since the food consumed can provoke an increase in the error in the study.
Diet - fatty and fried foods that have increased load on the liver should be excluded. For 2-3 days before donating blood, it is recommended to follow a diet.
Alcohol - alcoholic beverages provoke the formation of toxins, which makes the liver work several times more. Any 3-4 days alcoholic drinks need to be excluded.
stress and absence good sleep and rest - overvoltage can provoke inaccuracies in the study, so you should have a good rest and sleep before donating blood.

A kind of preparation for analysis helps to obtain more reliable data, reducing the risks of possible errors.

What values are considered low?

The level of alkaline phosphatase in the blood may change with age and also depends on gender. Therefore, low rates are appropriate to consider for certain categories of patients.

In men, the results of the analysis are reduced, such as:

18-35 years - less than 45 units / l;
35-45 years - less than 40 units / l;
45-65 years - less than 38 units / l;
older than 65 - less than 37.5 units / l.

For women, deviations from the norm are considered values such as:

18-25 years - less than 48 units / l;
25-35 years - less than 45 units / l;
35-45 years - less than 44 units / l;
older than 45 years - less than 40 units / l.

For older people over 66, the lower limit rises significantly, respectively. low values are indicators that are below 150 units / l.

In childhood, ALP phosphatase is considered low at such marks:

newborns and children of the first year of life - less than 85 units / l;
1-5 years - less than 68 units / l;
5-10 years - less than 65 units / l;
10-15 years - less than 80 units / l.

At the time of bearing a child, the level of phosphatase increases several times, since in total The enzyme is supplemented with molecules synthesized by the placenta.

Therefore, during this period of time, it is important to ensure that there is no decrease in phosphatase, which can lead to the development negative consequences both for the mother's body and for the child.

Ask your question to the doctor of clinical laboratory diagnostics

Anna Poniaeva. Graduated from the Nizhny Novgorod medical academy(2007-2014) and residency in clinical laboratory diagnostics (2014-2016).

Alkaline phosphatase is a hydrolysis enzyme that removes phosphate from various types 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 cell membranes 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 surface layer mucosa of the small intestine, 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.

For diagnosing 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, monoester phosphohydrolase phosphoric acid. These monoesters have molecular weights from 70 to 120 kDa.

1 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 passage in the body of rapid processes of its restructuring, which are associated with various systems life support and 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. On the present stage standardized laboratory medical technique there is no definition for 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.

To determine the amount of this type of compounds, any specialist conducts a series clinical research. However, the boundaries normal indicators phosphatases are extensive and dependent on a large number 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 additional feature diagnosing diseases of the body.

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 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 sign, which allows 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 in the body of diseases associated with damage to bones and bone tissue.

Elevated serum phosphatase always signals possible defeat 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, it is detected, then this signals 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.

3 Causes of an increase in 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 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 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 various factors. This group includes the condition female body like the period of childbearing, adolescence, women under 20 years of age and men under the age of 30 years.

4 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 enzyme can vary over a wide range, therefore, only according to the results of a study of the amount of enzyme in the blood serum accurate diagnosis cannot be installed. This indicator can be used in diagnostics to obtain complete information about the patient's disease.

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

Determination of enzyme activity in intestinal juice is used in the assessment functional state gastrointestinal tract and intestinal mucosa. During the study, the determination of enzyme activity is carried out separately in duodenum and skinny. 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 juice jejunum fluctuates in the range from 11 to 28 u/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.

Hypophosphatasia is a rarely progressive metabolic disease having a 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.