To make things more confusing Roche mentiones in it's own reference range
booklet entitled: "Reference ranges for adults and children, W. Heil, R.
Koberstein, B. Zawta. 2002" both the reference ranges mentioned by you for
their IFCC (modified, liquid) method as the reference ranges for their
original IFCC method. The last being derived from a publication by Norbert
Tietz himself. (Tietz NW, Shuey DF. Clin Chem 1986;32:1593-5)
In this publication the same phenomenon is described:
37degrees IFCC method:
20 - 50 yrs W <98
M <128
>60 yrs W <141
M <119
Does this reflect enhanced bone turnover in postmenopausal women?
Bart Ballieux
Dr. B.E.P.B. Ballieux
Clinical Biochemist
Leiden University Medical Centre
P.O.box 9600
2300 RC Leiden
The Netherlands
Tel:+3171-5262165/2278
Fax: +3171-5266753
email: [log in to unmask]
-----Original Message-----
From: Paul Masters [mailto:[log in to unmask]]
Sent: vrijdag 2 mei 2003 11:36
To: [log in to unmask]
Subject: Alkaline phosphatase ranges
We measure ALP on Roche Modular P using the IFCC method with
manufacturer-quoted ranges of 40 - 129 (men) and 35 - 104 (women), both
based on approx n=220.
One of our local GPs believes that he is getting too many high results in
normal patients (eg those about to go onto statins) and, indeed has data
showing 20% of his female results are >104 (vs 6% for men >129).
I have confirmed this on another large sample (n=6000) from the LIS.
Interestingly, analysing by age and sex suggests a definite increase with
age in women and my provisional ranges for the assay now would be:
Women: up to 50 y 40 - 110
50 - 60 y 40 - 130
60 - 70 y 40 - 140
over 70 y 40 - 150
Men up to 50 y 40 - 110
over 50 y 40 - 130
Does anyone have any similar data, or a good explanation for the rising ALP
in older women? Is it physiological or pathological? If I changed the ULNs
as above would I be hiding disease from the GPs or preventing unnecessary
worry and repeat tests??
Paul
Dr Paul Masters
Consultant Chemical Pathologist
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