Several years ago Tom Whitehead published data based on BUPA screening and
showed a marked age variation for ALP in women; not so great in men.
Data for women:
Age ALP (Upper limit)
______ __________________
95% 99%
____ ____
<45 88 111
45 - 54 107 137
55-64 124 160
65-67 131 225
68-71 131 157
>71 135 169
(Data from TP Whitehead et al 1994; BUPA Medical Research and Development)
Alkaline phosphatase activity which slightly higher than "normal" in
apparently healthy older people (especially noticeable in women at the
menopause) may reflect the high incidence of mild, sub-clinical Paget's
disease in the elderly.
Garry
----------------------------------------------------------
Dr Garry John
Consultant Clinical Biochemist
Norfolk and Norwich University Hospital
Tel: +44 (0) 1603 286 933
e mail: [log in to unmask]
-----Original Message-----
From: Paul Masters [mailto:[log in to unmask]]
Sent: 02 May 2003 10:36
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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