Jump to ContentJump to Main Navigation
Show Summary Details

Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

IMPACT FACTOR increased in 2015: 3.017
Rank 5 out of 30 in category Medical Laboratory Technology in the 2014 Thomson Reuters Journal Citation Report/Science Edition

SCImago Journal Rank (SJR) 2015: 0.873
Source Normalized Impact per Paper (SNIP) 2015: 0.982
Impact per Publication (IPP) 2015: 2.238

See all formats and pricing


Select Volume and Issue


30,00 € / $42.00 / £23.00

Get Access to Full Text

Association between serum alkaline phosphatase and C-reactive protein in the United States National Health and Nutrition Examination Survey 2005–2006

Matthew Webber1 / Aisling Krishnan1 / Neil G. Thomas1 / Bernard M.Y. Cheung1

1School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK

Corresponding author: Prof. Bernard M.Y. Cheung, University Department of Medicine, Queen Mary Hospital, Hong Kong, China Phone: +852 28554049, Fax: +852 28186474,

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 48, Issue 2, Pages 167–173, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2010.052, December 2009

Publication History

Published Online:


Background: Alkaline phosphatase (ALP) is a widely used marker for skeletal and hepatobiliary disorders, but its activity is also increased in atherosclerosis and peripheral vascular disease. It is an inflammatory marker like C-reactive protein (CRP). We therefore analyzed its relationship with CRP in the United States National Health and Nutrition Examination Survey (NHANES) 2005–2006.

Methods: The analysis included 4155 men and non-pregnant women over the age of 20 years. The relationship between log-transformed ALP and plasma CRP was analyzed using univariate and multivariate models.

Results: ALP activity was significantly correlated with age, waist circumference, body mass index, blood pressure, exercise, alcohol, triglycerides, and other liver enzymes after adjusting for age, gender and ethnicity (p<0.001). ALP was significantly associated with a higher frequency of cardiovascular disease (p=0.02), hypertension (p=0.01) hypercholesterolemia (p=0.04), and diabetes (p=0.02). Compared to the lowest quartile of ALP, the adjusted odds ratio (OR) associated with the highest quartile were 1.9 [95% confidence intervals (CI) 1.1–3.5], 1.6 (95% CI 1.0–2.5), 1.5 (95% CI 1.1–2.1) and 1.7 (95% CI 1.0–2.4) for cardiovascular disease, hypertension, hypercholesterolemia, and diabetes, respectively. In multivariate analysis, log ALP was an independent predictor of log CRP (p=1.0×10−6). A multivariate model that included log ALP, ethnicity, glycohemoglobin, waist circumference, albumin, apolipoprotein B, γ-glutamyltransferase and uric acid explained 40% of the variance in log CRP.

Conclusions: ALP is a marker of cardiometabolic risk, but it needs to be tested as part of a multivariate model in prospective studies.

Clin Chem Lab Med 2010;48:167–73.

Keywords: alkaline phosphatase; cardiovascular disease; C-reactive protein; NHANES

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Jean-Paul Lallès
Nutrition Reviews, 2014, Volume 72, Number 2, Page 82
Wi-Sun Ryu, Seung-Hoon Lee, Chi Kyung Kim, Beom Joon Kim, Hyung-Min Kwon, and Byung-Woo Yoon
Atherosclerosis, 2014, Volume 232, Number 2, Page 313
Kelly K. Ferguson, Rita Loch-Caruso, and John D. Meeker
Environmental Science & Technology, 2012, Volume 46, Number 1, Page 477
Bernard M.Y. Cheung, Kwok-Leung Ong, Annette W.K. Tso, Stacey S. Cherny, Pak-Chung Sham, Tai-Hing Lam, and Karen S.L. Lam
Clinica Chimica Acta, 2011, Volume 412, Number 15-16, Page 1326

Comments (0)

Please log in or register to comment.