Wednesday, September 16, 2020

A-phosphatase in females

 Q: Alkaline phosphatase (AP) levels is physiologically higher in? (select one) 

A) elderly females 

B) younger females

Answer: A

Alkaline phosphatase is an integral part of the liver function test (LFT). But it should be read with caution. Its over-interpretation may lead to unnecessary workup. It should be interpreted in conjunction with other LFT markers, clinical and radiological data. Serum AP comes from the liver and bones. It particularly varies with age like it can be three times higher in children and adolescents due to physiologic osteoblastic activity. Similarly, a healthy elderly female above the age of 65 may have a 50 percent higher AP level than that for a healthy female in 20s or 30s. On the other hand, a healthy female within the third trimester of pregnancy may have a very abnormal AP due to an influx into the maternal blood of placental AP. Another interesting finding is the higher serum AP level in persons with blood types O and B after eating a fatty meal. Similarly, it could be higher than normal in a diabetic patient.




1. Shipman Kate Elizabeth, Holt Ashley David, Gama Rousseau. Interpreting an isolated raised serum alkaline phosphatase level in an asymptomatic patient BMJ 2013; 346 :f976

2. Nannipieri M, Gonzales C, Baldi S, et al. Liver enzymes, the metabolic syndrome, and incident diabetes: the Mexico City diabetes study. Diabetes Care 2005; 28:1757.

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