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Clinical Chemistry, Vol 42, 1796-1804, Copyright © 1996 by American Association for Clinical Chemistry
HW Woitge, MJ Seibel and R Ziegler
Department of Internal Medicine, University of Heidelberg, Germany.
To evaluate the diagnostic validity of new assays for bone-specific alkaline phosphatase (BAP), we compared measurements of total alkaline phosphatase (TAP) in serum with results for three different assays of serum BAP in healthy adults (n = 119), patients with chronic nonskeletal disorders (n = 123), and patients with metabolic bone diseases (n = 113). Serum TAP was determined by a standard colorimetric assay, BAP by the methods of lectin precipitation (L-BAP), enzyme immunoassay (E-BAP), and immunoradiometric assay (I-BAP). Impairment of liver function resulted in significant increases of all alkaline phosphatase (AP) measurements, with the smallest changes being exhibited by E-BAP. Compared with the results by TAP, diagnostic sensitivity (i.e., of values exceeding the reference interval) was not improved by BAP, but receiver-operating characteristic (ROC) curve analyses revealed improved discrimination for primary hyperparathyroidism by E-BAP. These results indicate that, in the presence of liver disease, the specificity of AP measurements is improved by measuring BAP. In most other clinical situations, serum TAP appears to provide sufficient clinical information; however, the cross- sectional study design used here allows no statement about the usefulness of BAP in serial measurements.
The following articles in journals at HighWire Press have cited this article:
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  B. Lumbreras-Lacarra, J. M. Ramos-Rincon, and I. Hernandez-Aguado Methodology in Diagnostic Laboratory Test Research in Clinical Chemistry and Clinical Chemistry and Laboratory Medicine Clin. Chem., March 1, 2004; 50(3): 530 - 536. [Abstract] [Full Text] [PDF]
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H. W. Woitge, E. Horn, A. V. Keck, B. Auler, M. J. Seibel, and M. Pecherstorfer Biochemical Markers of Bone Formation in Patients with Plasma Cell Dyscrasias and Benign Osteoporosis Clin. Chem., April 1, 2001; 47(4): 686 - 693. [Abstract] [Full Text] [PDF]
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D. R. Dufour, J. A. Lott, F. S. Nolte, D. R. Gretch, R. S. Koff, and L. B. Seeff Diagnosis and Monitoring of Hepatic Injury. I. Performance Characteristics of Laboratory Tests Clin. Chem., December 1, 2000; 46(12): 2027 - 2049. [Abstract] [Full Text] [PDF]
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H. W. Woitge, H. Oberwittler, S. Heichel, A. Grauer, R. Ziegler, and M. J. Seibel Short- and Long-Term Effects of Ibandronate Treatment on Bone Turnover in Paget Disease of Bone Clin. Chem., May 1, 2000; 46(5): 684 - 690. [Abstract] [Full Text] [PDF]
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B. C. Kress, I. A. Mizrahi, K. W. Armour, R. Marcus, R. D. Emkey, and A. C. Santora II Use of Bone Alkaline Phosphatase to Monitor Alendronate Therapy in Individual Postmenopausal Osteoporotic Women Clin. Chem., July 1, 1999; 45(7): 1009 - 1017. [Abstract] [Full Text] [PDF]
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 H. W. Woitge, C. Scheidt-Nave, C. Kissling, G. Leidig-Bruckner, K. Meyer, A. Grauer, S. H. Scharla, R. Ziegler, and M. J. Seibel Seasonal Variation of Biochemical Indexes of Bone Turnover: Results of a Population-Based Study J. Clin. Endocrinol. Metab., January 1, 1998; 83(1): 68 - 75. [Abstract] [Full Text]
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C. P. Price, T. P. Milligan, and C. Darte Direct comparison of performance characteristics of two immunoassays for bone isoform of alkaline phosphatase in serum Clin. Chem., November 1, 1997; 43(11): 2052 - 2057. [Abstract] [Full Text] [PDF]
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W. Withold, H. W. Woitge, and M. J. Seibel More on Total and Bone-Specific Alkaline Phosphatase • Authors of the article referred to respond: Clin. Chem., September 1, 1997; 43(9): 1670 - 1671. [Full Text]
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