Serum alkaline phosphatase, body composition, and risk of metabolic syndrome in middle-aged Korean

Some papers have suggested that alkaline phosphatase (ALP) level is a predictor of the metabolic syndrome (MetS) in the general population. However, the association is still controversial, and the mechanisms underlying an association between ALP level and the MetS have not been elucidated. We analyz...

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Published inENDOCRINE JOURNAL Vol. 60; no. 3; pp. 321 - 328
Main Authors Oh, Ki Won, Lee, Won Young, Kang, Moo Il, Kim, Mee Kyoung, Park, Se Eun, Rhee, Eun-Jung, Park, Cheol Young, Baek, Ki Hyun
Format Journal Article
LanguageEnglish
Published Japan The Japan Endocrine Society 2013
Subjects
Online AccessGet full text
ISSN0918-8959
1348-4540
1348-4540
DOI10.1507/endocrj.EJ12-0331

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Abstract Some papers have suggested that alkaline phosphatase (ALP) level is a predictor of the metabolic syndrome (MetS) in the general population. However, the association is still controversial, and the mechanisms underlying an association between ALP level and the MetS have not been elucidated. We analyzed the association between serum ALP level and the development of the MetS over a 4-year period. A total of 14,224 subjects who visited the Health Promotion Center for a medical examination in 2005 were followed up after 4 years. Serum ALP level correlated positively with body fat mass and visceral fat mass. The adjusted geometric mean ALP levels were higher in subjects with elevated C-reactive protein level or greater fat mass (P < 0.001). None of the subjects had the MetS at baseline, but 1,179 exhibited the MetS at the 4-year follow-up. After multiple adjustments, the odds ratio (OR) was substantially higher for development of the MetS (OR 1.56, 95% confidence intervals, 1.21-2.01) in subjects in the highest ALP quintile compared with those in the lowest quintile. After adjusting for various covariates, we found significant associations between the quintile of serum ALP level and abdominal obesity, low high-density lipoprotein cholesterol level, and high triglyceride level. Higher serum ALP level was a significant predictor of the MetS in middle-aged Koreans. Serum ALP level correlated positively with body fat mass and independently with a more atherogenic lipid profile in the general population in Korea.
AbstractList Some papers have suggested that alkaline phosphatase (ALP) level is a predictor of the metabolic syndrome (MetS) in the general population. However, the association is still controversial, and the mechanisms underlying an association between ALP level and the MetS have not been elucidated. We analyzed the association between serum ALP level and the development of the MetS over a 4-year period. A total of 14,224 subjects who visited the Health Promotion Center for a medical examination in 2005 were followed up after 4 years. Serum ALP level correlated positively with body fat mass and visceral fat mass. The adjusted geometric mean ALP levels were higher in subjects with elevated C-reactive protein level or greater fat mass (P < 0.001). None of the subjects had the MetS at baseline, but 1,179 exhibited the MetS at the 4-year follow-up. After multiple adjustments, the odds ratio (OR) was substantially higher for development of the MetS (OR 1.56, 95% confidence intervals, 1.21-2.01) in subjects in the highest ALP quintile compared with those in the lowest quintile. After adjusting for various covariates, we found significant associations between the quintile of serum ALP level and abdominal obesity, low high-density lipoprotein cholesterol level, and high triglyceride level. Higher serum ALP level was a significant predictor of the MetS in middle-aged Koreans. Serum ALP level correlated positively with body fat mass and independently with a more atherogenic lipid profile in the general population in Korea.
Some papers have suggested that alkaline phosphatase (ALP) level is a predictor of the metabolic syndrome (MetS) in the general population. However, the association is still controversial, and the mechanisms underlying an association between ALP level and the MetS have not been elucidated. We analyzed the association between serum ALP level and the development of the MetS over a 4-year period. A total of 14,224 subjects who visited the Health Promotion Center for a medical examination in 2005 were followed up after 4 years. Serum ALP level correlated positively with body fat mass and visceral fat mass. The adjusted geometric mean ALP levels were higher in subjects with elevated C-reactive protein level or greater fat mass (P < 0.001). None of the subjects had the MetS at baseline, but 1,179 exhibited the MetS at the 4-year follow-up. After multiple adjustments, the odds ratio (OR) was substantially higher for development of the MetS (OR 1.56, 95% confidence intervals, 1.21-2.01) in subjects in the highest ALP quintile compared with those in the lowest quintile. After adjusting for various covariates, we found significant associations between the quintile of serum ALP level and abdominal obesity, low high-density lipoprotein cholesterol level, and high triglyceride level. Higher serum ALP level was a significant predictor of the MetS in middle-aged Koreans. Serum ALP level correlated positively with body fat mass and independently with a more atherogenic lipid profile in the general population in Korea.Some papers have suggested that alkaline phosphatase (ALP) level is a predictor of the metabolic syndrome (MetS) in the general population. However, the association is still controversial, and the mechanisms underlying an association between ALP level and the MetS have not been elucidated. We analyzed the association between serum ALP level and the development of the MetS over a 4-year period. A total of 14,224 subjects who visited the Health Promotion Center for a medical examination in 2005 were followed up after 4 years. Serum ALP level correlated positively with body fat mass and visceral fat mass. The adjusted geometric mean ALP levels were higher in subjects with elevated C-reactive protein level or greater fat mass (P < 0.001). None of the subjects had the MetS at baseline, but 1,179 exhibited the MetS at the 4-year follow-up. After multiple adjustments, the odds ratio (OR) was substantially higher for development of the MetS (OR 1.56, 95% confidence intervals, 1.21-2.01) in subjects in the highest ALP quintile compared with those in the lowest quintile. After adjusting for various covariates, we found significant associations between the quintile of serum ALP level and abdominal obesity, low high-density lipoprotein cholesterol level, and high triglyceride level. Higher serum ALP level was a significant predictor of the MetS in middle-aged Koreans. Serum ALP level correlated positively with body fat mass and independently with a more atherogenic lipid profile in the general population in Korea.
Author Kang, Moo Il
Baek, Ki Hyun
Park, Cheol Young
Oh, Ki Won
Kim, Mee Kyoung
Park, Se Eun
Rhee, Eun-Jung
Lee, Won Young
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– sequence: 1
  fullname: Kang, Moo Il
  organization: Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
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  fullname: Kim, Mee Kyoung
  organization: Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
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  fullname: Park, Se Eun
  organization: Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
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  fullname: Rhee, Eun-Jung
  organization: Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
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10.1210/jc.2011-2280
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References 17. Mirza MA, Alsiö J, Hammarstedt A, Erben RG, Michaëlsson K, et al. (2011) Circulating fibroblast growth factor-23 is associated with fat mass and dyslipidemia in two independent cohorts of elderly individuals. Arterioscler Thromb Vasc Biol 31: 219-227.
2. Tonelli M, Curhan G, Pfeffer M, Sacks F, Thadhani R, Melamed ML, et al. (2009) Relation between alkaline phosphatase, serum phosphate, and all-cause or cardiovascular mortality. Circulation 120: 1784-1792.
15. Ali AT, Penny CB, Paiker JE, Psaras G, Ikram F, et al. (2006) The effect of alkaline phosphatase inhibitors on intracellular lipid accumulation in preadipocytes isolated from human mammary tissue. Ann Clin Biochem 43: 207-213.
7. Kerner A, Avizohar O, Sella R, Bartha P, Zinder O, et al. (2005) Association between elevated liver enzymes and C-reactive protein: possible hepatic contribution to systemic inflammation in the metabolic syndrome. Arterioscler Thromb Vasc Biol 25: 193-197.
10. Bae SJ, Choe JW, Chung YE, Kim BJ, Lee SH, et al. (2011) The association between serum osteocalcin levels and metabolic syndrome in Koreans. Osteoporos Int 22: 2837-2846.
8. Nakanishi N, Suzuki K, Tatara K (2004) Serum gamma-glutamyltransferase and risk of metabolic syndrome and type 2 diabetes in middle-aged Japanese men. Diabetes Care 27: 1427-1432.
14. Ali AT, Penny CB, Paiker JE, Psaras G, Ikram F, et al. (2006) The relationship between alkaline phosphatase activity and intracellular lipid accumulation in murine 3T3-L1 cells and human preadipocytes. Anal Biochem 354: 247-254.
6. Blayney MJ, Pisoni RL, Bragg-Gresham JL, Bommer J, Piera L, et al. (2008) High alkaline phosphatase levels in hemodialysis patients are associated with higher risk of hospitalization and death. Kidney Int 74: 655-663.
22. Grethen E, Hill KM, Jones R, Cacucci BM, Gupta CE, et al. (2012) Serum leptin, parathyroid hormone, 1,25-dihydroxyvitamin D, fibroblast growth factor 23, bone alkaline phosphatase, and sclerostin relationships in obesity. J Clin Endocrinol Metab 97:1655-1662.
9. Hanley AJ, Williams K, Festa A, Wagenknecht LE, D’Agostino RB Jr, et al. (2005) Liver markers and development of the metabolic syndrome: the insulin resistance atherosclerosis study. Diabetes 54: 3140-3147.
21. Ali AT, Paiker JE, Crowther NJ. (2006) The relationship between anthropometry and serum concentrations of alkaline phosphatase isoenzymes, liver-enzymes, albumin, and bilirubin. Am J Clin Pathol 126:437-442.
12. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, et al. (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28: 412-419.
4. Ryu WS, Lee SH, Kim CK, Kim BJ, Yoon BW (2010) Increased serum alkaline phosphatase as a predictor of long-term mortality after stroke. Neurology 75: 1995-2002.
3. Krishnamurthy VR, Baird BC, Wei G, Greene T, Raphael K, et al. (2011) Associations of serum alkaline phosphatase with metabolic syndrome and mortality. Am J Med 124: 566.e1-7.
19. Regidor DL, Kovesdy CP, Mehrotra R, Rambod M, Jing J, et al. (2008) Serum alkaline phosphatase predicts mortality among maintenance hemodialysis patients. J Am Soc Nephrol 19: 2193-2203.
5. Beddhu S, Ma X, Baird B, Cheung AK, Greene T (2009) Serum alkaline phosphatase and mortality in African Americans with chronic kidney disease. Clin J Am Soc Nephrol 4: 1805-1810.
20. Zelle DM, Corpeleijn E, van Ree RM, Stolk RP, van der Veer E, et al. (2010) Markers of the hepatic component of the metabolic syndrome as predictors of mortality in renal transplant recipients. Am J Transplant 10: 106-114.
18. Kovesdy CP, Ureche V, Lu JL, Kalantar-Zadeh K (2010) Outcome predictability of serum alkaline phosphatase in men with pre-dialysis CKD. Nephrol Dial Transplant 25: 3003-3011.
1. Lomashvili KA, Garg P, Narisawa S, Millan JL, O’Neill WC (2008) Upregulation of alkaline phosphatase and pyrophosphate hydrolysis: potential mechanism for uremic vascular calcification. Kidney Int 73: 1024-1030.
13. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, et al.; American Heart Association; National Heart, Lung, and Blood Institute (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 112: 2735-2752.
11. Saverymuttu SH, Joseph AE, Maxwell JD (1986) Ultrasound scanning in the detection of hepatic fibrosis and steatosis. Br Med J(Clin Res Ed) 292: 13-15.
16. Hruska KA, Mathew S (2011) The roles of the skeleton and phosphorus in the CKD mineral bone disorder. Adv Chronic Kidney Dis 18: 98-104.
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15
16
17
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2
3
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5
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References_xml – reference: 4. Ryu WS, Lee SH, Kim CK, Kim BJ, Yoon BW (2010) Increased serum alkaline phosphatase as a predictor of long-term mortality after stroke. Neurology 75: 1995-2002.
– reference: 15. Ali AT, Penny CB, Paiker JE, Psaras G, Ikram F, et al. (2006) The effect of alkaline phosphatase inhibitors on intracellular lipid accumulation in preadipocytes isolated from human mammary tissue. Ann Clin Biochem 43: 207-213.
– reference: 2. Tonelli M, Curhan G, Pfeffer M, Sacks F, Thadhani R, Melamed ML, et al. (2009) Relation between alkaline phosphatase, serum phosphate, and all-cause or cardiovascular mortality. Circulation 120: 1784-1792.
– reference: 9. Hanley AJ, Williams K, Festa A, Wagenknecht LE, D’Agostino RB Jr, et al. (2005) Liver markers and development of the metabolic syndrome: the insulin resistance atherosclerosis study. Diabetes 54: 3140-3147.
– reference: 22. Grethen E, Hill KM, Jones R, Cacucci BM, Gupta CE, et al. (2012) Serum leptin, parathyroid hormone, 1,25-dihydroxyvitamin D, fibroblast growth factor 23, bone alkaline phosphatase, and sclerostin relationships in obesity. J Clin Endocrinol Metab 97:1655-1662.
– reference: 21. Ali AT, Paiker JE, Crowther NJ. (2006) The relationship between anthropometry and serum concentrations of alkaline phosphatase isoenzymes, liver-enzymes, albumin, and bilirubin. Am J Clin Pathol 126:437-442.
– reference: 1. Lomashvili KA, Garg P, Narisawa S, Millan JL, O’Neill WC (2008) Upregulation of alkaline phosphatase and pyrophosphate hydrolysis: potential mechanism for uremic vascular calcification. Kidney Int 73: 1024-1030.
– reference: 5. Beddhu S, Ma X, Baird B, Cheung AK, Greene T (2009) Serum alkaline phosphatase and mortality in African Americans with chronic kidney disease. Clin J Am Soc Nephrol 4: 1805-1810.
– reference: 12. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, et al. (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28: 412-419.
– reference: 19. Regidor DL, Kovesdy CP, Mehrotra R, Rambod M, Jing J, et al. (2008) Serum alkaline phosphatase predicts mortality among maintenance hemodialysis patients. J Am Soc Nephrol 19: 2193-2203.
– reference: 13. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, et al.; American Heart Association; National Heart, Lung, and Blood Institute (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 112: 2735-2752.
– reference: 16. Hruska KA, Mathew S (2011) The roles of the skeleton and phosphorus in the CKD mineral bone disorder. Adv Chronic Kidney Dis 18: 98-104.
– reference: 3. Krishnamurthy VR, Baird BC, Wei G, Greene T, Raphael K, et al. (2011) Associations of serum alkaline phosphatase with metabolic syndrome and mortality. Am J Med 124: 566.e1-7.
– reference: 10. Bae SJ, Choe JW, Chung YE, Kim BJ, Lee SH, et al. (2011) The association between serum osteocalcin levels and metabolic syndrome in Koreans. Osteoporos Int 22: 2837-2846.
– reference: 8. Nakanishi N, Suzuki K, Tatara K (2004) Serum gamma-glutamyltransferase and risk of metabolic syndrome and type 2 diabetes in middle-aged Japanese men. Diabetes Care 27: 1427-1432.
– reference: 6. Blayney MJ, Pisoni RL, Bragg-Gresham JL, Bommer J, Piera L, et al. (2008) High alkaline phosphatase levels in hemodialysis patients are associated with higher risk of hospitalization and death. Kidney Int 74: 655-663.
– reference: 11. Saverymuttu SH, Joseph AE, Maxwell JD (1986) Ultrasound scanning in the detection of hepatic fibrosis and steatosis. Br Med J(Clin Res Ed) 292: 13-15.
– reference: 14. Ali AT, Penny CB, Paiker JE, Psaras G, Ikram F, et al. (2006) The relationship between alkaline phosphatase activity and intracellular lipid accumulation in murine 3T3-L1 cells and human preadipocytes. Anal Biochem 354: 247-254.
– reference: 17. Mirza MA, Alsiö J, Hammarstedt A, Erben RG, Michaëlsson K, et al. (2011) Circulating fibroblast growth factor-23 is associated with fat mass and dyslipidemia in two independent cohorts of elderly individuals. Arterioscler Thromb Vasc Biol 31: 219-227.
– reference: 20. Zelle DM, Corpeleijn E, van Ree RM, Stolk RP, van der Veer E, et al. (2010) Markers of the hepatic component of the metabolic syndrome as predictors of mortality in renal transplant recipients. Am J Transplant 10: 106-114.
– reference: 7. Kerner A, Avizohar O, Sella R, Bartha P, Zinder O, et al. (2005) Association between elevated liver enzymes and C-reactive protein: possible hepatic contribution to systemic inflammation in the metabolic syndrome. Arterioscler Thromb Vasc Biol 25: 193-197.
– reference: 18. Kovesdy CP, Ureche V, Lu JL, Kalantar-Zadeh K (2010) Outcome predictability of serum alkaline phosphatase in men with pre-dialysis CKD. Nephrol Dial Transplant 25: 3003-3011.
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SubjectTerms Adipose Tissue
Adult
Alanine Transaminase - blood
Alkaline phosphatase
Alkaline Phosphatase - blood
Aspartate Aminotransferases - blood
Body Composition
C-Reactive Protein - analysis
Cholesterol, LDL - blood
Female
Humans
Inflammation
Intra-Abdominal Fat
Liver - enzymology
Male
Metabolic syndrome
Metabolic Syndrome - epidemiology
Middle Aged
Obesity - enzymology
Obesity, Abdominal - enzymology
Republic of Korea - epidemiology
Risk Factors
Triglycerides - blood
Title Serum alkaline phosphatase, body composition, and risk of metabolic syndrome in middle-aged Korean
URI https://www.jstage.jst.go.jp/article/endocrj/60/3/60_EJ12-0331/_article/-char/en
http://mol.medicalonline.jp/en/journal/download?GoodsID=cq6endoc/2013/006003/009&name=0321-0328e
https://www.ncbi.nlm.nih.gov/pubmed/23149655
https://www.proquest.com/docview/1323278531
Volume 60
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ispartofPNX Endocrine Journal, 2013, Vol.60(3), pp.321-328
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