Elevated Alkaline Phosphatase: A Potential Marker of Bone Metabolism in Metabolic Syndrome
DOI:
https://doi.org/10.4314/njbmb.v40i1.1Keywords:
metabolic syndrome (MetS) , alkaline phosphatase (ALP), bone turnover, orthopaedic assessment, fracture, Bone Mineral Density (BMD), Body Mass Index (BMI)Abstract
Metabolic syndrome (MetS) is characterised by metabolic dysregulation, chronic inflammation, and increased cardiovascular risk, and may also impair bone remodelling. Alkaline phosphatase (ALP), a biomarker of bone formation, reflects skeletal turnover. This cross-sectional study at Igbinedion University Teaching Hospital, Edo State, Nigeria, assessed ALP in 75 MetS patients diagnosed using the Joint Interim Statement (JIS) criteria. Serum ALP was measured using the p-nitrophenyl phosphate (pNPP) assay, with values above the laboratory reference range (>120 U/L) considered elevated, indicative of subclinical skeletal remodelling abnormalities. Elevated ALP was observed in 34.7% of participants, suggesting that nearly one in three individuals with MetS may have subclinical skeletal changes. Among these, 21.3% were females (p > 0.05), indicating a possible gender trend. Body mass index (BMI) was significantly associated with ALP levels (p = 0.009), with 85.7% of obese participants exhibiting elevated ALP, highlighting adiposity as a potential driver of altered bone metabolism. These findings support the hypothesis that insulin resistance and chronic inflammation in MetS contribute to skeletal alterations, independent of bone mineral density (BMD). Routine ALP assessment in MetS, particularly in patients with extreme BMI, may facilitate early detection of bone health risks. Longitudinal studies are warranted to clarify causal relationships and guide integrated strategies for fracture prevention in MetS.
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The authors have not made the research data publicly available, as it is not required for the interpretation or replication of the findings presented in this study.
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Copyright (c) 2025 Harmony U. Ibezim, Osasenaga Bencharles, Imesidayo O. Eboreime-Oikeh, Helen K. Njoya, John O. Osarenkhoe, Vincent Makelemi (Author)
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