Alkaline Phosphatase



Alkaline phosphatase (ALP) is present in almost all body tissues, located at or in cell membranes. It occurs at particularly high levels in interstitial epithelium, kidney tubules, bone (osteoblasts), liver and placenta. The precise metabolic function of ALP has not yet been fully elucidated, however the enzyme is associated with intestinal lipid transport and bone calcification. ALP originates in approximately equal proportions from the liver and the skeletal system. Approximately 25% of healthy individuals also have intestinal ALP which accounts for approximately 10% of the total ALP in a fasting sample. Increases in total ALP are either due to physiological causes, or are caused by diseases of the liver or bone. Physiological increases in ALP are found in pregnancy from the 2nd trimester onwards due to placental ALP, in growing children due to bone ALP and postprandially in individuals with blood groups B and O, who are secretors of blood group substance H (intestinal ALP).The most common cause of elevated ALP is hepatobiliary disease, with pathological ALP levels found in approximately 60% of patients with disease of the liver or biliary tract. ALP levels may also be elevated in primary bone diseases, such as osteomalacia, osteogenesis imperfecta, vitamin D intoxication and primary bone tumors. ALP levels may also be increased in secondary bone diseases, such as skeletal metastases, and in diseases such as multiple myeloma, acromegaly, renal insufficiency, hyperthyroidism, ectopic ossification, sarcoidosis, bone tuberculosis and healing fractures. In bone diseases such as Paget’s disease, vitamin D deficiency rickets and metastatic bone disease, ALP activity is a good indicator of bone activity, in the absence of co-existing chronic liver disease. Total ALP is only occasionally elevated in some metabolic bone diseases such as hyperparathyroidism, osteopenia or osteoporosis.Reduced levels of ALP are found in familial hypophosphatasia, hypoparathyroidism, achondroplasia, adynamic bone disease in dialysis patients, pituitary dwarfism, chronic radiation sickness and malnutrition

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Alkaline Phosphatase


Serum Separator Tube (SST®)

Do not remove the stopper at any time. Do not centrifuge immediately after drawing blood. Allow the blood to clot in an upright position for at least 30 minutes but not longer than 1 hour before centrifugation. Centrifuge for at least 15 minutes at 2200-2500 RPM within one hour of collection. Label the tube with the patient’s last name, patient’s first name, date of birth, date of collection, and time of collection.

Room temperature:
Refrigerated: 7 Days