Alkaline phosphatase as a screening test for osteomalacia

Area of Science:

• Endocrinology
• Metabolic Bone Disease
• Diagnostic Screening

Background:

• Vitamin D deficiency is prevalent in Pakistan, leading to delayed osteomalacia diagnosis and significant morbidity from pathological fractures.
• Current diagnostic approaches often result in delayed identification of osteomalacia in adults.

Purpose of the Study:

• To evaluate the efficacy of Serum Alkaline Phosphatase (SALP) as a screening test for osteomalacia.
• To determine if SALP levels can aid in the early detection of osteomalacia.

Main Methods:

• The study screened patients presenting with chronic back or non-specific pain for raised SALP levels.
• Serum calcium levels were also assessed in patients suspected of osteomalacia.
• Data was collected from July 2002 to June 2005 at Fatima Hospital, Baqai Medical University.

Main Results:

• Out of 334 patients screened, 116 (35%) had elevated SALP levels.
• Osteomalacia was diagnosed in 92 (79.3%) of those with raised SALP.
• A significant proportion (53.4%) of osteomalacia cases had normal serum calcium levels.

Conclusions:

• Relying solely on serum calcium for screening can lead to missed osteomalacia diagnoses.
• Serum Alkaline Phosphatase is recommended as the preferred screening method for osteomalacia.
• Utilizing SALP for screening can improve early detection and management of osteomalacia.