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Colorimetric Analysis of Alkaline Phosphatase Activity in S. aureus Biofilm
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Reference interval for total alkaline phosphatase in adults.

Line Philipsen1, Lærke Andersen1, Stine Linding Andersen1,2

  • 1Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark.

Scandinavian Journal of Clinical and Laboratory Investigation
|February 18, 2026
PubMed
Summary

Establishing consistent reference intervals for alkaline phosphatase (ALP) is crucial for diagnosing liver and bone disorders. This study determined adult ALP reference intervals across multiple laboratory methods, leading to a unified 40-120 IU/L range in Denmark.

Keywords:
Biochemistrybileboneenzyme assayliver

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Area of Science:

  • Clinical Biochemistry
  • Laboratory Medicine
  • Diagnostic Markers

Background:

  • Alkaline phosphatase (ALP) is a key indicator for liver and bone conditions.
  • Plasma ALP measurement is a routine biochemical test.
  • Establishing accurate reference intervals (RIs) is essential for clinical interpretation.

Purpose of the Study:

  • To establish reference intervals for total ALP in adults using common laboratory methods.
  • To compare ALP RIs across different analytical platforms.
  • To implement a standardized RI for total ALP in clinical practice.

Main Methods:

  • Cross-sectional study involving blood donors and general practice patients in North Denmark.
  • ALP levels measured on Alinity, Atellica, and Cobas platforms using enzymatic methods.
  • Non-parametric RIs determined using 2.5th and 97.5th percentiles, with outlier exclusion.
  • Analysis included methods with and without correction factors for Alinity.

Main Results:

  • Established RIs varied slightly across methods before correction.
  • After applying a correction factor to the Alinity method, RIs became largely consistent.
  • A uniform RI of 40-120 IU/L was implemented in the region.
  • The percentage of samples falling outside this RI was minimal across methods.

Conclusions:

  • A uniform reference interval of 40-120 IU/L for total ALP is reliable across commonly used laboratory methods.
  • Method-specific correction factors, like for Alinity, enhance consistency.
  • Standardized RIs improve diagnostic accuracy and patient care for liver and bone disorders.