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Updated: Jun 4, 2026

Colorimetric Analysis of Alkaline Phosphatase Activity in S. aureus Biofilm
04:59

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Establishing Continuous Reference Intervals for Alkaline Phosphatase in the Pediatric Population from 2 Tertiary

Hatice Saracoglu1, Gozde Erturk Zararsiz2, Fatma Demet Arslan3

  • 1Department of Medical Biochemistry, Erciyes University Faculty of Medicine, Kayseri, Türkiye.

Turkish Archives of Pediatrics
|June 2, 2026
PubMed

Insights

New age- and sex-specific continuous alkaline phosphatase (ALP) reference intervals (RIs) were established for children. Regional differences in pediatric ALP levels were also identified, highlighting the need for localized RIs.

Area of Science:

  • Biochemistry
  • Pediatrics
  • Clinical Chemistry

Background:

  • Alkaline phosphatase (ALP) levels in children exhibit significant age and sex variability.
  • Establishing accurate reference intervals (RIs) is crucial for interpreting pediatric ALP test results.
  • Previous RIs may not fully capture the dynamic changes in ALP during childhood and adolescence.

Purpose of the Study:

  • To determine age- and sex-specific continuous reference intervals (RIs) for alkaline phosphatase (ALP) in the pediatric population.
  • To compare local RIs for pediatric ALP between two distinct regions in Türkiye (Kayseri and Izmir).
  • To evaluate the utility of continuous RIs for improved interpretation of pediatric ALP levels.

Main Methods:

  • Retrospective analysis of ALP activity in pediatric patients (0-18 years) from two tertiary centers in Türkiye.
  • Development of continuous RIs using the Generalized Additive Models for Location, Scale, and Shape (GAMLSS) method.
  • Calculation of discrete RIs following the Clinical and Laboratory Standards Institute EP28-A3c guideline.

Main Results:

  • Sex-specific continuous RIs demonstrated distinct ALP patterns throughout childhood and adolescence.
  • Females showed an ALP peak around age 11, while males peaked around age 13.
  • Higher ALP levels were observed in Kayseri compared to Izmir, with significant regional differences emerging in later adolescence.

Conclusions:

  • Continuous RIs offer a more precise and adaptable method for interpreting pediatric ALP results, accounting for age and sex variations.
  • The study emphasizes the clinical significance of region- and sex-specific RIs for accurate pediatric ALP evaluation.
  • Implementing these localized RIs can enhance diagnostic accuracy and clinical decision-making in pediatric care.
Abstract

Keywords:
Age groupsalkaline phosphatasepediatricsreference rangessex

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