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Immunoradiometric method and electrophoretic system compared for quantifying bone alkaline phosphatase in serum

V O Van Hoof1, M Martin, P Blockx

  • 1Department of Clinical Chemistry, University Hospital Antwerp, Edegem, Belgium.

Clinical Chemistry
|June 1, 1995
PubMed
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Comparing two methods for measuring serum bone alkaline phosphatase (ALP), a marker of osteoblastic activity, found good overall correlation. However, the immunoradiometric assay (IRMA) requires electrophoresis confirmation for high bone ALP values due to liver ALP interference.

Area of Science:

  • Biochemistry
  • Clinical Chemistry
  • Medical Diagnostics

Background:

  • Serum bone alkaline phosphatase (ALP) is a key marker of osteoblastic activity, crucial for assessing bone turnover.
  • Accurate quantification of bone ALP is essential for diagnosing and monitoring bone-related diseases.
  • Existing methods for bone ALP measurement have limitations, necessitating comparative studies.

Purpose of the Study:

  • To compare the accuracy and reliability of agarose electrophoresis and immunoradiometric assay (IRMA) for quantifying serum bone alkaline phosphatase (ALP).
  • To identify potential interferences and limitations of each method, particularly in patient populations with renal failure or malignant disease.

Main Methods:

  • Agarose electrophoresis (Isopal, Beckman) and an immunoradiometric assay (IRMA) using monoclonal antibodies (Ostase, Hybritech) were employed.

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  • Serum samples from 293 patients (79 with end-stage renal failure, 214 with malignant disease) were analyzed.
  • Correlation analysis, including z-value standardization, was performed to compare the two methods.

    • Main Results:

    • A good overall correlation (r = 0.92) was observed between electrophoresis and IRMA for bone ALP quantification.
    • Significant cross-reactivity of the IRMA with high liver ALP activity was identified as a source of interference, particularly affecting high bone ALP readings.
    • Electrophoresis demonstrated better reliability for detecting low bone ALP activities and confirmed IRMA results at low concentrations (< or = 5 micrograms/L).

    Conclusions:

    • The IRMA method is acceptable as a screening tool for serum bone ALP.
    • Confirmation by electrophoresis is mandatory for high bone ALP values obtained via IRMA to exclude liver ALP interference.
    • Electrophoresis remains the preferred method for accurately detecting low bone ALP activities.