Serum Alkaline Phosphatase: An Alternative To Skeletal Age Assessment
Purpose- To assess the growth status of adolescents by cervical vertebra maturity indicators (CVMI) and its correlation with the level of serum alkaline phosphatase (ALP) and also to evaluate the diagnostic importance of serum alkaline phosphatase as an indicator of skeletal maturation.
Settings and Design: prospective cross sectional observational study
Methods and Materials - 150 subjects (75 males and 75 females) were selected in the age group 6-17 years of age.The study sample was distributed into three groups based on chronological age Group-I(Pre- Pubertal) consisting of sample between 6-9 yrs, Group-II(Pubertal) between 10-13 yrs & Group-III (Post- Pubertal)14-17yrs of age, with each group containing 25 males and females each. To appraise the cervical vertebral development by Hassel and Farman method lateral cephalograms were taken in natural head position. To evaluate the serum Alkaline phosphatase levels 2 ml of venous blood sample was collected and was subjected to biochemical assessment.
Statistical analysis used: paired sample T test, Pearson Correlation Coefficient , ANOVA analysis
Results- The mean alkaline phosphatase levels were evaluated in each group, Group II (Pubertal) had the highest alkaline phosphatase level which was statistically significant among all groups. The correlation between alkaline phosphatase and CVMI was assessed using Pearson Correlation Coefficient. A significant negative correlation between the two entities was found (r =-0.630, p<0.001). On evaluating the CVMI stages and alkaline phosphatase levels individually in males and females, males had higher levels which were statistically significant.
Conclusions-The study demonstrates age trends in the level of serum alkaline phosphatase levels that may be used to evaluate the skeletal maturation. The levels in males were higher than females which also are of diagnostic importance.