The level of alkaline phosphatase in the blood. Increased alkaline phosphatase in the blood - what does it mean

Alkaline phosphatase (AP) is an enzyme that catalyzes the cleavage of a phosphate group from a compound, showing its maximum activity in an alkaline environment (pH = 8 - 10). Alkaline phosphatase is present in many cells of the body - the liver, bones, intestines, bile ducts, kidneys, lungs, even in the placenta.

The main diagnostic value is the determination of alkaline phosphatase in order to determine the state of bone tissue and the biliary system. When their cells are damaged, this enzyme is released into the blood.

With congestion of bile (cholestasis), the activity of alkaline phosphatase increases due to damage to the epithelial cells lining the bile ducts.

In the bone tissue there are cells - osteoblasts, responsible for the formation of bones. It is they who mainly produce alkaline phosphatase. The level of alkaline phosphatase can be used to judge the activity of osteoblasts. For example, elevated levels of alkaline phosphatase will be noted in individuals who have suffered fractures.

Due to the fact that there are many localizations of the enzyme, for a more accurate diagnosis of specific diseases, it is possible to determine, for example, bone alkaline phosphatase.

The determination of alkaline phosphatase is one of the indicators of a biochemical blood test. It is assigned to:

• to diagnose the condition of the bile ducts, to assess the presence of stagnation, blockage by a stone or tumor;
• evaluate bone growth;
• determine the spread of the tumor in the bone;

Table 1 shows the symptoms of damage to the bile ducts and bone tissue, in the event of which a study of the level of alkaline phosphatase is prescribed.

Table 1. Clinical manifestations of lesions of the bile ducts and bones.

Venous blood is the material that must be donated for the study. To exclude the influence of various factors, it is necessary to prepare. Preparation is standard for any blood test.

1. Blood is donated on an empty stomach. You can drink some water in the morning.
2. Refrain from smoking 3 hours before blood sampling.
3. The day before the analysis, maintain physical and emotional peace.
4. The attending physician should be familiar with the list of drugs taken, since there are a number of medications that affect the activity of the enzyme.

How much does an alkaline phosphatase test cost?

You can study the activity of alkaline phosphatase free of charge under the compulsory medical insurance policy at the clinic where you are observed. You can also take the test for a fee at the medical center. The average cost will be about 200 - 300 rubles.

Do not confuse alkaline and acid phosphatase. The latter also catalyzes the elimination of phosphoric acid residues from organic compounds, but the optimal conditions for its operation are pH = 5 - 5.5. The purpose for which the determination of acid phosphatase is carried out is prostate cancer.

Alkaline phosphatase activity is measured by kinetic colorimetric determination. It is measured as a unit per liter (U/L). Table 2 shows the reference values ​​of alkaline phosphatase depending on age.

Table 2. Alkaline phosphatase reference values.

The high activity of the enzyme in children is due to the increased process of bone tissue growth. Then, with age, the level of alkaline phosphatase in the blood gradually decreases.

In pregnant women, alkaline phosphatase activity is higher. The level rise starts from the second semester and is about 25 - 126 U / l. In the 3rd trimester, the activity of alkaline phosphatase is 38 - 230 U / l.

The reasons for the low activity of alkaline phosphatase can be:

• taking oral contraceptives;
• anemia;
• blood transfusion;
• deficiency of thyroid hormones;
• lack of magnesium and zinc;
• hypophosphatasemia - a violation of bone calcification, is a hereditary disease;
• placental insufficiency in pregnant women.

Decreased enzyme levels are not as common as increased enzyme activity.

There are several groups of causes leading to high activity of alkaline phosphatase in the blood.

1. Bone lesions. These include Paget's disease, bone metastasis, osteosarcoma, softening of the bones (osteomalacia).
2. Pathology of the hepatobiliary system - congestion in the bile ducts (cholestasis) due to their obstruction, caused by a stone or tumor, which leads to the development of obstructive jaundice. Also with liver cancer or metastasis to it, hepatitis, cirrhosis. Involvement of the liver in the development of infectious mononucleosis.
3. Pathology of other organs and tissues - hyperparathyroidism, myeloma, sepsis, intestinal damage (ulcerative colitis, perforation).

Alkaline phosphatase refers to a specific enzyme that can be found in many body tissues. It is present in bones, biliary tract cells, liver and placenta.

With the help of alkaline phosphatase (AP), reactions associated with the elimination of phosphate from organic compounds are activated in the body. The enzyme belongs to hydrolases, which means it converts biochemical substrates by adding water elements. It contributes to the unhindered movement of phosphorus throughout the body.

The peak of alkaline phosphatase activity is fixed in the pH medium, therefore, “alkaline” is present in its name.
The level of the enzyme reflects the state of the bone tissue and the hepatobiliary system (gall bladder and bile ducts, liver). Also, according to its content in the blood, one can judge the compliance of phosphorus-calcium metabolism with the needs of the body.

An increased content of the enzyme is observed both in physiological conditions of the body and in severe pathologies.

Symptoms of an increase in alkaline phosphatase

An increase in the amount of alkaline phosphatase compared to the norm can be manifested by the following symptoms:

• feeling tired;
• pain in the right hypochondrium;
• loss of appetite;
• bouts of nausea;
• pain in the bones and joints.

Such manifestations signal an unhealthy state of the body. They are characteristic of many diseases, so it is simply necessary to conduct a study of the composition of the blood. The results of the analysis will provide information on the content of the enzyme.

Alkaline phosphatase is increased: causes

An increase in the concentration of alkaline phosphatase is observed in relatively healthy people in the following cases:

• alcohol poisoning;
• long-term use of medications. Their list is quite extensive and contains several hundred items. Especially dangerous are drugs that can cause the so-called hepatotoxic effect. This means that their long-term use will easily disrupt the structure and functions of the liver;
• pregnancy.

An increase in the level of the enzyme associated with pathologies most often occurs with the development of diseases that damage bone tissue, liver and kidneys.

Three groups of such ailments can be distinguished.
I. Liver damage, its destruction (destruction) and bile flow problems:

• Cirrhosis is a painful process in which normal organ tissue is replaced by scar tissue. All liver functions are inhibited.
• Hepatitis, most often viral and autoimmune. With this disease, the content of alkaline phosphatase exceeds the norm three times.
• Primary tumor in the liver and secondary cancer - the penetration of metastases of neoplasms that have arisen in other organs.
• Primary sclerosing cholangitis is a chronic liver disease that results in inflammation, liver failure, and portal hypertension. The disease is rare.
• Primary biliary cirrhosis is a consequence of a previous disease. A day or two after the onset of the disease, the level of alkaline phosphatase increases four times and does not decrease even after recovery. It will take at least a week before the enzyme content returns to the normal range.
• Infectious mononucleosis is an acute viral disease. The liver is affected, peculiar changes in the composition of the blood occur.
• Cholestasis is the stagnation of bile.
• Extrahepatic obstruction of the bile ducts by stones that interfere with the outflow of bile.

II. Pathological changes in bone tissue:

• Paget's disease is a chronic and complex disease. The mechanism of bone repair is damaged, which leads to their increased destruction, deformation and weakening.
• Osteomalacia is a systemic disease of the skeleton, which is accompanied by softening and deformation of the bones. The disease disrupts mineral metabolism, and phosphoric acid, calcium salts and vitamins leave the body.
• Osteogenic sarcoma is a malignant primary bone tumor. It originates and develops directly in their depth.
• Metastases that have penetrated into the bone structure from other organs.
• Increased metabolism in bone tissue. It occurs during the healing of fractures.

III. Other diseases:

• Primary hyperparathyroidism is an ailment of the endocrine system caused by increased activity of the parathyroid glands. It is accompanied by a pronounced violation of the exchange of phosphorus and calcium.
• Heart attack.
• Ulcerative colitis.
• Intestinal perforation.

Medical statistics informs that in more than half of patients, the excess of alkaline phosphatase is caused by liver pathologies.

Features of increasing alkaline phosphatase in men and women

The normative amount of alkaline phosphatase in men is higher than in the fair sex, by 20-25 units. Over the years, it changes in both sexes and tends to increase.

An abnormal amount of natural alkaline phosphatase is manifested as a result of:

• excessive or intense physical activity;
• avitaminosis and nutritional errors.

In the fair sex, the level of the enzyme increases:

• during the period of bearing crumbs, mainly in the third trimester;
• during breastfeeding;
• after menopause.

Women who take contraceptives with hormones are more likely to develop a disease such as cholestatic jaundice or intrahepatic cholestasis.

And men who are already 50 years old often suffer from Paget's disease. This disease can be inherited.

Features of the growth of alkaline phosphatase in children

The amount of the enzyme and its activity in children is always higher than in adults.

This situation can continue until the onset of puberty. All this is natural and is explained by the peculiarities of the physiology of children, because they have vigorous growth of bone tissue.

At the same time, data on the content of alkaline phosphatase help to diagnose liver pathologies, which are accompanied by insufficient supply of bile to the duodenum. The level of the enzyme in such ailments often rises and becomes much higher than the normal value.

An increased amount of alkaline phosphatase in children signals the possible development of such diseases:

• rickets;
• hyperparathyroidism;
• Infectious mononucleosis;
• intestinal infection;
• damage to bone tissue, including malignant tumors;
• Paget's disease.

For the timely diagnosis of rickets, fixing the level of alkaline phosphatase is invaluable. An increase in the content of the enzyme during the development of this disease occurs much earlier than the first symptoms appear.

Alkaline phosphatase above normal: what to do?

First of all, do not self-medicate. The growth of the enzyme is not a disease, but only a symptom that accompanies a specific ailment.

It should also be borne in mind that an elevated level of alkaline phosphatase can be of a natural nature. Excess activity of the enzyme is sometimes observed in healthy people. In these cases, it is a consequence of physiological characteristics and processes in the human body.

Therefore, only a specialist can find out the real reasons for the increase in the level of the enzyme. He will prescribe additional studies, according to the results of which he accurately diagnoses the disease and determines the therapy.

In order for the level of alkaline phosphatase to normalize, it is necessary to cure the underlying disease. Simply adjusting the indicator to the optimal limits will not work.

Alkaline phosphatase is a specific enzyme that belongs to the group of hydrolases. This enzyme can be observed in all parts of the human body.

This enzyme is especially common in osteoblasts, intestinal mucosa, in the mammary gland, in the placenta, in the walls of the bile ducts.

Types of alkaline phosphatase

Phosphatase is divided into several types:
- placental;
- renal;
- hepatic;
- intestinal;
- bone.

Like all enzymes like it, it is necessary for various chemical reactions to take place inside the human body. A minimal amount of alkaline phosphatase is required to carry out these reactions. And if there are any abnormalities in the body, this may mean that alkaline phosphatase is elevated. The reasons for the increase in this enzyme can be quite different.

How alkaline phosphatase works

This enzyme carries out the dephosphorylation reaction. This reaction consists in the elimination of phosphate from organic substances, which takes place at the molecular level. Alkaline phosphatase in the blood has a constant certain concentration. The enzyme is able to transport phosphorus across the cell membrane. In addition, phosphatase is an indicator of the norm of calcium-phosphorus metabolism. The greatest activity of the enzyme is manifested in the pH of the medium, in the range of 8.6-10.1. Hence the name - alkaline.

Alkaline phosphatase in the blood

The range of indications of the content of the normal level in phosphatase is quite wide. The readings fluctuate from 44 IU / l to 147 IU / l. Do not immediately panic if the Causes can be absolutely harmless. For example, this figure in pregnant women is usually slightly overestimated. It is also overestimated in adolescents who have opened the stage of puberty. All this is due to the growth of the placenta or bone tissue, and does not at all indicate various abnormalities in the human body. Also, the phosphatase index depends on the age and gender of the person.
At the moment, there is no standardized methodology, so the variation in the norm indicators also depends on the reagents that are used in the laboratory for research.

Alkaline phosphatase. Norm indicators

One of the options for determining abnormalities in the body is alkaline phosphatase. The norm for women, men and children is slightly different, this should be paid attention to. The level of this enzyme in the body in women is slightly lower than in men. While in children, the level of this enzyme is much higher than in adults.

A normal indicator of alkaline phosphatase in a child is:

In newborns: 245-255 units / l;
- in children aged 1 to 9 years: 345-355 units / l;
- in children aged 10 to 15 years: 275-285 units / l;
- in adolescents aged 16 to 19 years: 145-155 units / l.

Norm for men:

Age from 21 to 30 years: 100-110 units / l;
- at the age of 30 to 45 years: 110-120 units / l;
- at the age of 46 to 54 years: 120-130 units / l;
- at the age of 55 to 70 years: 135-145 units / l;
- over the age of 71 years: 180-190 units / l.

In adults, depending on gender, alkaline phosphatase is slightly different.

The norm for women is:

Age from 21 to 30 years: 80-90 units / l;
- at the age of 30 to 45 years: 90-100 units / l;
- at the age of 46 to 54 years: 105-115 units / l;
- at the age of 55 to 70 years: 125-135 units / l;
- over the age of 71 years: 155 -165 units / l;

It can be concluded that in men, relative to female indicators, alkaline phosphatase is slightly increased. The norm in women is less than the male norm by about 20 units / l.

Causes of elevated alkaline phosphatase

It has already been said what alkaline phosphatase depends on. The rate is increased, and this may not pose a health risk. But it also happens vice versa, when an increased indicator is the first and accurate warning that significant disturbances are observed in the patient's body.

An increase in the index of the enzyme in question can be affected by:

From the biliary tract and liver:

Tumor of the bile duct;
- obstructive jaundice, which can be provoked by obstruction of the bile ducts;
- liver cancer;
- scars of the bile ducts, provoked by surgical interventions;
- stones in the bile ducts;
- cancer of the stomach or pancreas;
- cirrhosis of the liver;
- infectious mononucleosis;
- Hepatitis of any origin. With this disease, alkaline phosphatase is increased approximately 3 times.

Causes of the affected bones:

Paget's disease. This disease is characterized by abnormal bone growth, as well as a violation in certain places of the bone structure. In this disease, very high rates of the enzyme in question are observed;
- bone tumor;
- osteosarcoma, which is a malignant tumor on the bone;
- softening of the bones, provoked (osteomalacia).

Other reasons:

myocardial infarction;
- hyperparathyroidism, which is a hormonal disease, with it there is an excess of parathyroid hormone formed by the parathyroid glands. Because of what, calcium is washed out of the bones;
- perforation of the intestine (through damage);
- ulcerative colitis.

Causes of Low Alkaline Phosphatase

It is not always elevated alkaline phosphatase that is considered a deviation. The norm in women and men may deviate downward.

Lowering the level of phosphatase can be affected by:

In large doses;
- severe anemia;
- hypothyroidism (low function of the thyroid gland);
- hypophostasia (rare congenital disease that provokes softening of the bone);
- insufficient amount of zinc and magnesium in the body;
- insufficiency of the placenta (in pregnant women).

What influences the result

For promotion:

During pregnancy, the placenta contains alkaline phosphatase. The norm in women during this period is not considered too high;
- after fractures, an increased indicator of the level of alkaline phosphatase is also noted;
- since adolescents and children experience rapid bone growth, the level of the enzyme in question increases;
- some drugs, such as Paracetamol, Aspirin, Allopurinol, various antibiotics and a variety of other drugs, can also increase the level of phosphatase in the blood;
- data on the level of the dephosphorylation enzyme may be observed increased after cooling the blood taken for analysis.

Oral contraceptives can lower the level of this enzyme.

Testing for alkaline phosphatase

During the analysis of alkaline phosphatase in the blood, specific reagents are added to the donor's serum that react to phosphatase. Then, using precise methods, the concentration of the obtained products is measured. Each tissue, be it the intestines, placenta or liver, contains its own specific type of alkaline phosphatase. During the analysis, the concentration of specific types of enzyme is measured.

It takes a few minutes for a patient to have a blood sample tested for this enzyme. In some cases, after a meal, alkaline phosphatase is intensively produced in the intestines in humans. In this case, the results of the analysis may be distorted. Therefore, the patient should not eat or drink water before taking this test.

Thanks to modern laboratory methods, test results can be obtained after a few hours.

Based on all the data, we can conclude that the minimum alkaline phosphatase in the blood is the norm. An increase in the level of this enzyme can both warn of any deviations or disorders, and absolutely not alarm. In any case, this is not the last indicator of changes in the human body.

Doctors often prescribe one or another biochemical blood test, but if you have heard of most of them at least once throughout your life, then an alkaline phosphatase test almost always takes you by surprise. What is it and why is it being studied? Why is alkaline phosphatase elevated in the blood?

What is alkaline phosphatase?

This is an enzyme that cleaves phosphate from a molecule of substances of organic origin. It is especially active in an alkaline environment - this is the reason for its name. A small amount of alkaline phosphatase is found throughout the body. Most of this enzyme is in the liver, bone tissue and placenta.

A small amount of the enzyme in the blood is considered the norm, since cells tend to constantly renew themselves. But if they die in large numbers, then the analysis reveals that alkaline phosphatase in the blood is elevated. The reasons for this phenomenon are varied. If the indicators differ significantly from the norm, then one can suspect the pathology of the bones, intestines, liver, or a malignant process in the body.

The norms of this enzyme depend on the age and gender of the person. In children, ALP is normally higher than in adults, and in women it is lower than in men. On average, normal levels of phosphatase in the blood range from 20 to 140 International units per liter.

When is an alkaline phosphatase test ordered?

Analysis for alkaline phosphatase may be included in the list of mandatory studies for certain categories of workers who have contact with harmful substances, and during preventive examinations. Alkaline phosphatase analysis may be prescribed in preparation for surgery. It is also determined to assess liver function or diagnose jaundice.

This study can clarify the situation with pain in the abdomen, in the right hypochondrium, itching of the skin, weakness, loss of appetite, nausea, vomiting, bone lesions. With these pathological processes, alkaline phosphatase is increased.

The influence of negative factors on alkaline phosphatase

There are factors that can affect the result of the analysis, that is, it will indicate a pathology, but in fact it may not be in the body. Circumstances leading to a false positive result include:

• period of healing of fractures;
• pregnancy;
• time of active bone growth;
• some medicinal substances that affect the activity of the enzyme: Paracetamol, antibiotics, acetylsalicylic acid;

Increased alkaline phosphatase with errors at the preanalytical stage, for example, if the blood was cooled. When taking hormonal contraceptives, the indicator may decrease.

Why is alkaline phosphatase elevated?

The results of the analyzes sometimes discourage us. Not always a person is ready to accept that he has some kind of health problem. Increased alkaline phosphatase in the blood - what does it mean? Most often, this indicates a pathology of the liver or biliary tract. The reasons include obstructive jaundice, which is associated with impaired patency of the biliary tract. If alkaline phosphatase is elevated, then this may indicate stones in the gallbladder, as well as scars of the biliary tract after surgery. A high level of the enzyme sometimes indicates cancer, cirrhosis, hepatitis, or a malignant process in the stomach.

Strongly increased alkaline phosphatase in liver cancer and metastasis in it. Among infectious diseases in which the enzyme index increases, infectious mononucleosis can be noted.

Alkaline phosphatase is also elevated in bone lesions. There is an increase in the level of this indicator in hyperparathyroidism, myocardial infarction, intestinal perforations, ulcerative colitis.

An increase in an enzyme found in bone tissue

Why is alkaline phosphatase increased in bone tissue? The fact is that the bone tissue of this enzyme contains quite a lot, so it reacts to any changes in the bones. Bone ALP is secreted by osteoblasts, which are large cells with a single nucleus. They are located directly on the surface of the bone tissue, and it is in these places that its intensive formation occurs. Most of all, alkaline phosphatase increases in Paget's disease, which is characterized by excessive growth of bone tissue and a violation of its very structure.

If osteosarcoma develops or bone metastases appear, then alkaline phosphatase also rises. When there is not enough calcium in the body, the bones begin to soften. The enzyme is sensitive to this process, which is also called osteomalacia, in connection with this, its level in the blood rises.

Bone ALP increases during bone growth and fusion, so it is significantly higher in children and adolescents than in more mature patients. Its increase is observed with fractures.

Why does hepatic alkaline phosphatase increase?

Alkaline phosphatase is found in large quantities in the liver, so any changes in its work are reflected in the levels of the enzyme in the blood serum. It begins to be released in large quantities from hepatocytes, which is reflected in the blood picture, including in the analysis for alkaline phosphatase. Quite often, an increase in the enzyme indicates damage to the liver cells or a violation of the functions of the liver itself.

Decreased alkaline phosphatase

ALP is not only increased, but also the level of this substance can be significantly reduced. It is also associated with any disease.

One such disease is hypophosphatasemia. This is a hereditary pathology, which lies in the fact that phosphatase is constantly excreted in the urine. Enhanced release of the body from this substance leads to its acute deficiency.

Hypothyroidism is another disease in which the level of alkaline phosphatase in the blood decreases. With a decrease in the activity of the thyroid gland, due to a lack of certain trace elements, the production of phosphatase also undergoes changes, which then affect human health.

Lack of vitamin B12, C, zinc or folic acid can also lead to a decrease in alkaline phosphatase. This disease is called pernicious anemia. Sometimes this substance can decrease with a lack of growth hormone in children.

Special attention is paid to the condition of the placenta during fetal maturation. If alkaline phosphatase in the blood of a pregnant woman is lowered, then this indicates that the placenta is developing defectively. It is a vital organ for the health of the child, so you need to monitor the performance of this substance in expectant mothers.

Lowered and increased alkaline phosphatase in the blood: what does this mean? We have already decided and found out what the consequences of fluctuations in this substance can be. Be healthy!

Alkaline phosphatase(wrong spelling alkaline phosphatase) is an enzyme involved in the transport of phosphorus through the cell membrane and is an indicator of phosphorus-calcium metabolism. Alkaline phosphatase is found in bone tissue, intestinal mucosa, hepatocytes of the liver, in the cells of the renal tubules and in the placenta. The main volume of alkaline phosphatase is located in the intestinal mucosa (the content of alkaline phosphatase in the intestine is 30–40 times greater than in the tissue of the liver and pancreas and 100–200 times greater than in the salivary glands, gastric mucosa, bile). Alkaline phosphatase is produced by the surface layer of the intestinal mucosa, but its role in digestion is secondary. Its main functions are associated with the processes of general metabolism.

To diagnose various diseases and conditions, an alkaline phosphatase test is performed in blood serum, in urine, in intestinal juice, in feces, and alkaline phosphatase isoenzymes are determined: hepatic, bone, intestinal, placental, Regan and Nagayo isoenzymes in blood serum, in amniotic fluid .

Chemically, alkaline phosphatase is a group of isoenzymes, phosphohydrolases of orthophosphoric acid monoesters, having a molecular weight of 70 to 120 kDa, hydrolyzing phosphoric acid esters in the range from 8.6 to 10.1 pH. Alkaline phosphatase code as an enzyme, EC 3.1.3.1.

Analysis of small intestine juice for alkaline phosphatase

The activity of alkaline phosphatase in the range from 10 to 45 U / ml is considered normal. An increase in the activity of alkaline phosphatase in duodenal juice from 46 to 100 U / ml is considered as weak, from 101 to 337 U / ml - as significant, over 337 U / ml - as sharp. The activity of alkaline phosphatase may depend on the nature of nutrition, which reduces the diagnostic value of the determination of alkaline phosphatase in intestinal juice (Sablin OA and others).

Determination of alkaline phosphatase in the analysis of feces

• in adults - from 45 to 420 units / g
• in children - from 327 to 9573 units / g

Professional medical literature concerning the role of alkaline phosphatase in gastroenterology

• Sablin O.A., Grinevich V.B., Uspensky Yu.P., Ratnikov V.A. Functional diagnostics in gastroenterology. Teaching aid. - St. Petersburg. - 2002. - 88 p.


• Vasilenko V.V. Interpretation of the results of liver tests // Medical Bulletin. Clinician School. - 2011. - No. 5 (546) .

Normal indicators of alkaline phosphatase in biochemical studies

• Constant time method (in µkat/l): men 0.9–2.3, women 0.7–2.1, children under 14 1.2–6.3
• Kinetic method with LACHEMA reagent (in IU / l): adults - up to 120, children - up to 250, newborns - up to 150
• Kinetic method with KONE reagent 80–295 IU/l

Alkaline phosphatase in blood serum

The activity of alkaline phosphatase is largely dependent on the age and, to a lesser extent, on the sex of the patient. It, in particular, increases during puberty and intensive growth of bone tissue. Currently, there is no standardized method for determining the activity of alkaline phosphatase in blood serum, specific figures may vary slightly depending on the reagents used and the research method. Below are the reference values ​​of alkaline phosphatase activity using the IFCC method at 30 C in U/l (M. D. Balyabina, V. V. Slepysheva, A. V. Kozlov):

• children: newborns - 250
• from one year to 9 years - 350
• from 10 to 14 years old - 275 (for boys) and 280 (for girls)
• boys from 15 to 19 years old - 155
• girls from 15 to 19 years old - 150
• adults: from 20 to 24 years old - 90 (m) and 85 (w)
• from 25 to 34 years old - 95 (m) and 85 (w)
• from 35 to 44 years old - 105 (m) and 95 (w)
• from 45 to 54 years old - 120 (m) and 100 (w)
• from 55 to 64 years old - 135 (m) and 110 (w)
• from 65 to 74 years old - 95 (m) and 85 (w)
• over 75 years old - 190 (m) and 165 (w)

• children under one year old: 150–507
• boys aged 1 to 12 and girls aged 1 to 15: 0–500
• male patients aged 12 to 20: 0–750
• male patients over 20 years of age and female patients over 15 years of age: 40–150

It also increases the activity of alkaline phosphatase by taking various drugs, including "gastroenterological" ones: itopride (growth spurt in adolescents

Hypophosphatasia