Araştırma Makalesi
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Sağlıklı Türk Çocuklarında Serum Alkalen Fosfataz Düzeylerinin Belirlenmesi

Yıl 2025, Cilt: 3 Sayı: 3, 104 - 114, 28.12.2025

Öz

Amaç: Alkalen fosfataz (ALP), birçok dokuda bulunan bir enzimdir ve fosfat metabolizması ile kemik oluşumunda rol oynar. Bu çalışmanın amacı, yaş, cinsiyet ve pubertal evrelere göre serum ALP düzeylerini belirlemektir.
Yöntem: Bu çalışma Eylül 2012-Eylül 2013 tarihleri arasında Keçiören Eğitim ve Araştırma Hastanesi Pediatri Polikliniğine rutin kontrol için başvuran çocuklarda gerçekleştirilmiştir. Çocuklarda serum Alkalen Fosfataz düzeylerini belirlemek amacıyla 1063 (511 erkek, 552 kız) çocuk çalışmaya dahil edilmiştir. Her iki cinsiyette yaşa göre serum ALP düzeylerinin dağılımı belirlenmiştir.
Bulgular: Serum ALP düzeyleri, çocuklarda bebeklik döneminde en yüksek düzeylerde saptanmış, sonrasında kademeli olarak azalmış, 8 yaşından itibaren tekrar yükselmiş ve 12–14 yaşlarında yüksek seyrederek 14 yaşından sonra giderek azalmıştır. Çocukların pubertal evrelerine göre değerlendirildiğinde, her iki cinste de pubertal evre 2–3’te yüksek ALP düzeyleri görülürken, evre 4–5’te ALP düzeylerinde azalma saptanmıştır. Çocukların gelişim dönemlerine göre değerlendirildiğinde, bebeklik döneminde D vitamini eksikliği %44, okul öncesi dönemde %20, okul döneminde %31 ve adölesan dönemde %58,5 olarak bulunmuştur. Çalışmamızda cinsiyetlere göre değerlendirildiğinde, tüm yaş gruplarında erkeklerde D vitamini eksikliği %30,3, kızlarda ise %41,9 olarak tespit edilmiştir.
Sonuç: ALP düzeyleri hızlı gelişim aşamalarında daha yüksek bulunmuş ve bunun pubertal evreler ile ilişkisi gösterilmiştir. Ayrıca, vitamin D eksikliği tespit edilmiş ve önemi vurgulanmıştır.

Etik Beyan

Ref No: B.10.4.İSM.4.06.68.49/ Keçiören Eğitim ve Araştırma Hastanesi Etik Kurulu Kararı. Tarih: 12.09.2012

Destekleyen Kurum

Keçiören Eğitim ve Araştırma Hastanesi

Teşekkür

Keçiören Eğitim ve Araştırma Hastanesi

Kaynakça

  • 1. Lowe D, Sanvictores T, Zubair M, John S. Alkaline phosphatase. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
  • 2. Cannalire G, Pilloni S, Esposito S, Biasucci G, Di Franco A, Street ME. Alkaline phosphatase in clinical practice in childhood: focus on rickets. Front Endocrinol (Lausanne). 2023;14:1111445.
  • 3. Vimalraj S. Alkaline phosphatase: structure, expression and its function in bone mineralization. Gene. 2020;754:144855.
  • 4. Orimo H. The mechanism of mineralization and the role of alkaline phosphatase in health and disease. J Nippon Med Sch. 2010;77(1):4–12.
  • 5. Ma HW. Rickets-like genetic diseases. Zhongguo Dang Dai Er Ke Za Zhi. 2013;15(11):923–7.
  • 6. Millán JL. The role of phosphatases in the initiation of skeletal mineralization. Calcif Tissue Int. 2013;93(4):299–306.
  • 7. Lala V, Zubair M, Minter DA. Liver function tests. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
  • 8. Arıca V, Arıca S, Gücük S, Edirne T. Serum 25-hydroxyvitamin D levels in healthy children aged 0–36 months in Van province. Turk Pediatri Ars. 2010;45(3):86–90.
  • 9. Amrein K, Scherkl M, Hoffmann M, et al. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr. 2020;74(11):1498–513.
  • 10. Loh TP, Metz MP. Trends and physiology of common serum biochemistries in children aged 0–18 years. Pathology. 2015;47(5):452–61.
  • 11. Statland BE, Nishi HH, Young D. Serum alkaline phosphatase: total activity and isoenzyme determinations by centrifugal fast analyzer. Clin Chem. 1972;18(12):1468–74.
  • 12. Shaikh U, Alpert PT. Practices of vitamin D recommendation in Las Vegas, Nevada. J Hum Lact. 2004;20(1):56–61.
  • 13. Abhangi KK, Choudhari SR, Butala PB, Goyal SR, Yadav TG. Salivary total protein and alkaline phosphatase activity as biomarkers for skeletal maturity and growth prediction. Int J Clin Pediatr Dent. 2023;16(4):603–7.
  • 14. Ahmed S, Zierk J, Khan AH. Reference intervals for alkaline phosphatase in Pakistani children using data mining. Lab Med. 2020;51(5):484–90.
  • 15. Namgung R, Tsang RC. Bone in the pregnant mother and newborn at birth. Clin Chim Acta. 2003;333(1–2):1–1.
  • 16. Topal I, Gumus B. Bone-specific alkaline phosphatase and osteocalcin levels for age determination in children. Am J Forensic Med Pathol. 2020;41(3):182–7.
  • 17. Yamada Y. Laboratory test values in children significantly depend on age: alkaline phosphatase focus. Rinsho Byori. 2014;62(8):795–801.
  • 18. Lü KL, Xie SS, Liu E, et al. Age-wise trends in alkaline phosphatase in 167,625 Chinese children. Clin Biochem. 2020;79:34–40.
  • 19. Bahnemiri MG, Mirabedini S, Mohammadi P, et al. Serum alkaline phosphatase reference in healthy children aged 1–8 years. Caspian J Intern Med. 2022;13(4):749–54.
  • 20. Şen T, Derman O, Kınık E. Alkaline phosphatase levels according to sexual maturation stages in male adolescents. Turk Pediatri Ars. 2002;37:33–8.
  • 21. Pludowski P, Takacs I, Boyanov M, et al. Prevention, diagnosis and treatment of vitamin D deficiency: expert consensus. Nutrients. 2022;14(7):1483.
  • 22. Misra M. Vitamin D insufficiency and deficiency in children and adolescents. UpToDate; 2013.
  • 23. Mansbach JM, Ginde AA, Camargo CA Jr. Serum 25-hydroxyvitamin D levels among US children aged 1–1 years. Pediatrics. 2009;124:1404–10.
  • 24. Saintonge S, Bang H, Gerber LM. New definition of vitamin D deficiency in US adolescents. Pediatrics. 2009;123:797–803.
  • 25. Gordon CM, Feldman HA, Sinclair L, et al. Vitamin D deficiency in healthy infants and toddlers. Arch Pediatr Adolesc Med. 2008;162:505–12.
  • 26. Ladang A, Rousselle O, Huyghebaert L, et al. Parathormone, bone alkaline phosphatase and vitamin D status in children and teenagers. Acta Clin Belg. 2022;77(1):4–9.
  • 27. Alpdemir M, Alpdemir MF. Vitamin D deficiency status in Turkey: a meta-analysis. Int J Med Biochem. 2019;2(3):118–31.
  • 28. Yeşiltepe-Mutlu G, Aksu ED, Bereket A, Hatun Ş. Vitamin D status across age groups in Turkey. J Clin Res Pediatr Endocrinol. 2020;12(3):248–54.

Determination Of Serum Alkaline Phosphatase Levels In Healthy Turkish Children

Yıl 2025, Cilt: 3 Sayı: 3, 104 - 114, 28.12.2025

Öz

Objective: Alkaline phosphatase (ALP) is an enzyme found in many tissues and plays a role in phosphate metabolism and bone formation. This study aimed to determine serum ALP levels according to age, gender, and pubertal stage.
Method: This study was conducted on children with no history of chronic disease or medication who attended the pediatric outpatient clinic of Keçiören Training and Research Hospital for routine control between September 2012 and September 2013. To determine the serum Alkaline Phosphatase levels in children, 1,063 (511 male, 552 female) children were included. The ranges of serum ALP levels in both genders according to age were determined.
Results: Serum ALP levels were highest in children during infancy, gradually decreased, rose again from the age of 8, remained high at 12-14 years of age, and gradually decreased after the age of 14. Regarding their pubertal stage, it was noted that ALP levels are high in both genders in stages 2-3, whereas they are decreased in stages 4-5. Regarding their childhood stage, vitamin D insufficiency was found in 44% during infancy, 20% in preschool children, 31% in school children, and 58.5% during adolescence. In our study, vitamin D deficiency was found among 30.3% of boys and 41.9% of girls across all age groups.
Conclusion: ALP levels were higher during the rapid developmental stages, and their relationship with the pubertal stage was demonstrated. Additionally, vitamin D deficiency was identified, and its significance was highlighted.

Etik Beyan

Ref No: B.10.4.İSM.4.06.68.49/ Ethics Committee Decision of Keçiören Training and Research Hospital. Date: 12.09.2012

Destekleyen Kurum

Keçiören Training and Research Hospital

Teşekkür

Keçiören Training and Research Hospital

Kaynakça

  • 1. Lowe D, Sanvictores T, Zubair M, John S. Alkaline phosphatase. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
  • 2. Cannalire G, Pilloni S, Esposito S, Biasucci G, Di Franco A, Street ME. Alkaline phosphatase in clinical practice in childhood: focus on rickets. Front Endocrinol (Lausanne). 2023;14:1111445.
  • 3. Vimalraj S. Alkaline phosphatase: structure, expression and its function in bone mineralization. Gene. 2020;754:144855.
  • 4. Orimo H. The mechanism of mineralization and the role of alkaline phosphatase in health and disease. J Nippon Med Sch. 2010;77(1):4–12.
  • 5. Ma HW. Rickets-like genetic diseases. Zhongguo Dang Dai Er Ke Za Zhi. 2013;15(11):923–7.
  • 6. Millán JL. The role of phosphatases in the initiation of skeletal mineralization. Calcif Tissue Int. 2013;93(4):299–306.
  • 7. Lala V, Zubair M, Minter DA. Liver function tests. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
  • 8. Arıca V, Arıca S, Gücük S, Edirne T. Serum 25-hydroxyvitamin D levels in healthy children aged 0–36 months in Van province. Turk Pediatri Ars. 2010;45(3):86–90.
  • 9. Amrein K, Scherkl M, Hoffmann M, et al. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr. 2020;74(11):1498–513.
  • 10. Loh TP, Metz MP. Trends and physiology of common serum biochemistries in children aged 0–18 years. Pathology. 2015;47(5):452–61.
  • 11. Statland BE, Nishi HH, Young D. Serum alkaline phosphatase: total activity and isoenzyme determinations by centrifugal fast analyzer. Clin Chem. 1972;18(12):1468–74.
  • 12. Shaikh U, Alpert PT. Practices of vitamin D recommendation in Las Vegas, Nevada. J Hum Lact. 2004;20(1):56–61.
  • 13. Abhangi KK, Choudhari SR, Butala PB, Goyal SR, Yadav TG. Salivary total protein and alkaline phosphatase activity as biomarkers for skeletal maturity and growth prediction. Int J Clin Pediatr Dent. 2023;16(4):603–7.
  • 14. Ahmed S, Zierk J, Khan AH. Reference intervals for alkaline phosphatase in Pakistani children using data mining. Lab Med. 2020;51(5):484–90.
  • 15. Namgung R, Tsang RC. Bone in the pregnant mother and newborn at birth. Clin Chim Acta. 2003;333(1–2):1–1.
  • 16. Topal I, Gumus B. Bone-specific alkaline phosphatase and osteocalcin levels for age determination in children. Am J Forensic Med Pathol. 2020;41(3):182–7.
  • 17. Yamada Y. Laboratory test values in children significantly depend on age: alkaline phosphatase focus. Rinsho Byori. 2014;62(8):795–801.
  • 18. Lü KL, Xie SS, Liu E, et al. Age-wise trends in alkaline phosphatase in 167,625 Chinese children. Clin Biochem. 2020;79:34–40.
  • 19. Bahnemiri MG, Mirabedini S, Mohammadi P, et al. Serum alkaline phosphatase reference in healthy children aged 1–8 years. Caspian J Intern Med. 2022;13(4):749–54.
  • 20. Şen T, Derman O, Kınık E. Alkaline phosphatase levels according to sexual maturation stages in male adolescents. Turk Pediatri Ars. 2002;37:33–8.
  • 21. Pludowski P, Takacs I, Boyanov M, et al. Prevention, diagnosis and treatment of vitamin D deficiency: expert consensus. Nutrients. 2022;14(7):1483.
  • 22. Misra M. Vitamin D insufficiency and deficiency in children and adolescents. UpToDate; 2013.
  • 23. Mansbach JM, Ginde AA, Camargo CA Jr. Serum 25-hydroxyvitamin D levels among US children aged 1–1 years. Pediatrics. 2009;124:1404–10.
  • 24. Saintonge S, Bang H, Gerber LM. New definition of vitamin D deficiency in US adolescents. Pediatrics. 2009;123:797–803.
  • 25. Gordon CM, Feldman HA, Sinclair L, et al. Vitamin D deficiency in healthy infants and toddlers. Arch Pediatr Adolesc Med. 2008;162:505–12.
  • 26. Ladang A, Rousselle O, Huyghebaert L, et al. Parathormone, bone alkaline phosphatase and vitamin D status in children and teenagers. Acta Clin Belg. 2022;77(1):4–9.
  • 27. Alpdemir M, Alpdemir MF. Vitamin D deficiency status in Turkey: a meta-analysis. Int J Med Biochem. 2019;2(3):118–31.
  • 28. Yeşiltepe-Mutlu G, Aksu ED, Bereket A, Hatun Ş. Vitamin D status across age groups in Turkey. J Clin Res Pediatr Endocrinol. 2020;12(3):248–54.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Çocuk Sağlığı ve Hastalıkları (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Emine Hafize Erdeniz 0000-0003-2669-0890

Ayşe Derya Buluş 0000-0003-2865-4420

Nesibe Andıran 0000-0001-8970-604X

Gönderilme Tarihi 2 Eylül 2025
Kabul Tarihi 31 Ekim 2025
Yayımlanma Tarihi 28 Aralık 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 3 Sayı: 3

Kaynak Göster

Vancouver Erdeniz EH, Buluş AD, Andıran N. Determination Of Serum Alkaline Phosphatase Levels In Healthy Turkish Children. SMJ. 2025;3(3):104-1.