Positive Association of Serum Alkaline Phosphatase Level with Severe Knee Osteoarthritis: A Nationwide Population-Based Study.

Hye-Min Park,Yong-Jae Lee,Jun-Hyuk Lee

doi:10.3390/diagnostics10121016

Hye-Min Park, Yong-Jae Lee + Show 1 more

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https://doi.org/10.3390/diagnostics10121016

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Abstract

Serum alkaline phosphatase (ALP), a well-known marker of hepatobiliary and bone disorders, has recently been discovered to be a biochemical marker of cardiometabolic diseases and chronic low-grade inflammation. We aimed to evaluate the association of serum ALP level with knee osteoarthritis in the general population. The study included 3060 men and women aged ≥50 years who participated in the 2009–2011 Korea National Health and Nutrition Examination Survey. The participants were categorized into three groups based on log-transformed serum ALP level as follows: T1 (1.74–2.32), T2 (2.33–2.43), and T3 (2.44–3.01). Their radiographs were evaluated by two well-trained radiologists using the Kellgren–Lawrence (KL) grading system. After excluding those with KL Grade 0, we categorized the remaining participants into two groups, a severe osteoarthritis group (KL Grade 4) and a non-severe osteoarthritis group (KL Grades 1 to 3). The odds ratios (ORs) with 95% confidence intervals (CIs) of severe osteoarthritis according to the tertiles of log-transformed serum ALP levels of patients with osteoarthritis were calculated using a weighted multivariate logistic regression analysis. Compared with T1, the adjusted ORs (95% CIs) for severe osteoarthritis of the T3 serum ALP group was 1.613 (1.087–2.394; p = 0.018) after adjusting for the confounding variables. Conclusively, serum ALP activity was independently and positively associated with severe knee osteoarthritis in middle-aged and older adults.

Highlights

Osteoarthritis is the most common type of arthritis in old adults, with a substantial cost to the individual and society [1,2]
In light of these novel findings, we aimed to investigate the relationship between serum Alkaline phosphatase (ALP) levels and knee osteoarthritis in a Korean population aged ≥50 years, using data from the 2009 to 2011 Korea National Health and Nutrition Examination Survey (KNHANES)
The proportion of male sex, social drinker, moderate osteoarthritis, and severe osteoarthritis increased with increasing log-transformed serum ALP tertiles

Summary

Introduction

Osteoarthritis is the most common type of arthritis in old adults, with a substantial cost to the individual and society [1,2]. Osteoarthritis was considered a result of aging and identified as a joint degenerative disease [5]. The multifactorial risk factors of osteoarthritis, such as genetic factors, obesity, and subclinical inflammation, have been associated with the progressive phases of cartilage degeneration [6]. Abnormal ALP levels in blood have long been regarded to be associated with liver, gall bladder, and bone disorders. Emerging evidence suggests that serum ALP level is considered an inflammatory mediator associated with cardiometabolic diseases, including metabolic syndrome, type 2 diabetes, hypertension, and dyslipidemia [7,8]. In recent years, accumulated evidence shows that systemic low-grade inflammation, which reflects metabolic overload, plays an important role in the pathogenesis and progression of osteoarthritis [13,14]

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