Abstract
Although alkaline phosphatase (ALP) correlates with cardiovascular risk in adults, there are no studies in children. We evaluated the association between serum ALP levels, calcium-phosphorus product (Ca*P) and cardiovascular risk markers in healthy children. Children aged 7.9 ± 1.4 (n = 379) were recruited in this cross-sectional study. The main outcome measures were systolic and diastolic blood pressure (SBP and DBP) and carotid intima-media thickness (cIMT). Additional assessments were body-mass index (BMI), waist circumference, homeostatic model assessment of insulin resistance (HOMA-IR) and fasting lipids, ALP, serum calcium, phosphorus and Ca*P. ALP was directly correlated with BMI (p < 0.0001), waist circumference (p < 0.0001), SBP (p < 0.0001), cIMT (p = 0.005), HOMA-IR (p < 0.0001), and fasting triglycerides (p = 0.0001). Among them, in children with Ca*P values above the median the associations were BMI (r = 0.231; p = 0.001), waist (r = 0.252; p < 0.0001), SBP (r = 0.324; p < 0.0001), cIMT (r = 0.248; p = 0.001) and HOMA-IR (r = 0.291; p < 0.0001)]. ALP independently associated with SBP (β = 0.290, p < 0.001) and cIMT (β = 0.179, p = 0.013) in children with higher Ca*P, after adjusting for confounding variables. Circulating ALP is associated with a more adverse cardiovascular profile in children with higher Ca*P. We suggest that serum ALP and Ca*P levels could contribute to the assessment of risk for cardiovascular disease in children.
Highlights
Cardiovascular disorders have become a major public health concern due to their high prevalence in the adult population, their prevention during childhood is crucial
In the whole sample of subjects, Alkaline phosphatase (ALP) showed positive correlations with body-mass index (BMI), BMI-SDS, waist circumference, systolic blood pressure (SBP), carotid intima-media thickness (cIMT), insulin, Homeostatic model assessment of insulin resistance (HOMA-IR) and fasting triglycerides (Table 2); and to a lesser extent, associations were found with age, fat fraction and DBP (Table 2)
Circulating ALP was found to relate to cardiovascular risk markers, such as SBP and cIMT, in school-aged children with higher circulating calcium-phosphorus product (Ca*P)
Summary
Cardiovascular disorders have become a major public health concern due to their high prevalence in the adult population, their prevention during childhood is crucial. High circulating ALP, has been related to cardiovascular and coronary heart disease events independently of body-mass index (BMI), systolic blood pressure (SBP) or serum www.nature.com/scientificreports/. Both calcium and phosphorus are essential substrates involved in the mineralization process. An elevated serum Ca*P concentration is considered to be a risk factor for coronary artery disease in adults with metabolic syndrome[9]. In this context, our aim is to study whether circulating ALP concentrations are related to cardiovascular risk markers in school-aged children, in those with higher Ca*P. We study the associations of ALP with anthropometric and metabolic parameters as they might act as confounding factors in cardiovascular risk assessment
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