Association of serum alkaline phosphatase levels with bone mineral density, osteoporosis prevalence, and mortality in US adults with osteoporosis: evidence from National Health and Nutrition Examination Survey (NHANES) 2005–2018
Main finding · Prevalence of osteoporosis per 1 SD increase in T-ALPResult — go to the resultOdds ratio 1.005 95% CI 1.005–1.005Authors' conclusion
Based on a representative sample of US adults, elevated serum T-ALP levels were found to be significantly associated with both reduced BMD and an increased risk of osteoporosis across all participants, as well as with a higher all-cause mortality in individuals with osteoporosis.
Study context
- Population
- US adults aged 18 to 85 years from NHANES 2005–2018; mortality from the National Death Index up to December 31, 2019944 with osteoporosis
- Participants
- 13,724 adults
- Exposure
- Higher vs lower serum total alkaline phosphatase
- Outcome
- Prevalence of osteoporosis per 1 SD increase in T-ALP
Methodological detailsNHANES 2005–2018, weighted logistic regression, Cox proportional hazards models, restricted cubic spline regression, subgroup analysis
- NHANES 2005–2018
- Weighted logistic regression
- Cox proportional hazards models
- Restricted cubic spline regression
- Subgroup analysis
Main finding
As reported in the abstract
Odds ratio
1.005
95% CI 1.005–1.005
P < 0.001
Per 1 SD increase in T-ALP
OR 1.005 (95% CI 1.005–1.005); P < 0.001
Per 1 SD increase in T-ALP, as printed
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| All-cause mortality per 1 SD increase in T-ALP, individuals with osteoporosis · median 133 months follow-up | HR 1.004 (95% CI 1.002–1.006) | P < 0.001 | |
| Prevalence of osteoporosis, highestvs lowest T-ALP | OR 1.292 (95% CI 1.021–1.636) | P = 0.033 | |
| All-cause mortality, highestvs lowest T-ALP, individuals with osteoporosis | HR 1.232 (95% CI 1.041–1.459) | P = 0.015 | |
| 0.512Ratio (log scale) |
- All-cause mortality per 1 SD increase in total alkaline phosphatase (T-ALP), individuals with osteoporosis: 221 deaths among 944 with osteoporosis
Original publication
Association of serum alkaline phosphatase levels with bone mineral density, osteoporosis prevalence, and mortality in US adults with osteoporosis: evidence from NHANES 2005–2018. Osteoporos Int. Published 29 November 2024. doi:10.
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