4.3 Article

Systems biomarker characteristics of circulating alkaline phosphatase activities for 48 types of human diseases

Journal

CURRENT MEDICAL RESEARCH AND OPINION
Volume 38, Issue 2, Pages 201-209

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/03007995.2021.2000715

Keywords

Systems biomarker; alkaline phosphatase; area under the curve (AUC); receiving operator curve (ROC); accuracy; sensitivity; specificity

Funding

  1. Natural Science Foundation of China [309 81672585, 11804151]
  2. Taishan Scholar Fellowship

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Most human diseases are accompanied by systems changes, and alkaline phosphatase has been identified as a decent systems biomarker for 19 different types of diseases. Understanding the molecular mechanisms of up-and-down-regulation of ALP activities could be key to understanding the body's reactions during disease progression.
Background Most human diseases are accompanied by systems changes. Systems biomarkers should reflect such changes. The phosphorylation and dephosphorylation of biomolecules maintain human homeostasis. However, the systems biomarker characteristics of circulating alkaline phosphatase, a routine blood test conducted for many human diseases, have never been investigated. Method This study retrieved the circulating alkaline phosphatase (ALP) activities from patients with 48 clinically confirmed diseases and healthy individuals from the database of our hospital during the past five years. A detailed analysis of the statistical characteristics of ALP was conducted, including quantiles, receiving operator curve (ROC), and principal component analysis. Results Among the 48 diseases, 45 had increased, and three had decreased median levels of ALP activities compared to the healthy control. Preeclampsia, hepatic encephalopathy, pancreatic cancer, and liver cancer had the highest median values, whereas nephrotic syndrome, lupus erythematosus, and nephritis had decreased median values compared to the healthy control. Further, area under curve (AUC) values were ranged between 0.61 and 0.87 for 19 diseases, and the ALP activities were the best systems biomarker for preeclampsia (AUC 0.87), hepatic encephalopathy (AUC 0.87), liver cancer (AUC 0.81), and pancreatic cancer (AUC 0.81). Conclusions Alkaline phosphatase was a decent systems biomarker for 19 different types of human diseases. Understanding the molecular mechanisms of over-up-and-down-regulation of ALP activities might be the key to understanding the whole-body systems' reactions during specific disease progression.

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