Bone-specific alkaline phosphatase and metabolic dyslipidaemia in type 2 diabetes mellitus
Kunal Agrawal, Shrimanjunath Sankanagoudar, Andystar Syiemlieh, Ravindra ShuklaBackground and objectives
Previous studies have attempted to associate elevated liver enzymes with the onset of diabetes. However, clinically relevant data on total and bone-specific alkaline phosphatase (ALP and B-ALP) in Indians who have a higher predisposition to metabolic syndrome (MetS) and cardiovascular disease remain limited. Since type 2 diabetes mellitus (T2DM) and MetS share common risk factors, including dyslipidaemia, this study aimed to evaluate total ALP and B-ALP levels and examine their association with metabolic dyslipidaemia in T2DM.
Methods
A case-control study was conducted with 80 participants (40 T2DM cases and 40 healthy controls). Fasting samples were analysed for plasma glucose, serum lipid profile, HbA1c, insulin, and B-ALP. B-ALP was quantified using a commercial ELISA kit (Fine Test, China). Group differences were evaluated using Mann-Whitney U-test, and associations were examined using Spearman’s rank correlation.
Results
Serum total ALP and B-ALP levels were significantly higher in patients with T2DM than in controls [ALP: 95 (80.5–116) U/L vs. 84.5 (68 -104.5) U/L, P =0.03; B-ALP: 22.32 (12.54–32.81) ng/mL vs. 13.55 (6.66–26.12) ng/mL, P =0.03]. In T2DM patients, B-ALP showed a significant negative correlation with total cholesterol (TC) (rho=-0.3788, P =0.02) and low-density lipoprotein cholesterol (LDL-C) (rho=-0.3881, P =0.01). Subgroup analysis indicated a positive association between B-ALP and anthropometric indices in patients with T2DM without MetS.
Interpretation and conclusions
Total ALP and B-ALP were elevated in T2DM, and B-ALP showed inverse associations with total cholesterol and low-density lipoprotein cholesterol (LDL-C) in this cohort from western Rajasthan.