한국 소아청소년의 정상 Serum Alkaline Phosphatase 참고치: 국민건강영양조사 2009년 자료를 이용
Serum Alkaline Phosphatase Levels in 10-20 Year Old Healthy Korean Children and Adolescents - Based on the 2009 Korean National Health and Nutrition Examination Survey -
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목적: 소아청소년의 혈중 알칼라인 포스파타제(sALP) 참고치는 연령, 성별, 검사 시약의 종류에 따라 다르다. 그러나국내 소아청소년의 연령, 성별에 따른 참고치가 없어 이를 제시하고자 한다. 방법: 국민건강영양조사의 원시자료를 이용하여 10-19.9세 정상 소아 청소년 1,366 (남자 707, 여자 659)명의 sALP 를 분석하였다. 국민건강영양조사에서 측정된 sALP는 Pureauto S ALP 시약을 사용하여 Hitach 7600 자동 분석기로측정되었다. 결과: 총 sALP는 평균치가 남아에서 12-13세 경에 1,044±0.8 U/L로 최고치를 보였고, 이후 감소하여 남아는 17세경에 성인 상한치인 336 U/L에 도달하였고, 여아에서는 10세 이후 감소하여 15세 경에 277 U/L까지 떨어졌다. 또한,남아는 키 150-160 cm에 sALP가 최고점을 찍고 감소하였으며 여아는 130-140 cm 정도에서 감소하기 시작하여 남아는 170 cm, 여아는 160 cm 이후에 성인 수준으로 떨어졌다. 결론: 본 연구에서 소아청소년의 나이, 성별에 따른 sALP 값을 제시하였으며, 이를 근거로 골대사 질환을 감별하는데도움이 될 것이다. 그러나 시약에 따라 정상 참고치에 차이가 있을 수 있어 해석에 주의해야 한다.
Abstract
Purpose: Serum alkaline phosphatase (sALP) levels show great variation with age and sex in children and adolescents. We aimed to study pediatric age- and sex-specific reference ranges for sALP and how the pattern changed according to age . Methods: Cross-sectional results from 1366 healthy Korean children and adolescents (10-19.9 years) from the Korean National Health and Nutrition Examination Survey were analyzed. We constructed age- and sex-specific reference data for sALP with a Hitachi Automatic Analyzer 7600 using Pureauto S ALP. We assessed its peak both in relation to age. Results: Reference values for sALP according to age were constructed. Peak sALP levels were found at 12-13 years in boys (P < 0.001). Total sALP levels decreased to the adult level at the age of 17 in boys and 15 in girls, respectively. Conclusion: This study provides reference values for sALP by age for Korean children and adolescents. This normative data that includes upper and lower limits will provide a basis from which to better evaluate sALP levels, especially for bone disorders such as rickets and vitamin D deficiency. However, caution should be made in interpreting sALP levels because different buffers might lead to different values in the same serum.
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