The Relationship between Serum Alkaline Phosphatase and Arterial Stiffness in Korean Adults

Aim: Serum alkaline phosphatase (ALP), a useful marker of hepatobiliary or bone disorders, has recently been found to be associated with cardiovascular diseases. This study aimed to examine the association of serum ALP level with arterial stiffness, as measured by brachial-ankle pulse wave velocity. Methods: This cross-sectional study included 2476 participants (1486 men and 990 women) aged ≥ 20 years who underwent a medical examination. Pearson correlation analyses were conducted to examine the bivariate correlations between baPWV and clinical variables. To examine the independent relationship between serum ALP and baPWV, a multiple linear regression analysis was conducted with baPWV as the dependent variable in a sex-specific manner. Results: After adjusting for age, body mass index, current smoking, alcohol drinking, regular exercise, hypertension, type 2 diabetes, dyslipidemia, chronic kidney disease, log-transformed AST, log-transformed ALT, and log-transformed GGT levels, log-transformed serum ALP level was positively and independently associated with baPWV (β = 78.6 for men, P = 0.001; and β = 85.3 for women, P < 0.001). Conclusions: Serum ALP level was positively and independently associated with baPWV in men and women, suggesting that an elevated ALP level may be a useful surrogate marker for arterial stiffness in adult men and women.