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Concurrent Assays of Circulating Bone Gla-Protein and Bone Alkaline Phosphatase: Effects of Sex, Age, and Metabolic Bone Disease^*

Endocrine Research Unit (R.J.D., J.M.P., B.L.R.), Sections of Clinical Chemistry (J.F.O.) and Clinical Immunology (J.A.K.), Mayo Clinic and Mayo Foundation Rochester, Minnesota 55905
the Department of Biochemistry, University of Vermont (K.G.M.) Burlington, Vermont 05405

Address requests for reprints to: Dr. Riggs, Endocrine Research Unit, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905.

We measured the serum concentrations of 2 biochemical markers of bone formation, bone Gla-protein (BGP) and bone alkaline phosphatase (BAP), in 164 normal subjects and 164 patients with metabolic bone disorders. The data were reported as Z scores (deviation in SDs from the sex-specific age regression in normal subjects). Both serum BGP and BAP distinguished abnormalities well (mean Z scores for BGP and BAP, respectively) and gave concordant results in patients with hypoparathyroidism (–1.7, –1.4), hyperthyroidism (+1.1, +1.8), primary hyperparathyroidism (+3.6, +2.5), acromegaly (+1.2, +2.8), and postmenopausal osteoporosis (+0.4, +1.9). The 2 markers gave discordant results, however, in patients with glucocorticoid excess (–2.4, +0.9), Paget’s disease (+1.8, +41.8), chronic renal failure (+16.3, +0.4), and osteolytic metastases (–1.4, +5.9). These discrepancies may have occurred because srum BGP and BAP concentrations reflect different aspects of osteoblast function or because there are differences in their clearance from the circulation. Consequently, more information is derived about the level of bone formation across the wide range of metabolic bone disorders when both biochemical markers are assayed.

^* This work was supported by NIH grants RR-585 and AG-04875 from the USPHS.

Received June 25, 1987.

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