Serum alkaline phosphatase is associated with arterial stiffness and 10‐year cardiovascular disease risk in a Chinese population

BACKGROUND Serum alkaline phosphatase (ALP) has been recognized as a biomarker of cardiovascular disease (CVD) risk, recently. This study aimed to explore the association of ALP with arterial stiffness and 10-year CVD risk. METHODS A total of 12 539 participants without CVD who underwent health examinations including serum ALP level were retrospectively analysed. Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV), and 10-year CVD risk was evaluated by Framingham risk score. RESULTS All participants were stratified into four groups according to the quartile of serum ALP. Participants with high ALP quartiles had higher cardiovascular parameters and baPWV, as well as an increase 10-year CVD risk. There was a dose-response relationship between serum ALP level and baPWV (OR = 1.134, 95% CI 1.103-1.165, P < .001). Logistic regression analysis showed that serum ALP was positively associated with elevated baPWV and 10-year CVD risk after adjustment for traditional CVD risk factors in both women and men. In receiver operating characteristic (ROC) curve analysis, the optimal cut-off point of serum ALP for elevated baPWV was 84U/L and the area under the ROC curve (AUROC) was 0.740 (95% CI 0.726-0.754, P < .001), with 71.2% and 63.4% sensitivity and specificity, respectively, in women. The AUROC of serum ALP in women was larger than that in men [0.575 (95% CI 0.559-0.590), P < .001]. CONCLUSIONS Serum ALP is independently associated with arterial stiffness and 10-year CVD risk. Our results imply that serum ALP may be a promising marker to identify an increased risk for subclinical atherosclerosis in women needing further evaluation.