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The table shows the different ALP activities of the different samples before and after the heat treatment and as well as the percentage of the ALP activity remaining after the heat treatment. An increase in serum ALP levels is frequently associated with a variety of diseases (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=55333). Heat treatment was done to the different samples to identify the ALP isoenzyme, specifically to determine whether it was a bone ALP or a liver ALP. The samples that lost more than 30 percent of its ALP activity after the heat treatment could be identified as a bone ALP since bone ALP is inactivated when subjected to heat. On the other hand, samples that has 30 percent or less ALP activity loss could be identified as a liver ALP.
As shown in the results, Sample A has a 66 IU/L total ASP activity. The value of the ALP remains within the normal range of 30 – 90 U/L. Patient A suffers from type I diabetes mellitus but his ALP remains normal. Thus, this shows that ALP is not an indicator for type I diabetes mellitus.
Sample B has a total ALP activity of 207 I/UL, which is above the normal range of 30 U/L to 90 U/L. High ALP usually means that the bone or liver has been damaged (http://www.labtestsonline.org/understanding /analytes/alp/test.html). The heat treatment on sample B decreased its ALP activity to only 20% percent, meaning more than 30% percent of the activity was lost. Therefore, the source of the increased ALP is the bone ALP.
Increased levels of bone ALP in patient B may be due to her fractured bone because ALP is released into the blood during injury http://www.medterms.com/script/main/art.asp?articlekey=33915. The increased levels of bone ALP also suggest that patient B has a bone disease. The patient has the symptoms of the bone disease called Osteomalacia. Osteomalacia is a condition in which the bones become soft (http://www.webmd.com/hw/health_guide_atoz/sto167518.asp?navbar= hw1717). It is caused by vitamin D deficiency which in turn is caused by poor diet or malnutrition. Symptoms of Osteomalacia include weakness, lack of appetite, weight loss, pain, and bones that fracture easily. (http://www.webmd.com/hw/health_guide_atoz/sto167518.asp?navbar= hw1717). Some of these symptoms were seen in the patient. Living in a run-down area and having 8 children could have also contributed to her poor health condition. High ALP in the patient showed the possible presence of a bone disease.
Sample C has a 299 IU/L total ALP activity which is also above the normal range. Seventy-nine percent ALP activity after the heat treatment indicates that the source of the excess ALP is the liver ALP.
High levels of liver ALP suggest that the possible cause of the abdominal pains of the patient was due to liver damage. Also, the patient was obese and there are studies that show that obesity can lead to a number of diseases, one of which is liver disease. More specifically, it is the non alcoholic fatty liver disease (NAFD) that is more directly associated with obesity. Non alcoholic fatty liver disease refers to a wide spectrum of liver diseases ranging from the most common, fatty liver (accumulation of fat in the liver, also known as steatosis), to non alcoholic steatohepatitis (NASH, fat in the liver causing liver inflammation), to cirrhosis (irreversible, advanced scarring of the liver as a result of chronic inflammation of the liver) (http://www.medicinenet.com/script/main/art.asp?articlekey=46582). Non alcoholic fatty liver disease is currently the most common liver disease in the US and worldwide, affecting estimated 10-24% of the world’s population. (http://www.annecollins.com/weight_health/fatty-liver-disease-obesity.htm) The main cause of NAFD is insulin resistance, a metabolic disorder in which cells become insensitive to the effect of insulin. One of the most common risk factors for insulin resistance is obesity, especially central abdominal obesity (http://www.annecollins.com/weight_health/fatty-liver-disease-obesity.htm).