Evidence map›Paper›PMID 26167920›Full record

ArticlePloS one2015

Serum Alkaline Phosphatase and Risk of Incident Cardiovascular Disease: Interrelationship with High Sensitivity C-Reactive Protein.

Setor K Kunutsor, Stephan J L Bakker, Jenny E Kootstra-Ros, Ronald T Gansevoort, John Gregson, Robin P F Dullaart

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 1 synthesis or guideline pooled it, 73 citations in OpenAlex.

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  13. Urine cotinine versus self-reported smoking and the risk of chronic kidney disease.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Setor K KunutsorDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; School of Clinical Sciences, University of Bristol, Bristol, United Kingdom.
Stephan J L BakkerDepartment of Internal Medicine, University of Groningen and University Medical Center, Groningen, The Netherlands; Top Institute Food and Nutrition, Wageningen, The Netherlands.
Jenny E Kootstra-RosDepartment of Clinical Chemistry, University of Groningen and University Medical Center, Groningen, The Netherlands.
Ronald T GansevoortDepartment of Internal Medicine, University of Groningen and University Medical Center, Groningen, The Netherlands.
John GregsonDepartment of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Robin P F DullaartDepartment of Endocrinology, University of Groningen and University Medical Center, Groningen, The Netherlands.
University Medical Center Groningen · NLLondon School of Hygiene & Tropical Medicine · GBUniversity of Bristol · GBUniversity of Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlkaline phosphatase (ALP) has been suggested to be associated with cardiovascular disease (CVD) risk, however, important aspects of the association, such as shape and independence from established risk factors, have yet to be characterized in detail. We assessed the association of ALP with CVD risk and determined its utility for CVD risk prediction.

methodsAlkaline phosphatase activity was measured at baseline in the PREVEND prospective cohort involving 6,974 participants aged 28-75 years without pre-existing CVD. Hazard ratios (95% confidence intervals [CI]) and measures of risk discrimination and reclassification were assessed.

resultsDuring a median follow-up of 10.5 years, 737 participants developed CVD. Serum ALP was correlated with several risk markers for CVD, with strongest correlations for age (r = 0.30; P < 0.001), gamma-glutamyltransferase (r = 0.26; P < 0.001), and C-reactive protein (CRP) (r = 0.25; P < 0.001). There was a non-linear "J-shaped" relationship between ALP and CVD risk. In analyses adjusted for conventional risk factors, the hazard ratio (95% CI) for CVD in a comparison of the top quintile versus bottom quintiles 1-4 of ALP values was 1.34 (1.14 to 1.56; P<0.001), which persisted after additional adjustment for potential confounders 1.33 (1.13 to 1.55; P<0.001). However, the association was somewhat attenuated after adjustment for CRP 1.24 (1.05 to 1.45; P=0.009). Addition of information on ALP to a CVD risk prediction model containing established risk factors did not improve the C-index or net reclassification.

conclusionsAvailable evidence suggests a non-linear association between ALP activity and CVD risk, which is partly dependent on CRP. Taking account of conventional risk factors, additional information on ALP does not improve CVD risk assessment.

Indexed as

AdultAlkaline PhosphataseCardiovascular DiseasesC-Reactive ProteinFemaleHumansMaleMiddle AgedRisk FactorsAlkaline PhosphataseC-Reactive Protein

Identifiers

PMID26167920
PMCPMC4500413
OpenAlexW2248110638

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.