RESUMO
BACKGROUND: Alkaline phosphatase (ALP) is a widely used marker for skeletal and hepatobiliary disorders, but its activity is also increased in atherosclerosis and peripheral vascular disease. It is an inflammatory marker like C-reactive protein (CRP). We therefore analyzed its relationship with CRP in the United States National Health and Nutrition Examination Survey (NHANES) 2005-2006. METHODS: The analysis included 4155 men and non-pregnant women over the age of 20 years. The relationship between log-transformed ALP and plasma CRP was analyzed using univariate and multivariate models. RESULTS: ALP activity was significantly correlated with age, waist circumference, body mass index, blood pressure, exercise, alcohol, triglycerides, and other liver enzymes after adjusting for age, gender and ethnicity (p<0.001). ALP was significantly associated with a higher frequency of cardiovascular disease (p=0.02), hypertension (p=0.01) hypercholesterolemia (p=0.04), and diabetes (p=0.02). Compared to the lowest quartile of ALP, the adjusted odds ratio (OR) associated with the highest quartile were 1.9 [95% confidence intervals (CI) 1.1-3.5], 1.6 (95% CI 1.0-2.5), 1.5 (95% CI 1.1-2.1) and 1.7 (95% CI 1.0-2.4) for cardiovascular disease, hypertension, hypercholesterolemia, and diabetes, respectively. In multivariate analysis, log ALP was an independent predictor of log CRP (p=1.0x10(-6)). A multivariate model that included log ALP, ethnicity, glycohemoglobin, waist circumference, albumin, apolipoprotein B, gamma-glutamyltransferase and uric acid explained 40% of the variance in log CRP. CONCLUSIONS: ALP is a marker of cardiometabolic risk, but it needs to be tested as part of a multivariate model in prospective studies.
Assuntos
Fosfatase Alcalina/sangue , Proteína C-Reativa/metabolismo , Inquéritos Epidemiológicos , Inquéritos Nutricionais , Fatores Etários , Pressão Sanguínea , Pesos e Medidas Corporais , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/metabolismo , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/etnologia , Diabetes Mellitus/metabolismo , Feminino , Humanos , Hipercolesterolemia/epidemiologia , Hipercolesterolemia/etnologia , Hipercolesterolemia/metabolismo , Hipertensão/epidemiologia , Lipídeos/sangue , Fígado/enzimologia , Masculino , Análise Multivariada , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais , Estados Unidos/epidemiologiaRESUMO
A retrospective audit on the "Plan of the day" (POD) selection and intra-fractional bladder fillings were carried out on twenty adaptive bladder radiotherapy patients at a single institution. Treatment time, differences in bladder volume and displacement of outer bladder wall expansion over the treatment fraction were analysed. Average treatment time was 8.9â¯min. The mean percentage difference in bladder volume pre and post treatment was 13.7%, resulting in expansion of the bladder predominately in the superior and anterior directions. This audit confirmed that the institution's POD process sufficed without being significantly affected by the intra-fractional bladder filings.
RESUMO
[This corrects the article DOI: 10.1016/j.tipsro.2019.01.001.].