Abstract
Although bone metabolism is reportedly associated with production and maturation of blood corpuscles, and serum alkaline
phosphatase (ALP) levels have been associated with bone metabolism, no published study has investigated the association
between ALP and anemia. Furthermore, although ALP is known as an enzyme affected by alcohol consumption, there are no
reports in the literature on associations between ALP and the risk of anemia in relation to drinking status. We conducted a
cross-sectional study of 907 men aged 30-89 years undergoing a general health check-up to investigate the associations
between ALP and anemia in relation to drinking status. Of the 907 participants, 120 men were diagnosed with anemia. The
association between ALP and anemia was J-shaped. With the second quartile of ALP (194-228 IU/L) (Q2) as the reference
group, the multivariable adjusted OR and 95%CI for anemia were 1.91 (95%CI: 0.96-3.82) for < 194 IU/L (Q1), 1.84 (95%CI:
0.93-3.62) for 229-277 IU/L (Q3) and 2.83 (95%CI:1.49-5.37) for > 277 IU/L (Q4). When the analysis was limited to non-drinkers,
the associations became stronger with corresponding values of 3.34 (95%CI: 1.28-8.74), 3.18 (95%CI: 1.28-7.88) and
3.22 (95%CI:1.37-7.59). Not only lower but also higher levels of serum ALP are associated with anemia for men, especially
non-drinkers. For analyses of associations between ALP and anemia, alcohol consumption should thus be considered a potential
confounder.
