{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T22:28:57Z","timestamp":1790202537517,"version":"4.1.0"},"reference-count":11,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1982,6]]},"abstract":"<jats:p>Plasma calcium and phosphate concentrations and alkaline phosphatase activities were examined retrospectively in 50 patients with histologically proven osteomalacia and 50 age- and sex-matched control subjects with normal bone histology. An abnormal plasma alkaline phosphatase activity was more useful than an abnormal plasma calcium or phosphate concentration in distinguishing between normal and osteomalacic subjects, producing a false-negative rate of 14% and a false-positive rate of 8%. False-negative and false-positive rates of 10% and 8% respectively were obtained when the presence of an abnormality in any one of the three biochemical measurements was used as a predictor of histological osteomalacia. When discriminant analysis was applied to plasma calcium, phosphate and alkaline phosphatase together a false-negative rate of 12% and a false-positive rate of 0% was obtained.<\/jats:p>\n                  <jats:p>Sixty-two patients in whom a diagnosis of osteomalacia was suspected were investigated prospectively, using both single biochemical abnormalities and the classification functions derived from the discriminant analysis of all three biochemical measurements to predict the presence or absence of histological osteomalacia. Plasma alkaline phosphatase activity gave false-negative and false-positive rates of 10% and 32% respectively but was a more reliable predictor of abnormal bone histology than were plasma calcium or plasma phosphate concentrations or the presence of an abnormality in any one of the three measurements. Discriminant analysis using plasma calcium, phosphate and alkaline phosphatase together produced a false-negative rate of 16% and a false-positive rate of 10%.<\/jats:p>\n                  <jats:p>We conclude that plasma alkaline phosphatase activity is the best single routine biochemical screening test for osteomalacia, although a high false-positive rate may occur. Direct discriminant analysis of plasma calcium, phosphate and alkaline phosphatase together provides a more sensitive method of detecting histological osteomalacia which should be useful in determining the prevalence of osteomalacia within high-risk populations.<\/jats:p>","DOI":"10.1136\/jcp.35.6.625","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"625-630","source":"Crossref","is-referenced-by-count":66,"title":["Value of plasma calcium, phosphate, and alkaline phosphatase measurements in the diagnosis of histological osteomalacia"],"prefix":"10.1136","volume":"35","author":[{"given":"Hedley","family":"Peach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliet E","family":"Compston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shobhana","family":"Vedi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo WL","family":"Horton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1982,6,1]]},"reference":[{"key":"ref_1","first-page":"403","volume":"49","author":"[Br, J Bone Joint Surg","year":"1976","unstructured":"J Bone Joint Surg [Br] 1976;49:403-23."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0140-6736(78)91318-1","article-title":"Bone disease after jejuno-ileal bypass for obesity","volume":"ii:","author":"Compston, J.E.; Horton, L.W.L.; Laker, M.F.","year":"1978","unstructured":"Compston JE, Horton LWL, Laker MF, et al. Bone disease after jejuno-ileal bypass for obesity. Lancet 1978;ii:1-4.","journal-title":"Lancet"},{"key":"ref_3","first-page":"643","article-title":"Interpretation of serum calcium in patients with abnormal chemical and histological studies, do not reduce the serum proteins","volume":"iv:","author":"Payne, R.B.; Little, A.J.; Williams, R.B.; Milner, JR","year":"1973","unstructured":"Payne RB, Little AJ, Williams RB, Milner JR. Interpretation of serum calcium in patients with abnormal chemical and histological studies, do not reduce the serum proteins. Br MedJ 1973;iv:643-6.","journal-title":"Br MedJ"},{"key":"ref_4","first-page":"434","article-title":"Bent DH. Statistical package for the social sciences","author":"Nie, N.H.; Hull, C.H.; Jenkins, J.G.; Steinbrenner, K.","year":"1975","unstructured":"Nie NH, Hull CH, Jenkins JG, Steinbrenner K, Bent DH. Statistical package for the social sciences. 2nd ed. London and New York: McGraw-Hill Book Company, 1975;434-67.","edition":"2nd ed"},{"key":"ref_5","first-page":"1141","article-title":"clinical, biochemical or radiological signs. Since false-negative rates are less significant in subpopulations which have a high prevalence of a disease, the discriminant function we have devised Shanks RA. Florid and subclinical rickets among immigrant children in Glasgow","volume":"i:","author":"Goel, K.M.; Sweet, E.M.; Logan, R.W.; Warren, J.M.; Arneil, G.C.","year":"1976","unstructured":"Goel KM, Sweet EM, Logan RW, Warren JM, Arneil GC, clinical, biochemical or radiological signs. Since false-negative rates are less significant in subpopulations which have a high prevalence of a disease, the discriminant function we have devised Shanks RA. Florid and subclinical rickets among immigrant children in Glasgow. Lancet 1976;i:1141-8.","journal-title":"Lancet"},{"key":"ref_6","first-page":"125","article-title":"Occult rickets and osteomalacia amongst the Asian immigrant population","volume":"42","author":"Holmes, A.M.; Enoch, B.A.; Taylor, J.L.; Jones, M.E.","year":"1973","unstructured":"Holmes AM, Enoch BA, Taylor JL, Jones ME. Occult rickets and osteomalacia amongst the Asian immigrant population. Q J Med 1973;42:125-49.","journal-title":"Q J Med"},{"key":"ref_7","first-page":"546","article-title":"Plasma 25-hydroxyvitamin D in pregnant Asian women and their babies","volume":"ii:","author":"Heckmatt, J.Z.; Peacock, M.; Davies, A.E.J.; McMurray, J.; Isherwood, D.M.","year":"1979","unstructured":"Heckmatt JZ, Peacock M, Davies AEJ, McMurray J, Isherwood DM. Plasma 25-hydroxyvitamin D in pregnant Asian women and their babies. Lancet 1979; ii:546-8.","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1177\/003693306601101203","article-title":"Osteomalacia in elderly women","volume":"11","year":"1966","unstructured":"Osteomalacia in elderly women. Scott Med J 1966;11: 429-35.","journal-title":"Scott Med J"},{"key":"ref_9","first-page":"575","article-title":"Osteomalacia in elderly patients with fracture of the pregnant Asian women.9 These figures almost certainly overestimate the prevalence of histological osteomalacia, but nevertheless indicate the high risk of rickets and osteomalacia in this population. The femoral neck. A clinico-pathological study","volume":"55","year":"1973","unstructured":"Osteomalacia in elderly patients with fracture of the pregnant Asian women.9 These figures almost certainly overestimate the prevalence of histological osteomalacia, but nevertheless indicate the high risk of rickets and osteomalacia in this population. The femoral neck. A clinico-pathological study. J Bone Joint Surg [Br] 1973;55:575-80.","journal-title":"J Bone Joint Surg [Br]"},{"key":"ref_10","article-title":"Nutrition and metabolic bone disease in old age. Lancet 1966; ii: 999-1001. prevalence of vitamin D deficiency and osteomalacia is also believed to be increased in the elderly British population'0-12 particularly those living in institu-","author":"Exton-Smith, A.N.; Hodkinson, H.M.; Stanton, B.R.","unstructured":"Exton-Smith AN, Hodkinson HM, Stanton BR. Nutrition and metabolic bone disease in old age. Lancet 1966; ii:999-1001. prevalence of vitamin D deficiency and osteomalacia is also believed to be increased in the elderly British population'0-12 particularly those living in institu-"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1093\/ajcn\/32.9.1934","article-title":"Nutritional status of institutionalised and non-institutionalised aged in Belfast, Northern Ireland","volume":"32","author":"Vir, S.C.; Love, A.H.G.","year":"1979","unstructured":"Vir SC, Love AHG. Nutritional status of institutionalised and non-institutionalised aged in Belfast, Northern Ireland. 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