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Nationwide Cross-sectional Study of Association between Pterygium and Alkaline Phosphatase in a Population from Korea
한국인에서 익상편과 혈청 알칼리인산가수 분해효소와의 관계
JKOS 2020 Jan;61(1):9-16
Published online January 15, 2020;
Copyright © 2020 The Korean Ophthalmological Society.
PDF Download Count: 52 / View Count: 69

Hyun Joon Kim, MD, PhD, Sang Hoon Rah, MD, PhD, Sun Woong Kim, MD, PhD, Soo Han Kim, MD, PhD
김현준 · 나상훈 · 김선웅 · 김수한

Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju, Korea
연세대학교 원주의과대학 안과학교실
Received June 20, 2019; Revised July 25, 2019; Accepted December 30, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: We determined whether elevated serum alkaline phosphatase (ALP) was related to prevalence, location, type, length, and recurrence of pterygium in a population from the Republic of Korea.
Methods: A nationwide cross-sectional dataset, the Korean National Health and Nutrition Examination Survey (2008-2011), was used in this study. All participants were > 30 years of age and underwent the ALP test and ophthalmic evaluation (n = 22,359). One-way analysis of variance, the chi-square test, and Fisher’s exact test were used to compare characteristics and outcomes among participants. Multivariable logistic regression was used to examine the possible associations between serum ALP levels and various types of pterygium. Data were adjusted for known risk factors for development of pterygium and ALP elevation (age, sex, residence, sunlight exposure, drinking, smoking, hypertension, diabetes, BMI, AST, ALT, vitamin D, and HDL).
Results: The overall prevalence of pterygium was 8.1%, and participants with pterygium had higher levels of serum ALP (p < 0.001). Participants with higher serum ALP had a significantly higher prevalence of all types of pterygium than those in the lower serum ALP quartiles. After adjusting for potential confounding factors, multivariate logistic regression analysis revealed that ALP was associated with the prevalence of pterygium (odds ratio [OR], 1.001; p = 0.038). Trend analysis between the OR and ALP quartiles revealed a linear trend in overall prevalence and in the intermediate type of pterygium. Subgroup analysis revealed a stronger correlation in participants > 50 years of age. One-way analysis of variance revealed an association between the size of pterygium and serum ALP quartile levels. Serum ALP was not associated with recurrence of pterygium.
Conclusions: Increased serum ALP was associated with the prevalence and size of pterygium.
Keywords : Alkaline phosphatase, Korean National Health and Nutrition Examination Survey Pterygium


February 2020, 61 (2)