Research Article Intestinal Alkaline Phosphatase Deficiency Is Associated with Ischemic Heart Disease Jagannath Malo, 1 Md. Jahangir Alam, 2 Munjareen Shahnaz, 3 Kanakaraju Kaliannan, 4 Gopal Chandra, 1 Tarek Aziz, 1 Tapas Sarker, 1 Mihir Bala, 1 Ratna Paul, 5 Chandan K. Saha, 6 Pradip K. Karmakar, 1 and Madhu S. Malo 7,8 1 National Institute of Cardiovascular Diseases, Dhaka 1207, Bangladesh 2 Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh 3 Bangladesh Medical College, Dhaka 1209, Bangladesh 4 Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA 5 Dhaka Medical College, Dhaka 1100, Bangladesh 6 Shaheed Tajuddin Ahmad Medical College, Gazipur, Dhaka, Bangladesh 7 MH Samorita Medical College, Dhaka 1208, Bangladesh 8 Diabetic Association of Bangladesh, Dhaka 1000, Bangladesh Correspondence should be addressed to Madhu S. Malo; madhumalo@hotmail.com Received 28 June 2019; Revised 20 November 2019; Accepted 30 November 2019; Published 13 December 2019 Academic Editor: Paulina Dumnicka Copyright © 2019 Jagannath Malo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. We have previously shown that the deficiency of the gut enzyme intestinal alkaline phosphatase (IAP) is associated with type 2 diabetes mellitus (T2DM) in humans, and mice deficient in IAP develop the metabolic syndrome, a precipitant of T2DM and ischemic heart disease (IHD). We hypothesized that IAP deficiency might also be associated with IHD in humans. We aimed to determine the correlation between the IAP level and IHD in humans. Methods and Results. The IHD patients were recruited from the National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh, and the control healthy participants were recruited from a suburban community of Dhaka. We determined the IAP level in the stools of 292 IHD patients (187 males, 105 females) and 331 healthy control people (84 males, 247 females). We found that compared to controls, IHD patients have approx. 30% less IAP (mean ± SEM: 63:7±3:5 vs. 44:9±2:1 U/g stool, respectively; p <0:000001), which indicates that IAP deficiency is associated with IHD, and a high level of IAP is probably protective against IHD in humans. The adjusted generalized linear model (GLM) of regression analysis predicted a strong association of IAP with IHD (p =0:0035). Multiple logistic regression analysis showed an independent inverse relationship between the IAP level and the IHD status (odds ratio, OR = 0:993 with 95% CI 0.987-0.998; p <0:01). Conclusions. IAP deficiency is associated with IHD, and a high level of IAP might be protective against IHD. 1. Introduction The ischemic heart disease (IHD) is the leading cause of death worldwide, making it the major global health problem with devastating consequences in terms of healthcare cost, morbidity, and mortality [1–7]. Globally, approx. 8.9 million people died of IHD in 2015, and more than 400,000 people die annually in the USA from IHD (synonymously known as coronary heart disease (CHD)) [3, 8]. A report from the American Heart Association on IHD showed that an esti- mated 16.5 million Americans suffer from IHD making the prevalence rate of 6.3% in US adults ≥ 20 years of age [9]. The direct and indirect healthcare cost of IHD in the USA was approx. 177 billion dollars in 2010 [10]. In the context of pathogenesis of IHD, various factors have been implicated, such as hypercholesterolemia, hypertension, diabetes, smoking, genetic predisposition, and depression [11–13]. Pathophysiologically, IHD is a Hindawi Disease Markers Volume 2019, Article ID 8473565, 11 pages https://doi.org/10.1155/2019/8473565