Heterogeneity of Serum Creatine Kinase Activity Among Racial and Gender Groups of the Population

Wong, Edward T.; Cobb, Camilla J.; Umehara, Mary K.; Wolff, G; Haywood, L. Julian; Greenberg, Tokoko T.; Shaw, S.T.

doi:10.1016/s0022-5347(17)49558-9

Cited by 15 publications

(20 citation statements)

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“…This is in accordance with the substantial heterogeneity observed in the normal population which showed significantly higher CK values in black men (high CK group) compared with white men (intermediate CK group) and women (low CK group) [22]. It was concluded that the differences between the subgroups are attributed to the relatively higher muscle mass in probands with higher CK levels, since skeletal muscle is the largest reservoir of CK in the body [22]. This view is furthermore supported by other studies showing increased CK levels at a later age, around puberty, in mild SMA [1,2,4].…”

Section: Discussionsupporting

confidence: 89%

“…Given that secondary myopathic changes might cause leakage of muscle enzymes, it is likely that patients with larger muscle bulks have higher CK levels than those who have severe muscle atrophy from early childhood. This is in accordance with the substantial heterogeneity observed in the normal population which showed significantly higher CK values in black men (high CK group) compared with white men (intermediate CK group) and women (low CK group) [22]. It was concluded that the differences between the subgroups are attributed to the relatively higher muscle mass in probands with higher CK levels, since skeletal muscle is the largest reservoir of CK in the body [22].…”

Section: Discussionsupporting

confidence: 79%

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Analysis of Creatine Kinase Activity in 504 Patients with Proximal Spinal Muscular Atrophy Types I–III from the Point of View of Progression and Severity

et al. 1998

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Mild to moderately elevated creatine kinase (CK) activity is a frequent biochemical finding in proximal spinal muscular atrophy (SMA). In a collaborative study on all types of childhood and juvenile onset SMA, we analysed the CK activity of 504 SMA patients (138 type I, 127 type II, 144 type IIIa, and 95 type IIIb patients). Under the assumption of a lognormal distribution of CK activity as the most appropriate statistical model, CK levels were transformed into logarithms and compared by standard deviation scores = CK-SDS (log). CK activity was statistically different between early and later onset SMA: in SMA I and II, about one-third of patients showed CK-SDS (log) >2 SD, the analysis of the means did not show significant differences. In SMA III, CK-SDS (log) was significantly higher (p < 0.01) than in the two other groups, which was most pronounced in SMA IIIb. More than 90% of SMA IIIb patients showed CK-SDS (log) values >2 vs. 57% in SMA IIIa. As similar values were obtained for a subgroup of 100 patients in whom the diagnosis of autosomal recessive SMA was confirmed by a deletion of the telomeric copy of the survival motor neuron gene, our results can be considered representative for SMA I–III. There was no correlation between CK level and disease duration. The fact that patients were ambulatory or chair-bound had no influence on CK activity in type III SMA. There was no sex influence in SMA I, II and IIIa. The observed higher male values in the group SMA IIIb are most likely the result of a lack of female patients with onset after puberty.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 79%

Analysis of Creatine Kinase Activity in 504 Patients with Proximal Spinal Muscular Atrophy Types I–III from the Point of View of Progression and Severity

et al. 1998

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“…23,24 In addition, normal isoenzymes were found in apparently healthy black people with high serum CK activities, as well as in other healthy population subgroups. 2,23,25,26 We therefore consider it unlikely that a major portion of the people from a random population sample, with normal blood pressures and normal CK activities, would have cardiovascular damage to the extent that it would lead to abnormal CK isoenzyme distribution.…”

Section: Discussionmentioning

confidence: 99%

“…[32][33][34] The molecular basis of the coordinated expression of different isoenzymes at specific subcellular sites in specific tissues and of the large differences in activity found between human subgroups is unknown. [1][2][3][4][5][6]35 High tissue CK activity, whether constitutive, induced, or both, may rather directly enhance contractile responses by enhancing cellular energy and contractile reserve. 3 CK acts as an energy transducer at the cardiovascular contractile proteins, supplying ATP for the contractile process.…”

Section: Discussionmentioning

confidence: 99%

“…43,51 High CK activity, low NO bioavailability, and attenuated NOmediated responses occur more often in black people. [1][2][3]14,[52][53][54] There is great interest in identifying the operative biochemical pathways that underlie variations in bioavailability of NO. 14,[52][53][54] Given the existing evidence on the synthesis of creatine, which requires a major portion of the available L-arginine, 43 and the greater concentration of creatine with higher CK activity, 51 high tissue CK activity may be one factor that reduces NO bioavailability, by reducing L-arginine available for NO synthesis.…”

Section: Discussionmentioning

confidence: 99%

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Creatine Kinase Activity Is Associated With Blood Pressure

et al. 2006

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Background-We previously hypothesized that high activity of creatine kinase, the central regulatory enzyme of energy metabolism, facilitates the development of high blood pressure. Creatine kinase rapidly provides adenosine triphosphate to highly energy-demanding processes, including cardiovascular contraction, and antagonizes nitric oxide-mediated functions. Relatively high activity of the enzyme, particularly in resistance arteries, is thought to enhance pressor responses and increase blood pressure. Tissue creatine kinase activity is reported to be high in black people, a population subgroup with greater hypertension risk; the proposed effects of high creatine kinase activity, however, are not "race dependent." We therefore assessed whether creatine kinase is associated with blood pressure in a multiethnic population. Methods and Results-We analyzed a stratified random sample of the population of Amsterdam, the Netherlands, consisting of 1444 citizens (503 white European, 292 South Asian, 580 black, and 69 of other ethnicity) aged 34 to 60 years. We used linear regression analysis to investigate the association between blood pressure and normal serum creatine kinase after rest, as a substitute measure of tissue activity. Creatine kinase was independently associated with blood pressure, with an increase in systolic and diastolic pressure, respectively, of 8.0 (95% CI, 3.3 to 12.7) and 4.7 (95% CI, 1.9 to 7.5) mm Hg per log creatine kinase increase after adjustment for age, sex, body mass index, and ethnicity. Conclusions-Creatine kinase is associated with blood pressure. Further studies are needed to explore the nature of this association, including how variation in cardiovascular creatine kinase activity may affect pressor responses.

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Follow-up of a large population of asymptomatic/oligosymptomatic hyperckemic subjects

et al. 2006

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Six years before the present study we performed a retrospective study of 114 subjects presenting with asymptomatic / oligosymptomatic hyperckemia (raised creatine kinase blood levels), a diagnosis being made in 21 of them. We now present the results of a long-term follow-up in 55 of the still undiagnosed 93 individuals. Most of them have remained asymptomatic and did not develop specific neuromuscular disorders. One subject became frankly symptomatic manifesting limb-girdle weakness. A diagnosis of dystrophinopathy carrier and one of possible type I SMA carrier were indirectly made in another two subjects. Almost all subjects still have hyperckemia, though the mean creatine kinase (CK) value is lower than before. CK levels have become normal in 12 subjects. Two died of neoplasia, and six developed non-neuromuscular disorders. We noted no follow-up differences in terms of CK modifications between subjects with pathological EMG and/or muscle biopsy findings and those with normal findings at first examination.

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Heterogeneity of Serum Creatine Kinase Activity Among Racial and Gender Groups of the Population

Cited by 15 publications

References 0 publications

Analysis of Creatine Kinase Activity in 504 Patients with Proximal Spinal Muscular Atrophy Types I–III from the Point of View of Progression and Severity

Analysis of Creatine Kinase Activity in 504 Patients with Proximal Spinal Muscular Atrophy Types I–III from the Point of View of Progression and Severity

Creatine Kinase Activity Is Associated With Blood Pressure

Follow-up of a large population of asymptomatic/oligosymptomatic hyperckemic subjects

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