Neal Ryan C, Ferdinand Keith C, Ycas Joseph, Miller Elinor
Baylor College of Medicine, Houston, Tex, USA.
Am J Med. 2009 Jan;122(1):73-8. doi: 10.1016/j.amjmed.2008.08.033.
Creatine kinase is expressed at high levels in muscle, where it plays a central role in energy metabolism. Highly elevated creatine kinase levels in blood may indicate muscle trauma or disease. However, it is known that baseline creatine kinase levels are higher in African Americans than in whites and that they are higher in men than in women. This analysis explores the relationship of ethnic origin, gender, and age to baseline blood creatine kinase levels in a large group of adults with hypercholesterolemia.
Data from the screening phases of 4 North American trials of statins, which included large numbers of specific racial/ethnic populations, were combined for analysis. The pooled population (N=11,346) included 2760 African Americans, 3301 whites, 2930 Hispanics, and 2355 South Asians.
Creatine kinase levels varied according to ethnic origin, gender, and age. African American participants had higher median creatine kinase levels than did individuals of the 3 other ethnicities. Within each ethnic group, men had higher median creatine kinase levels than women: African Americans, 135 versus 73 U/L; whites, 64 versus 42 U/L; Hispanics, 69 versus 48 U/L; and South Asians, 74 versus 50 U/L. An age-dependent decrease in creatine kinase levels was noted among men, but no such trend was seen among women. The median creatine kinase levels for younger African American men exceeded the standard upper limit of normal.
Physicians should use caution when interpreting creatine kinase levels that seem elevated, particularly when treating African American patients and younger men.
肌酸激酶在肌肉中高水平表达,在能量代谢中起核心作用。血液中肌酸激酶水平大幅升高可能表明肌肉创伤或疾病。然而,已知非裔美国人的基线肌酸激酶水平高于白人,且男性高于女性。本分析探讨了一大群高胆固醇血症成年人的种族、性别和年龄与基线血肌酸激酶水平之间的关系。
合并4项北美他汀类药物试验筛查阶段的数据进行分析,这些试验纳入了大量特定种族/族裔人群。汇总人群(N = 11346)包括2760名非裔美国人、3301名白人、2930名西班牙裔和2355名南亚人。
肌酸激酶水平因种族、性别和年龄而异。非裔美国参与者的肌酸激酶中位数水平高于其他3个种族的个体。在每个种族群体中,男性的肌酸激酶中位数水平高于女性:非裔美国人,135对73 U/L;白人,64对42 U/L;西班牙裔,69对48 U/L;南亚人,74对50 U/L。男性中观察到肌酸激酶水平随年龄下降,但女性中未观察到这种趋势。年轻非裔美国男性的肌酸激酶中位数水平超过正常标准上限。
医生在解释看似升高的肌酸激酶水平时应谨慎,尤其是在治疗非裔美国患者和年轻男性时。