Systems Biology & Medicine Center for Complex Diseases, Center for Clinical Research, the Affiliated Hospital of Qingdao University, Qingdao 266003, China; Department of Cardiology, Affiliated Hospital of Qingdao University, Qingdao 266003, China.
Systems Biology & Medicine Center for Complex Diseases, Center for Clinical Research, the Affiliated Hospital of Qingdao University, Qingdao 266003, China; Department of Cardiology, Affiliated Hospital of Qingdao University, Qingdao 266003, China; Department of Cardiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, China.
Clin Chim Acta. 2023 Apr 1;544:117335. doi: 10.1016/j.cca.2023.117335. Epub 2023 Apr 8.
Muscle damage leads to increased serum creatine kinase (CK) levels in diseases such as acute myocardial infarction. Still, many individuals have abnormal serum CK activities lacking muscle-related diagnoses. The current study hypothesized that failed or overactivated CK clearance by non-muscle organs/tissues might be responsible for increased or decreased CK activities in blood.
We analyzing 37,081 independent CK test results in 36 human diseases during the past 5 y.
We found that 33 out of 36 diseases were associated with decreased median CK activities compared to healthy controls. Besides muscle damage-related conditions, the highest mean CK activities were observed in hepatitis and cirrhosis. In contrast, 6 blood cell-related illnesses had the lowest mean CK values. ROC analysis showed that CK activities were the best biomarkers (AUC: 0.80-0.94) for the 6 blood-related diseases, especially myeloproliferative disorders. The principal component analysis revealed that the same category of diseases, such as liver-, blood -, kidney-, cancers, and vascular-related diseases, had clustered CK distributions.
We proposed that the liver and blood cells were mainly responsible for CK clearance in blood circulation based on overall results. The testable mechanisms were presented and discussed.
肌肉损伤会导致血清肌酸激酶（CK）水平在急性心肌梗死等疾病中升高。然而，许多人存在血清 CK 活性异常但缺乏与肌肉相关的诊断。本研究假设非肌肉器官/组织对 CK 清除的失败或过度激活可能是导致血液中 CK 活性升高或降低的原因。
我们分析了过去 5 年中 36 种人类疾病的 37081 项独立的 CK 检测结果。
我们发现 36 种疾病中有 33 种与健康对照组相比，CK 活性中位数降低。除了与肌肉损伤相关的疾病外，肝炎和肝硬化的平均 CK 活性最高。相比之下，6 种与血细胞相关的疾病的平均 CK 值最低。ROC 分析显示，CK 活性是 6 种血液相关疾病的最佳生物标志物（AUC：0.80-0.94），尤其是骨髓增生性疾病。主成分分析显示，同一类别疾病（如肝脏疾病、血液疾病、肾脏疾病、癌症和血管相关疾病）的 CK 分布聚类。
基于总体结果，我们提出肝脏和血细胞是 CK 在血液循环中清除的主要负责者。提出并讨论了可检验的机制。
