Research Institute of Orthopedics, The Affiliated Jiangnan Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou, China.
Medicine (Baltimore). 2023 Aug 11;102(32):e34724. doi: 10.1097/MD.0000000000034724.
Currently, it is unclear whether creatine phosphokinase (CPK) affects bone mineral density (BMD) in adolescents. We sought to clarify the relationship between CPK and total BMD in adolescents aged 12 to 19 years within normal values by conducting this study. A cross-sectional study was conducted using the 2011 to 2018 National Health and Nutrition Survey data to examine 1188 males (average age, 15.2 years) and 1629 females (average age, 15.4 years). In this study, CPK was the independent variable and total BMD was the outcome variable. In addition to using multivariate linear regression models, subgroup analyses were also conducted in order to examine the relationship between CPK levels and total BMD within normal ranges. Significant positive association was observed between the CPK levels and total BMD in adolescents (model 1: 0.0003 [0.0002, 0.0004], model 2: 0.0004 [0.0003, 0.0005] and model 3: 0.0004 [0.0003, 0.0004]). After adjusting for age, gender, race/ethnicity, body mass index, dietary protein intake, dietary protein intake, dietary fiber intake, poverty to income ratio, physical activities, total cholesterol, total protein, blood urea nitrogen, phosphorus, and serum calcium, CPK levels remained significantly associated with BMD (regression coefficients for quartiles 2 to 4 vs quartile1 were 0.0002, 0.0072, and 0.0154, respectively; P for trend <.001). The association was positive even when stratified by age, gender, and race. Further, adolescents aged 16 to 19 years were more likely to report positive relationships than adolescents aged 12 to 15 years. And the phase relationship between total BMD and CPK was further enhanced in boys. The results of our study show that CPK levels within the normal range are positively associated with total BMD in adolescents aged 12 to 19 years. Additionally, CPK may be a potential biomarker of bone health among adolescents.
目前，尚不清楚肌酸磷酸激酶（CPK）是否会影响青少年的骨密度（BMD）。我们通过进行这项研究，旨在明确 12 至 19 岁青少年中 CPK 与总 BMD 值在正常值范围内的关系。本研究采用 2011 年至 2018 年全国健康与营养调查数据进行横断面研究，共纳入 1188 名男性（平均年龄 15.2 岁）和 1629 名女性（平均年龄 15.4 岁）。在本研究中，CPK 为自变量，总 BMD 为因变量。除了使用多元线性回归模型外，还进行了亚组分析，以检验 CPK 水平与正常范围内总 BMD 的关系。研究结果显示，青少年的 CPK 水平与总 BMD 呈显著正相关（模型 1：0.0003[0.0002，0.0004]；模型 2：0.0004[0.0003，0.0005]；模型 3：0.0004[0.0003，0.0004]）。在校正年龄、性别、种族/民族、体重指数、膳食蛋白质摄入量、膳食纤维摄入量、贫困收入比、体力活动、总胆固醇、总蛋白、血尿素氮、磷和血清钙后，CPK 水平与 BMD 仍显著相关（四分位 2 至 4 与四分位 1 相比，回归系数分别为 0.0002、0.0072 和 0.0154；P<.001）。即使按年龄、性别和种族分层，这种相关性也是阳性的。此外，16 至 19 岁的青少年比 12 至 15 岁的青少年更有可能报告阳性关系。而且，在男孩中，总 BMD 和 CPK 之间的时相关系进一步增强。我们的研究结果表明，12 至 19 岁青少年的 CPK 水平在正常值范围内与总 BMD 呈正相关。此外，CPK 可能是青少年骨骼健康的潜在生物标志物。
