Radišić Biljak Vanja, Lazić Anja, Nikler Ana, Pekas Damir, Saračević Andrea, Trajković Nebojša
Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia.
University of Zagreb, Faculty of Kinesiology, Zagreb, Croatia.
Biochem Med (Zagreb). 2025 Jun 15;35(2):020502. doi: 10.11613/BM.2025.020502.
Creatine kinase (CK) activity has been generally considered as reliable blood marker for assessing muscle function, damage, and repair. However, the greatest challenge in the interpretation of CK activity remains the high variability in CK increase in relation to degrees of muscle cell damage or disturbance. Several known contributors to CK variability have been identified. The most important include the type of training, exercise intensity, gender differences, body composition, intra- and interindividual biological variability, as well as preanalytical and analytical considerations. Creatine kinase variability following different types of exercise reflects the complex interplay between exercise modality, intensity, individual physiology, and recovery strategies. High-intensity exercises, especially those involving eccentric muscle contractions, tend to produce more significant CK responses due to greater muscle fiber disruption. Gender differences in CK variability are pronounced, with men generally exhibiting higher CK activities following exercise compared to women. Creatine kinase variability is also closely linked to body composition, with muscle mass generally leading to higher CK activities post-exercise, while higher body fat may correlate with lower CK responses. Regarding preanalytical and analytical considerations, perhaps the greatest challenge in CK measurement is the limited sample stability, which should always be taken into consideration when analyzing CK activity in stored samples for research or clinical purposes. This review, through exploring all of the above-mentioned sources of CK variability, could facilitate the development of evidence-based practices for preventing overuse injuries, and promoting long-term athlete health and well-being.
肌酸激酶（CK）活性通常被视为评估肌肉功能、损伤和修复的可靠血液标志物。然而，CK活性解读中最大的挑战仍然是CK升高与肌肉细胞损伤或紊乱程度之间的高度变异性。已经确定了几个导致CK变异性的已知因素。其中最重要的包括训练类型、运动强度、性别差异、身体成分、个体内和个体间的生物学变异性，以及分析前和分析方面的考虑因素。不同类型运动后肌酸激酶的变异性反映了运动方式、强度、个体生理学和恢复策略之间复杂的相互作用。高强度运动，尤其是那些涉及离心性肌肉收缩的运动，由于更大的肌纤维破坏，往往会产生更显著的CK反应。CK变异性中的性别差异很明显，男性在运动后的CK活性通常比女性高。肌酸激酶变异性也与身体成分密切相关，肌肉量通常会导致运动后更高的CK活性，而更高的体脂可能与更低的CK反应相关。关于分析前和分析方面的考虑因素，CK测量中最大的挑战可能是样本稳定性有限，在为研究或临床目的分析储存样本中的CK活性时，这一点应始终予以考虑。本综述通过探讨上述所有导致CK变异性的因素，有助于制定基于证据的预防过度使用损伤的实践方法，并促进运动员的长期健康和福祉。
