title: Relationship of creatine kinase to body composition, disease state, and longevity in ALS.
abstract: Our objective was to explore if creatine kinase (CK) levels correlate with survival in amyotrophic lateral sclerosis (ALS), and whether a correlation is independent of other well-studied predictors such as location of onset, gender, age, fat free mass, spasticity, cramps, and fasciculations. We analyzed data from 80 ALS patients from a 48-week non-interventional longitudinal multicenter nutrition study with long term follow-up. The overall mean CK was 214 ± 191.8 U/l (range 22-1992 U/l). Forty-five percent of patients had at least one high CK value (> 200 U/l), and about half maintained a high CK value, but there was no trend over the study period. Male gender and extremity onset were significantly associated with high CK. In univariate analysis, age, bioelectric impedance spectroscopy (BIS) fat free mass, spasticity, and fasciculations were not associated with CK level. There was an association between CK and muscle cramps (p < 0.001). In survival analysis, low CK (≤ 200 U/l) was associated with a longer overall survival (p = 0.02), when adjusting for location of onset, age, race, gender, BIS fat free mass, and study site. In conclusion, CK may be a useful marker for ALS survival, which has implications for clinical care and the design of future clinical trials.
authors: a Department of Neurology , University of Utah , Salt Lake City , Utah , USA.
authors: Summer B
authors: SB
authors: Gibson
authors: b Department of Neurology , University of Kentucky , Lexington , Kentucky , USA.|c Neurology Service, Lexington VA Medical Center , Lexington , Kentucky , USA.|d Graduate Center for Nutrition, University of Kentucky , Lexington , Kentucky , USA.|e Graduate Center for Toxicology, University of Kentucky , Lexington , Kentucky , USA.
authors: Edward J
authors: EJ
authors: Kasarskis
authors: f Department of Internal Medicine , University of Utah , Salt Lake City , Utah , USA.|g Huntsman Cancer Institute , Salt Lake City , Utah , USA.
authors: Nan
authors: N
authors: Hu
authors: a Department of Neurology , University of Utah , Salt Lake City , Utah , USA.
authors: Stefan-M
authors: SM
authors: Pulst
authors: h Department of Biostatistics , College of Public Health, University of Kentucky , Lexington , Kentucky , USA.|i Sanders Brown Center on Aging, University of Kentucky , Lexington , Kentucky , USA.
authors: Marta S
authors: MS
authors: Mendiondo
authors: j Departments of Chemistry and Medicine , University of Vermont , Burlington , Vermont , USA.
authors: Dwight E
authors: DE
authors: Matthews
authors: k Department of Neurology , Columbia University , New York , NY , USA.
authors: Hiroshi
authors: H
authors: Mitsumoto
authors: l Department of Neurology , University of Vermont , Burlington , Vermont , USA.
authors: Rup
authors: R
authors: Tandan
authors: m Department of Neurology , Pennsylvania State University , Hershey , Pennsylvania , USA.
authors: Zachary
authors: Z
authors: Simmons
authors: h Department of Biostatistics , College of Public Health, University of Kentucky , Lexington , Kentucky , USA.|i Sanders Brown Center on Aging, University of Kentucky , Lexington , Kentucky , USA.|n Department of Statistics , College of Arts and Science, University of Kentucky , Lexington , Kentucky , USA.
authors: Richard J
authors: RJ
authors: Kryscio
authors: a Department of Neurology , University of Utah , Salt Lake City , Utah , USA.
authors: Mark B
authors: MB
authors: Bromberg
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000097:blood* / Q000150:complications / Q000401:mortality / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001823:Body Composition; D003402:Creatine Kinase / Q000097:blood*; D018450:Disease Progression; D017097:Electric Impedance; D005207:Fasciculation / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009120:Muscle Cramp / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D009128:Muscle Spasticity / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D011379:Prognosis; D012737:Sex Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003402:Creatine Kinase
keywords: CK; amyotrophic lateral sclerosis; biomarker; cramps; fasciculations