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. 1999 Sep;58(9):541–545. doi: 10.1136/ard.58.9.541

Decreased serum biochemical markers of muscle origin in patients with ankylosing spondylitis

E Giltay 1, D van Schaardenburg 1, L Gooren 1, P Kostense 1, B Dijkmans 1
PMCID: PMC1752948  PMID: 10460186

Abstract

OBJECTIVES—There is a lack of unanimity about (increased) serum levels of creatine kinase (CK) in patients with ankylosing spondylitis (AS), perhaps because of the inclusion of inappropriate controls. Therefore, serum levels of biochemical markers of muscle origin were assessed in AS patients compared with controls.
METHODS—In a comparative study serum levels of sarcoplasmic proteins indicating muscle cell leakage, creatinine, and C reactive protein (CRP) were measured. Fifty eight AS patients with a mean disease duration of 22 (SD 11) years and 58 age and sex matched controls (without back complaints) were included.
RESULTS—Lower serum levels in AS patients compared with controls were found for CK (mean (SD): 46 (21) v 76 (44) IU/l; p<0.001), aldolase (0.43 (0.36) v 0.58 (0.32) IU/l; p=0.001), creatinine (91 (13) v 96 (11) µmol/l; p=0.02), alanine aminotransferase (2.8 (1.5) v 4.1 (2.9) IU/l; p=0.001) and aspartate aminotransferase (7.0 (2.7) v 8.4 (3.5) IU/l; p=0.02). Also the lean body mass, as estimated by a formula using height, weight, age and sex, showed lower values in patients versus controls (56 (9) v 59 (9) kg; p=0.004), but creatinine clearance (by Cockcroft and Gault formula) was not different (p=0.48). Partial correlation coefficients adjusted for age and sex showed that CRP levels correlated negatively with CK and aldolase levels in AS patients (r= −0.48, p<0.001 and r= −0.37, p=0.005, respectively).
CONCLUSION—Serum levels of biochemical markers of muscle origin were lower in AS patients compared with controls. Patients with active AS, as reflected by high CRP levels, may have an increased protein degradation, predominantly in skeletal muscle.



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Figure 1  .

Figure 1  

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Scatter plot showing the association between LBM using the formula of Deurenberg et al19 and the LBM estimated by BIA20 in 44 healthy men and 30 healthy women. Spearman's correlation coefficient is given, as well as a dotted line of equality on which all points would lie if the two estimates gave the same results.

Figure 2  .

Figure 2  

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Serum levels of creatine kinase (on a logarithmic scale), aldolase, creatinine, aspartate aminotransferase and alanine aminotransferase, and the estimated lean body mass by a formula of Deurenberg et al,19 in 58 patients with ankylosing spondylitis compared with 58 age and sex matched controls. The p values were assessed by t tests for paired samples.

Figure 3  .

Figure 3  

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Scatter plot showing the association between C reactive protein level on a logarithmic scale and serum creatine kinase and aldolase in 58 patients with AS (in 48 men and 10 women). Partial correlation coefficients, adjusted for age and sex, and univariate regression lines are given.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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