What is Creatine Kinase (Ck)? How Many Should It Be? Low and High Causes

Due to the various ailments we experience throughout our life, we may need to apply to a healthcare institution for diagnosis and treatment services. During these services, physicians may benefit from some imaging and laboratory tests if they deem necessary. One of the tests carried out in this context in health institutions is the creatine kinase test or creatine kinase test, also known as CK.

What is Creatine Kinase (CK)?

Creatine; It is an important protein in the structure of muscle cells, especially in skeletal and cardiac muscles. Muscle cells require large amounts of energy to perform their contractile function. Although this energy is obtained mainly by the use of foodstuffs that are gained to the body through nutrition; Energy that may be required during contraction may need to be stored in muscle cells in various forms. One of these forms of energy stored in muscle cells is creatine phosphate.

Creatine protein, thanks to its unique structure; When combined with the phosphate molecule as a result of various biochemical reactions occurring in muscle cells, it becomes an energy store. In this way, some of the energy needed by muscle cells during sudden contractions is provided by creatine phosphate. Here, the main enzyme responsible for the production of the creatine phosphate molecule is creatine kinase (CK) or creatine phosphokinase (CPK).

Creatine kinase, which is indispensable for the physiology of muscle cells; Due to various ailments and conditions, it can enter the blood as a result of the deterioration of the integrity of the muscle cells. As a result, the amount of creatine kinase in the blood is greatly increased. In clinical applications, important data can be obtained in the diagnosis of various diseases by measuring the level of creatine kinase in the blood. These subforms, called isoenzymes; It provides the fulfillment of various functions from a biochemical point of view by being specialized for different tissues. In the clinic, thanks to isoenzymes, it is possible to detect the affected tissue according to the isoenzyme form in which the amount changes.

In this sense, creatine kinase has three basic isoenzymes identified so far. The following have been identified as creatine kinase isoenzymes.

a.Creatine fos phokinase-1 (CPK-1) or CK-BB: It is a form of isoenzyme that is more common in the body, originally in the brain and lung tissues. Because; It increases more in diseases affecting these tissues.

b.Creatine phosphokinase-2 (CPK-2) or CK-MB: This isoenzyme, especially located in heart muscle cells, increases in the blood in major heart diseases.

br>c.Creatine phosphokinase-3 (CPK-3) or CK-MM: It is the main isoenzyme in skeletal muscles. In this direction, it is the main isoenzyme form whose blood level rises in muscle diseases.

What is the Danger Limit for Creatine Kinase?

In order to evaluate the change in blood level of creatine kinase as clinically meaningful, reference values ​​in the blood must be determined. measurement must be determined. Since there is a difference in muscle mass between the sexes, the reference range for total creatine kinase measured in men is between 39 and 308 U/L; in women, it is considered to be between 26 – 192 U/L values.
However, together with the total creatine kinase value; Reference values ​​of related isoenzymes also have an important place in the diagnosis. In this regard, the reference range for the CK-MB isoenzyme, which provides meaningful data for diagnosis in the clinic and which is especially used for measurement; in the range of 0 – 4.9 ng/mL when the measured total CK value is below 500 U/L; When it is above 500 U/L, it is determined as 0.0 – 1.0% of the CK value. According to the isoenzyme form that increases with the creatine kinase value, it can be mentioned that there are various disorders in the body. For this reason, it would be appropriate for a specialist physician to evaluate CK values ​​that are determined to be high according to laboratory results.

What is Creatine Kinase Elevation?

Creatine kinase enzyme is used for skeletal and cardiac muscles in the body. Since it is one of the basic cellular elements, the level of creatine kinase in the blood increases due to the presence of various factors or health problems that cause damage to these cells. The specific creatine kinase isoenzyme form associated with the affected tissue is elevated. In other words; Detection of elevated creatine kinase in the blood usually indicates muscle breakdown in the body.
However, ; Especially in muscle diseases, creatine kinase alone is not a sufficient measure for clinical diagnosis. As a result of scientific research, different tests have been defined to help clinical diagnosis and various diagnostic criteria have been defined by means of guidelines. In this regard, various biochemical products containing electrolytes such as troponin, creatinine or potassium are examined together with creatine kinase to establish and confirm the correct diagnosis. since it is based on the measurement of total CK level and isoenzymes; High levels of creatine kinase in the blood may indicate many different disorders. In this direction, the presence of the following diseases should be suspected according to the creatine kinase isoenzyme form that increases in the blood: When the
CK-BB form is elevated, there are usually problems related to the nervous system and lung. In this sense, the following reasons may be effective:

• Cerebral-vascular diseases such as stroke
• Seizures in epilepsy type
• Brain tumors
• such as pneumonia lung and lower respiratory tract infections

When the CK-MB form is elevated, cardiac problems should be investigated. The following problems are suspected when the CK isoenzyme CK-MB, which is the most frequently measured isoenzyme, is measured in the clinic.

• Heart attack due to cardiovascular diseases
• Infectious diseases such as myocarditis that cause inflammation in the heart muscle
• Physical traumas that cause damage to the heart muscle

When the CK-MM form is elevated, skeletal muscle problems are often the case. CK-MM is usually associated with high total creatine kinase levels. In this regard, the following problems may be the underlying cause:

• Severe physical traumas leading to crushing or destruction of muscle tissue
• Destruction of muscle tissue due to prolonged inactivity
• Muscle after exercise of mouth destruction of muscle tissue
• Infections or some chronic diseases affecting muscle tissue
• Genetic muscle diseases such as Duchenne Muscular dystrophy
• Some rheumatological diseases such as polymyositis or dermatomyositis
• Malignant hyperthermia
• Side effects of various drugs that cause destruction in muscle tissue such as statin
• Intense muscle in muscle groups Epileptic seizures that cause diabetes

What is Low Creatine Kinase?

Since the enzyme creatine kinase is basically associated with muscle mass; The creatine kinase level measured in people whose muscle mass is weakened and decreased for various reasons can be calculated below the reference value. In this regard, the blood creatine kinase level is measured below normal in the following situations:

• Advanced age
• People with a sedentary lifestyle
• Weight loss
• Weak people with low muscle mass
• Advanced periods of diseases such as myasthenia gravis, muscular dystrophy

How to Treat High Creatine Kinase

Since creatine kinase elevation can indicate many different health problems, the correct diagnosis must first be made in order to apply the right treatment. In this regard, patients should be evaluated by a specialist physician with a detailed disease history and a detailed physical examination. When the physician deems necessary, he/she applies additional imaging and laboratory tests and determines the underlying cause definitively in the light of the data he has obtained. You can use the contact form on our website to reach us.

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