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Creatine Kinase Clinical Considerations: Ethnicity, Gender and Genetics
UNIFORMED SERVICES UNIV OF THE HEALTH SCIENCES BETHESDA MD DEPT OF MILITARY AND EMERGENCY MEDICINE
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Exertional rhabdomyolysis ER, or breakdown of skeletal muscle during exercise, is a potentially life-threatening event. ER can affect Warfighters in multiple settings, yet approaches for identifying persons susceptible to or at risk for ER have not been identified. Despite marked variability in baseline serum creatine kinase CK, individual CK values are typically used to both diagnose and manage ER. Factors that may affect CD include ethnicity, gender, and genetics. One candidate gene for CK levels is the interleukin-6 IL-6 gene, which codes for the cytokine, IL6. The purpose of this study was to investigate the contributions of ethnicity, gender, and genetics, in particular the IL-6 polymorphism, to variability in baseline CK. Baseline blood samples were obtained for measuring serum CK and genomic DNA was extracted from peripheral blood leukocytes to genotype participants for the C-174G IL-6 polymorphism. Among the cohort of 841 men and women, 610 were CaucasiansCA 44 African AmericansAA 17 AsiansAS and 36 HispanicsHI, with a mean age of 22.8 b4.9 years. Mean baseline CK for this population was 212 546 SD UL, with a minimum of 20 and maximum of 9,500 UL. Mean CK was significantly higher in African Americans p0.01 665 b1,482 UL compared to CA 180 367 UL, AS 254 b870 UL and HI 214 115 UL, and lower in women 133 118 UL than men 234 b615 UL. Interestingly, those with the GG genotype had significantly higher baseline CK levels relative to the C group C 165 b141 UL vs. GG 294 b874 UL p 0.05. Finally, the distribution of the IL-6 polymorphism differed by ethnicity 77.3 of AA had the GG genotype as compared 34.7, 60.4, and 55.6 of CA, AS, and HI, respectively p0.001.
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