Extended report
Decreased serum biochemical markers of muscle origin in
patients with ankylosing spondylitis
Erik J Giltaya, Dirkjan van Schaardenburgd, Louis J G Goorena, Piet J Kostensec, Ben A C Dijkmansb
a Institute of
Endocrinology, Reproduction and Metabolism, b Department of Rheumatology, c Department of Clinical Epidemiology
and Biostatistics, d University
Hospital Vrije Universiteit, Amsterdam, the Netherlands
Department of Rheumatology, Jan van Breemen
Institute, Amsterdam, the Netherlands
Correspondence to: Dr E J Giltay, Department of Endocrinology/Division of Andrology, University Hospital Vrije Universiteit, PO Box 7057, 1007 MB, Amsterdam, the Netherlands.
Accepted for publication 12 April 1999
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.
METHODSIn 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.
RESULTSLower 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).
CONCLUSIONSerum
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.
© 1999 by Annals of the Rheumatic Diseases
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