DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20171247

Association of creatine kinase and its isoenzymes (CK-MB, CK-BB) activity with high risk pregnancy

Asfia Khan, Brijesh Rathore, Kanchan Singh, Manisha Singh, Aparna Misra

Abstract


Background: Creatine kinase (CK) is a key enzyme of energy metabolism, especially in muscle tissue. CK has two polypeptide chains of M and B, and three isomers, CK-BB, CK-MB and CK- MM. In some conditions like acute myocardial infarction and neuromuscular disorders, increased CK activity is used as a part of diagnosis. CK can also be elevated in absence of neuromuscular diseases or cardiac injury, such as strenuous exercise, intramuscular injections etc. Several reports indicate elevated activity of serum CK in the maternal blood during child birth. This study aimed to correlate total CK and its isoenzymes activity in the cord blood with high risk pregnancies.

Methods: This was a Prospective observational study conducted in the Obstetrics and Biochemistry Department of Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India. Cord blood of 100 full term newborns was collected and serum was analyzed for total CK and its isoenzymes activity by modified IFCC method. SPSS software was used in data analysis.

Results: CK-total and its isoenzymes (CK-MB, CK-BB) activities were observed higher in cases with risk as compared to those without risk. Total CK activity was observed independent while CK-MB and CK-BB were found dependent on different risk factors like pregnancy induced hypertension and fetal distress etc.

Conclusions: Present study revealed that high risk pregnancies are associated with increased total CK, CK-MB as well as CK-BB activity.


Keywords


CK-Isoenzymes, CK-total, High risk pregnancy

Full Text:

PDF

References


Naithani M, Simalti AK. Biochemical Markers in perinatal asphyxia. J Nepal Paediatr Soc. 2011;31(2):151-6.

Wallimann T, Tokarska-Schlattner M, Schlattner U. The creatine kinase system and pleiotropic effects of creatine. Amino Acids. 2011;40(5):1333-48.

Hornikovaa D, Hermanb P, Mejsnarc J, Vecerb J, Zurmanova J. Creatine kinase structural changes induced by substrates. 2009;1794(2):270-4.

Capellan O, Hollander JE, Pollack C Jr, Hoekstra JW, Wilke E, Tiffany B, et al. Prospective evaluation of emergency department patients with potential coronary syndromes using initial absolute CK-MB vs. CK-MB relative index. J Emerg Med. 2003;24(4):361-7.

Voermans NC, de Visser M, Wokke JH, Brusse E. Increased CK activity in serum without symptoms: further investigations often unnecessary. Ned Tijdschr Geneeskd. 2013;157(41):A6315.

Kierdaszuk B, Kamińska A. Elevated plasma creatine kinase activity- does it always indicate muscle disease? Neurol Neurochir Pol. 2012;46(3):257-62.

Brancaccio P, Maffulli N, Mario Limongelli F. Creatine kinase monitoring in sport medicine. Br Med Bull. 2007;81-82(1):209-30.

Roby PV, Glenn CM, Watkins SL , Baxter LM, Kenny MA, Nazar-Stewart V, Mayock DE. Association of elevated umbilical cord blood creatine kinase and myoglobin levels with the presence of cocaine metabolites in maternal urine. Am J Perinatol. 1996;13(8):453-5.

Abramov Y, Abramov D, Abrahamov A, Durst R, Schenker J. Elevation of serum creatine phosphokinase and its MB isoenzyme during normal labor and early puerperium. Acta Obstet Gynecol Scand. 1996;75(3):255-60.

McNeely MDD, Berris B, Papsin FR, Lyons E, Schipper H. Creatine kinase and its isozymes in the serum of women during pregnancy and the peripartum period. Clin Chem. 1977;23(10):1878-80.

Wazir S, Yasmeen S, Parveen S, Nisar S, Parveen S, Chesti S, et al. Reliability of maternal serum creatinine phosphokinase (CPK) in the diagnosis of ectopic pregnancy. JK Sci. 2009;11(2):67-70.

Nakajima Y, Masaoka N. Evaluation of creatine kinase, lactate dehydrogenase, and amylase concentrations in umbilical blood of preterm infants after long-term tocolysis. Obstet Gynecol Int. 2014;2014:278379.

Kocylowski RD, Dubiel M, Gudmundsson S. Biochemical tissue-specific injury markers of the heart and brain in postpartum cord blood. Am J Obstet Gynecol. 2009;200(3):273.e1273.e25.

Sutton TM, O'Brien JF, Kleinberg F, House RF Jr, Feldt RH. Serum levels of creatine phosphokinase and its isoenzymes in normal and stressed neonates. Mayo Clin Proc. 1981;56(3):150-4.

Fonseca E, Garcia-Alonso A, Zárate A, Ochoa R, Galván RE, Jimenez-Solis G. Elevation of activity of creatine phosphokinase (CK) and its isoenzymes in the newborn is associated with fetal asphyxia and risk at birth. Clin Biochem. 1995;28(1):91-5.

Efstratiadis G, Voulgaridou A, Nikiforou D, Kyventidis A, Kourkouni E, Vergoulas G. Rhabdomyolysis updated. Hippokratia. 2007;11(3):129-37.

Rataj J, Kornacka M, Korman E. Usefulness of measuring bilirubin levels in cord blood for predicting hyperbilirubinemia in newborns. Ginekol Pol. 1994;65(6):276-80.

Farhat A, Ghamsari AA, Mohamadzadeh A, Khodadadi A, Rezaei M. Does umbilical cord bilirubin level have predictive value in pathologic neonatal hyperbilirubinemia? Iranian J Neonatol Spring. 2013;4(1):32-5.

Nabavi M, Ghorbani R, Asadi AM, Faranoush M. Factors associated with cord blood IgE levels. Asian Pac J Allergy Immunol. 2013;31(2):157-62.

Kaan A, Dimich-Ward H, Manfreda J, Becker A, Watson W, Ferguson A, et al. Cord blood IgE: its determinants and prediction of development of asthma and other allergic disorders at 12 months. Ann Allerg Asthma Immunol. 2000;84(1):37-42.

Warner A, Jang R. Biochemical measurement in cord blood as an indicator of neonatal maturity. Ann Clin Lab Sci. 1990;20(6):398-408.

Koh D, Hume R, Eisenhofer G, Ogston S, Watson J, Williams F. Maternal and fetal factors which influence cord blood glucose levels in term infants delivered by cesarean section. J Perinat Med. 2015;43(3):339-46.

Manomayangkul K, Siriussawakul A, Nimmannit A, Yuyen T, Ngerncham S, Reesukumal K. Reference values for umbilical cord blood gases of newborns delivered by elective cesarean section. J Med Assoc Thai. 2016;99(5):611-7.

Cleary-Goldman J, Malone FD, Vidaver J, Ball RH, Nyberg DA, Comstock CH, et al. Impact of maternal age on pregnancy outcome. Obstet Gynecol. 2005;105:983-90.

Poma PA. Effect of maternal age on pregnancy outcome. J Nat Med Assoc. 1981;73(11):1031-8.

Hediger ML, Scholl TO, Schall JI, Krueger PM. Young maternal age and preterm labour. Ann Epidemiol. 1997;7:400-6.

Hamad KH, Abed Y, Hamad BA. Risk factors associated with preterm birth in the Gaza strip: hospital based case-control study. La Ravue de Sante de la Mediterranee Orientale. 2007;13(5):1133-41.

Fretts RC, Schmittdiel J, McLean FH, Usher RH, Goldman MB. Increased maternal age and the risk of foetal death. N Engl J Med. 1995;333:953-7.

Petitti DB. The epidemiology of foetal death. Clin Obstet Gynecol. 1987;30:253-8.

Harlap S, Shiono PH, Ramcharan S. A life table of spontaneous abortions and the effect of age, parity and other variables. In: Porter IH, Hook EB, editors. Human embryonic and foetal death. New York: Academic Press; 1980.

Seoud MA, Nassar AH, Usta IM, Melhem Z, Kazma A, Khalil AM. Impact of advanced maternal age on pregnancy outcome. Am J Perinatol. 2002;19(1):1-8.

Peipert JF, Bracken MB. Maternal age: an independent risk factor for cesarean delivery. Obstet Gynecol. 1993;81(2):200-5.

Ecker JL, Chen KT, Cohen AP, Riley LE, Lieberman ES. Increased risk of cesarean delivery with advancing maternal age: indications and associated factors in nulliparous women. Am J Obstet Gynecol. 2001;185(4):883-7.

Chemnitz G, Nevermann L, Schmidt E, Schmidt FW, Lobers J. Creatine kinase (EC-No.2.7.3.2) and creatine kinase isoenzymes during pregnancy and labor and in the cord blood. Clin Biochem. 1979;12(6):277-81.

Abe F, Nagamine Y, Ueda T, Shima K. Creatine kinase activity and its isozyme levels in cord blood. Rinsho Byori. Japanese J Clin Pathol. 1992;40(8):875-80.

Nagdyman N, Kömen W, Ko HK, Müller C, Obladen M. Early biochemical indicators of hypoxic-ischemic encephalopathy after birth asphyxia. Pediatr Res. 2001;49(4):502-6.

Elshal HI, Abdel-Hameed A-ES. Study of serum markers of brain injury as early predictors of neonatal hypoxia/ischemia. Alex J Pedatr. 2005;19(1):77-82.

Nikliński W, Jóźwik M, Pałynyczko Z, Bartnicki J, Urban J. Acid-base status of the newborn in relation to cord blood serum creatine kinase isoenzymes' activities. Biomedica Biochimica Acta. 1989;48(2-3):S200-3.