Serum Uric Acid,Creatinine And Creatine Kinase In Patients With Amyotrophic Lateral Sclerosis And Their Relationships With Disease Progression

Objective:To investigate the levels of serum creatinine,uric acid and creatine kinase in patients with amyotrophic lateral sclerosis and their relationships with disease progression.Methods:A total of 67 patients with amyotrophic lateral sclerosis who were hospitalized in the Jiangxi Provincial People’s Hospital from December2019 to November 2021 were included as the case group and 67 healthy check-up in the physical examination center as the control group.The general data were collected,including name,age,sex,height,weight,course of disease,site of onset,past history,family history and medication.Creatinine,Uric acid and creatine kinase were recorded at admission.ALS Functional Rating Scale-revised(ALSFRS-R)was used to evaluate the severity of the disease,the Body Mass Index(BMI)and disease progression rate(ΔFS)were calculated.The patients in ALS group and control group were divided into two groups according to sex and location of onset,then the levels of creatinine,uric acid,creatine kinase and BMI in case group and control group were compared by independent samples t-Test.Spearman(abnormal distribution)/Pearson(normal distribution)correlation analysis and logistic regression were used to analyze the correlation between uric acid,creatinine,creatine kinase,BMI and the progression rate of ALS disease.SPSS26.0 was used for statistical analysis.Results:1.The level of serum creatinine in ALS group(51.41 ±12.17)umol/L was significantly lower than that in the control group(65.39 ±14.63)umol/L(P<0.01).After stratification according to sex,serum creatinine in male patients(55.46 ±13.20)umol/L was significantly lower than that in the control group(71.57 ±15.38)umol/L(P< 0.01),and in female patients(46.10 ±8.20)umol/L was significantly lower than that in the control group(58.53 ±10.29)umol/L(P < 0.01),The number of male patients was significantly lower than that of female patients,and the difference was statistically significant(P< 0.05).After stratification according to the site of onset,there was no significant difference in serum creatinine between the two groups(P>0.05).After grouping according to the course of disease,the number of male patients with short course of disease was significantly higher than that of male patients with long course,and the difference was statistically significant(P < 0.05).The correlation coefficient between serum creatinine and ALS disease progression rate in male patients was0.142(P > 0.05),and that between serum creatinine and ALS disease progression rate in female patients was 0.151(P>0.05).2.The level of serum uric acid in ALS group(288.44 ±61.31)umol/L was significantly lower than that in the control group(306.66 ±54.49)umol/L(P > 0.05).After stratification by sex,serum uric acid in male patients(306.25 ±46.99)umol/L was significantly lower than that in normal controls(331.71 ±38.39)umol/L(P<0.05),while in female patients(265.10 ±70.34)umol/L was lower than that in normal controls(279.25±56.74)umol/L(P > 0.05).The level of male patients was significantly higher than that of female patients,and the difference was statistically significant(P < 0.05).After stratification according to the site of onset,there was no significant difference in serum uric acid between the two groups(P > 0.05).After stratification according to different course of disease,there was no significant difference in uric acid between the two groups(P > 0.05).The correlation coefficient between uric acid and ALS disease progression rate in male patients was 0.353(P < 0.05),while that between uric acid and ALS disease progression rate in female patients was0.107(P > 0.05).It was considered that there was a weak correlation between uric acid and disease progression in male patients with ALS.3.The serum creatine kinase(161.60 ±94.89)IU/L in the ALS group was significantly higher than that in the control group(83.04 ±31.14)IU/L(P<0.01).After stratification by sex,the level of serum creatine kinase in male patients(188.50 ±106.16)IU/L was significantly higher than that in normal controls(91.2 ±31.50)IU/L(P< 0.01),and in female patients(126.35 ±63.73)IU/L was significantly higher than that in normal controls(74.11 ±28.61)IU/L(P<0.01).The level of male patients was significantly higher than that of female patients,and the difference was statistically significant(P<0.05).After stratification according to the location of onset,the level of serum creatine kinase in female bulbar onset group was higher than that in female limb onset group(P < 0.05).After stratification according to different course of disease,there was no significant difference in the level of creatine kinase in each group(P > 0.05).The correlation coefficient between creatine kinase and ALS disease progression rate in male patients was 0.614(P < 0.05),and that between creatine kinase and ALS disease progression rate in female patients was 0.577(P<0.05).It was considered that there was a positive correlation between serum creatine kinase level and ALS disease progression rate in ALS patients.4.Multivariate regression analysis showed that CK in male patients with ALS(OR=1.021,95%CI:1.005-1.038,P<0.05)、CK in female patients(OR=1.035,95%CI:1.007-1.063,P < 0.05)and age of female patients(OR=0.155,95%CI:1.014-1.345,P<0.05),these suggested that the level of CK in patients with ALS and age of female patients were related to disease progression and might be one of the independent factors affecting disease progression in ALS.Conclusion:The SCr level of ALS patients was lower than that of healthy controls,which was not significantly related to the disease progression rate;the UA level of male patients with ALS was lower than that of healthy controls and positively correlated with the disease progression rate of ALS;the CK level of ALS patients was higher than that of healthy controls and positively correlated with the disease progression rate of ALS,which was one of the independent factors affecting the disease progression of ALS.