• Paola Brancaccio, Nicola Maffulli, and Francesco Mario Limongelli.
• Department of Experimental Medicine-Sport Medicine, Centre of Excellence of Cardiovascular Disease, Seconda Università di Napoli, Napoli, Italy. pabranca@libero.it
• Br. Med. Bull. 2007 Jan 1; 81-82: 209-30.

AbstractAREAS OF GENERAL AGREEMENT: Total creatine kinase (CK) levels depend on age, gender, race, muscle mass, physical activity and climatic condition. High levels of serum CK in apparently healthy subjects may be correlated with physical training status, as they depend on sarcomeric damage: strenuous exercise that damages skeletal muscle cells results in increased total serum CK. The highest post-exercise serum enzyme activities are found after prolonged exercise such as ultradistance marathon running or weight-bearing exercises and downhill running, which include eccentric muscular contractions. Total serum CK activity is markedly elevated for 24 h after the exercise bout and, when patients rest, it gradually returns to basal levels. Persistently increased serum CK levels are occasionally encountered in healthy individuals and are also markedly increased in the pre-clinical stages of muscle diseases.

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