Creatine is a nitrogen-containing organic acid produced mainly in the kidney and liver and stored in high-energy-consuming tissues such as skeletal muscle and brain tissue. Creatine-phosphate (creatine-phosphate or creatine phosphate) is involved in the synthesis of adenosine triphosphate (ATP), which is the energy source of many metabolic processes in cells.
Creatine is mainly synthesized in the liver, kidney and pancreas, involving two-step enzymatic reactions. The first step is to synthesize guanidinoacetate (GAA) from arginine and glycine catalyzed by L-arginine-glycine amidine transferase (AGAT). The second step is the formation of creatine by GAA and S-adenosylmethionine catalyzed by GAMT. Creatine is mainly absorbed by brain, muscle and other tissues (via CT). Finally, creatinine is converted to creatinine by non-enzymatic reaction and is excreted from urine. Hypercreatine kinase (HCK) is common in various neuromuscular diseases. Generally speaking, the discovery of hypercreatine kinase (HCK) in the blood, especially the continuous increase, often indicates problems in the muscular system. Generally accompanied by the clinical manifestations of muscle involvement, but some patients with hyperCK have no clinical manifestations of muscle involvement, or only manifest atypical symptoms of muscle involvement such as myalgia, cramps, muscle stiffness, but no typical symptoms of muscle involvement, such as muscle weakness, pseudohypertrophy, muscle atrophy, myotonia, etc. When hypercreatine kinase is found, it is necessary to go to the hospital in time. It is suggested that the neuromuscular outpatient doctor in the Department of neurology should make a careful evaluation to determine the cause of hypercreatine kinase. There are many drugs to reduce creatine kinase in clinic. Instead of simply using creatine kinase, we should find out the reasons and treat them accordingly. Because the simple reduction of creatine kinase can not change the development of the disease, sometimes it masks the condition. The rise
