Abstract
Elevated levels of Creatine Kinase-MB (CK-MB) Isoenzyme are a common phenomenon among rotavirus (RV) diarrhea. However, few studies have addressed this issue using large sample size. In current study, 1,118 children (age <5 years) hospitalized with diarrhea in Guangzhou Women and Children’s Medical Center from 2012 to 2015 were finally included. Changing pattern of CK-MB and its relationship with RV-infection were analyzed and characterized. Multivariate linear regression models showed that RV-positive cases had a 28% rise in CK-MB compared to RV-negative cases (OR = 1.28, 95% CI: 1.15 to 1.41, P < 0.01) after controlling for age, gender, season of admission, and weight. The pattern of change showed that CK-MB level of RV-positive group started to rise immediately at the 1st day of diarrhea, reached the peak on days 2 to 4, declined during 4–9 days, and then reached a relatively stable level when compared to the RV-negative group. Mediation analyses showed that indirect effect of RV infection on the increase of CK-MB via Vesikari score was significant (β = 8.01, P < 0.01), but direct effect was not (β = 9.96, P = 0.12). Thus, elevated CK-MB value is a common finding in RV-infection and completely mediated by the severity of diarrhea. CK-MB monitoring may help to identify children with more severe viral infection.
Highlights
Death[2, 12, 13]
Exploratory analysis showed that both Creatine Kinase-MB Isoenzyme (CK-MB) and CK were significantly higher among RV-positive group than that of RV-negative group
We found that geometric means (GMs) of CK-MB increased dramatically at the first day of onset of diarrhea in the RV-infected children
Summary
Death[2, 12, 13]. Creatine Kinase-MB Isoenzyme (CK-MB), one form of the myocardial fraction of creatinine phosphokinase, was used extensively as an indication for myocardial damage. An elevation in CK-MB is a significant predictor of adverse heart events and was found to be correlated with myocardial infarct size[14, 15]. Recent studies suggested that RV infection may cause an increase in CK-MB Isoenzyme. Shi et al demonstrated that elevated CK-MB were found among 55% of the RV infected Chinese children aged 2–48 months[16], which was subsequently confirmed by Li et al.[17]. Current evidence for the potential relationship between RV infection and CK-MB (or CK) has been mainly based on small sample size. The determination of whether there is such an association has potential importance for managing RV infection, for preventing of adverse events, and for understanding mechanisms of severe complications caused by RV. A more comprehensive study with larger sample size and proper design was performed to (1) assess the association between RV infection and the level of CK-MB; (2) to explore the dynamic changes of CK-MB after RV infection; and (3) test this type of association: direct or indirect
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