Evidence of Clinical Pathology Abnormalities in People with ME/CFS from an Analytic Cross-Sectional Study

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Evidence of Clinical Pathology Abnormalities in People with ME/CFS from an Analytic Cross-Sectional Study

Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating disease presenting with extreme fatigue, post-exertional malaise, and other symptoms. In the absence of a diagnostic biomarker, ME/CFS is diagnosed clinically, although laboratory tests are routinely used to exclude alternative diagnoses. In this analytical cross-sectional study, we aimed to explore potential haematological and biochemical markers for ME/CFS, and disease severity. We reviewed laboratory test results from 272 people with ME/CFS and 136 healthy controls participating in the UK ME/CFS Biobank (UKMEB). After corrections for multiple comparisons, most results were within the normal range, but people with severe ME/CFS presented with lower median values (p < 0.001) of serum creatine kinase (CK; median = 54 U/L), compared to healthy controls (HCs; median = 101.5 U/L) and non-severe ME/CFS (median = 84 U/L). The differences in CK concentrations persisted after adjusting for sex, age, body mass index, muscle mass, disease duration, and activity levels (odds ratio (OR) for being a severe case = 0.05 (95% confidence interval (CI) = 0.02-0.15) compared to controls, and OR = 0.16 (95% CI = 0.07-0.40), compared to mild cases). This is the first report that serum CK concentrations are markedly reduced in severe ME/CFS, and these results suggest that serum CK merits further investigation as a biomarker for severe ME/CFS.
 
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most results were within the normal range, but people with severe ME/CFS presented with lower median values (p < 0.001) of serum creatine kinase (CK; median = 54 U/L), compared to healthy controls (HCs; median = 101.5 U/L) and non-severe ME/CFS (median = 84 U/L).
@nanonug - this is really really interesting. What a simple test, easily and cheaply performed I would think!

I wonder though about the discrepancy between that study and this one, which found in pertinent part:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2964609/
The plasma creatine kinase levels before and 24 h after exercise were low in patients and controls, suggesting normality of the muscular mitochondrial oxidative phosphorylation.
I'm not a scientist and don't know if I'm comparing apples to oranges here. But it appears that in the first study, people with ME/CFS have lower serum creatine kinase than healthy controls, and the more severely ill, the lower the CK.

The second study seems to be saying they found no difference in CK levels between persons with ME/CFS and healthy controls.

The first study does refer to serum CK and the second study uses plasma - I don't know if that's significant.

Can anyone help make sense of this?