Effects of prolonged strenuous exercise (marathon running) on biochemical and haematological markers used in the investigation of patients in the emergency department

Abstract

Objectives: To investigate the effects of strenuous exercise on commonly used biochemical and haematological variables in subjects running the 2002 London marathon. Methods: 34 healthy volunteers (7 female, 27 male) were recruited for the study. Blood was taken before the start (at registration) and immediately after completion of the marathon. Samples were analysed for urea and electrolytes, liver function tests, creatine kinase (CK), CK-MB isoenzyme, myoglobin, troponin I, full blood count, a clotting screen, and D-dimers. The results before and after exercise were compared. Pearson's correlation coefficients were calculated for all variables. Results: Significant increases were found in CK, CK-MB, aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and myoglobin following the marathon. However, there was no significant change in the level of troponin I. There was also evidence of activation of the coagulation and fibrinolytic cascades following the marathon, with a reduction in activated partial thromboplastin time, a reduction in fibrinogen, and an increase in D-dimers. Conclusions: The results confirm previous individual studies on marathon running and the biochemical and haematological tests routinely carried out in hospital. These are affected by prolonged exercise, and ''abnormal'' results in these tests may be normal after prolonged exercise and therefore not diagnostic of a disease process. The results of investigations in patients who have been exercising should be interpreted with caution.

Early changes of the anemia phenomenon in male 100-km ultramarathoners

“…1,2,5 In the literature, there are remarkable findings reporting significant changes of Hb, hematocrit, and RBC count in runners who strenuously push themselves during a marathon race, with mean cell volume (MCV) and mean cell Hb (MCH) negligibly affected. 6,7 "Foot strike hemolysis", a condition that develops from RBC destruction in the feet due to frequent striking on hard surfaces, has been proposed to explain the low level of haptoglobin in endurance runners. 5,8 Athletes can also lose considerable quantities of iron due to bleeding from the gastrointestinal and urinary tracts.…”

Changes in blood morphology and chosen biochemical parameters in ultra-marathon runners during a 100-km run in relation to the age and speed of runners

“…Blood samples analysed for indexes of liver and muscle damage, expressed as the percentage change in the blood plasma volume, were calculated following the indexes of Dill and Costill [9]. Reference values for the tested indexes were: red blood cells (RBC) (4.4-6 [30]. Blood samples were collected from the ulnar vein just before the run, after 25 km, 50 km, 75 km, and 100 km, as well as 12 h and 24 h after the end of the run.…”

Verificação do dano muscular através da avaliação da concentração de creatina quinase em indivíduos não atletas após prova de ciclismo não competitivo

“…Ao final do treinamento, os três grupos realizaram uma corrida de 22,4 km onde foi constatada uma elevação significativa dos níveis de CK apenas no grupo que não treinou durante os 30 dias. Smith et al [15], ao analisarem os efeitos do exercício prolongado em uma prova de maratona, encontraram correlação positiva entre o nível de condicionamento físico (mensurado através do tempo de realização da prova) e os níveis de CK avaliados após a maratona. Os dados apontaram menor liberação de CK nos atletas mais condicionados e maiores níveis de CK em atletas menos condicionados.…”