“…Another factor that has to be taken under consideration when measuring serum myostatin is physical activity of the patients. Results of most recent studies suggest that physical exercise attenuates myostatin gene and protein expression in skeletal muscles directly after training [ 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 ], while a decrease of physical activity achieved by daily step reduction increased myostatin mRNA expression [ 135 ]. In most studies, serum myostatin levels were found to increase acutely after various exercise types (ultramarathon, aerobic, resistance and high-intensity training) [ 136 , 137 , 138 , 139 , 140 , 141 ], and decrease in the long term as a result of physical training [ 90 , 142 , 143 , 144 , 145 , 146 ].…”