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      Comparison of Changes in Biochemical Markers for Skeletal Muscles, Hepatic Metabolism, and Renal Function after Three Types of Long-distance Running : Observational Study

      , PhD, , MD, PhD, , MD, PhD, , MD, , PhD

      Medicine

      Wolters Kluwer Health

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          Abstract

          The purpose of this study is to compare changes in biochemical markers for the skeletal muscles, hepatic metabolism, and renal function based on extreme long-distance running.

          Among healthy amateur endurance athletes who participated in a marathon, 100 km-, or 308 km ultramarathon, 15 athletes with similar physical and demographic characteristics were chosen to be the subjects in this study, upon completion of each course. The subjects’ blood was collected before and after the course to identify biochemical markers for the skeletal muscles, hepatic metabolism, and renal function.

          After all of the courses, creatinine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine transaminase (ALT), blood urea nitrogen (BUN), and creatinine were found to be significantly increased compared with values obtained before the race ( P <0.05 for each marker). CK, LDH, AST, and LDH were significantly higher after completion of the 100 km race than the marathon ( P <0.05) and were significantly higher after the 308 km race than the marathon or 100 km race ( P <0.05). Total protein was significantly lower after the 308 km race than the marathon or 100 km race ( P <0.05). Albumin significantly increased after the marathon but significantly decreased after the 308 km course ( P <0.05). Total and direct bilirubin were significantly increased after the 100 km and 308 km races ( P <0.05), and were significantly higher after the 308 km than the marathon or 100 km course ( P <0.05). BUN was significantly higher after the 100 km race than the marathon ( P <0.05) and was significantly lower after the 308 km than the 100 km race ( P <0.05). Creatinine was significantly higher after the marathon and 100 km than the 308 km race ( P <0.05). Uric acid significantly increased after the marathon and 100 km race ( P <0.05); it was significantly higher after completing the marathon and 100 km than the 308 km race ( P <0.05).

          Muscular damage, decline in hepatic function, and hemolysis in the blood were higher after running a 308 km race, which is low-intensity running compared with a marathon, and a temporary decline in renal function was higher after completing a 100 km race, which is medium-to-high intensity.

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          Biochemical markers of muscular damage.

          Muscle tissue may be damaged following intense prolonged training as a consequence of both metabolic and mechanical factors. Serum levels of skeletal muscle enzymes or proteins are markers of the functional status of muscle tissue, and vary widely in both pathological and physiological conditions. Creatine kinase, lactate dehydrogenase, aldolase, myoglobin, troponin, aspartate aminotransferase, and carbonic anhydrase CAIII are the most useful serum markers of muscle injury, but apoptosis in muscle tissues subsequent to strenuous exercise may be also triggered by increased oxidative stress. Therefore, total antioxidant status can be used to evaluate the level of stress in muscle by other markers, such as thiobarbituric acid-reactive substances, malondialdehyde, sulfhydril groups, reduced glutathione, oxidized glutathione, superoxide dismutase, catalase and others. As the various markers provide a composite picture of muscle status, we recommend using more than one to provide a better estimation of muscle stress.
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            Myofibrillar damage following intense eccentric exercise in man.

            Muscle soreness that has a delayed onset is a common feature among both athletes and untrained individuals who engage in unusual exercises. This study was designed to provide additional morphological data to assess the relevance and significance of our previous findings that the sore muscles contain fibers with disorganized myofibrillar material. Muscle biopsies were obtained from 12 males (mean age 25 +/- 7 years), who suffered from severe soreness in their thigh muscles 18--72 h following eccentric bicycle exercise. Their strength performance were tested in parallel. Knee extensor strength was decreased at all angular velocities soon after exercise but gradually increased over the subsequent days although slower at the fastest contractions. Disturbances of the cross-striated band pattern were constantly observed. They originated from the myofibrillar Z-band, which showed marked streaming, broadening and, at places, total disruption. The disturbances were found in every second to every third fiber up to 3 days after exercise and in one tenth of the fibers 6 days following the exercise. Type 2 fibers were predominantly affected. Thus, the eccentric exercise gives rise to muscles soreness and influences, on mechanical basis and selectively with regard to fiber type, the fine structure of the contractile apparatus.
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              The spectrum of rhabdomyolysis.

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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                May 2016
                20 May 2016
                : 95
                : 20
                Affiliations
                From the Department of Clinical Laboratory Science (K-AS), Shinsung University, Chungnam; Department of Rehabilitation Medicine (KDP), Gachon University Gil Medical Center, Incheon; and Department of Rehabilitation Medicine (JA, YP, Y-JK), College of Medicine, Sanggye-Paik Hospital, Inje University, Seoul, Republic of Korea.
                Author notes
                Correspondence: Y-JK Yongbum Park, Department of Rehabilitation Medicine, College of Medicine, Sanggye-Paik Hospital, Inje University, Nowon-gu, Seoul, South Korea (e-mail: rladudwn1383naver.com, swc328@ 123456naver.com ).
                Article
                03657
                10.1097/MD.0000000000003657
                4902411
                27196469
                Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.

                This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

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                Research Article
                Observational Study
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