Original article
Significant variation of traditional markers of liver injury after a half-marathon run

https://doi.org/10.1016/j.ejim.2011.02.007Get rights and content

Abstract

Background

While the promotion of health-related fitness is thereby widespread, less focus is currently being given on the biological influence that physical activity might exert on results of laboratory testing. As such, this study was undertaken to assess the kinetics of liver injury markers following physical exercise.

Design and methods

Total and direct bilirubin as well as the activity of biochemical markers of liver injury including aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), gamma-glutamyl transpeptidase (GGT) and creatine kinase (CK), were measured before and after a half-marathon.

Results

Significant increases occurred for GGT, AST, LDH, CK, total and direct bilirubin immediately after the run. AST, LDH, CK, total and direct bilirubin were still increased 24 h thereafter, whereas GGT decreased after 6 h. None of the athletes exceed the upper reference limit for ALT, ALP and GGT, whereas significant variations were instead observed for LDH, AST, CK, total and direct bilirubin.

Conclusions

Taken together, the results of our prospective investigation clearly attest that an acute bulk of aerobic physical exercise, such as a half-marathon, might produce significant changes in the activity of traditional biomarkers of liver injury, which should be carefully considered when investigating physically active individuals undergoing laboratory testing.

Introduction

Physical activity is one of the leading examples of how lifestyle has a profound effect on health. The current recommendations, endorsed by a variety of scientific societies and healthcare organizations such as the U.S. Department of Health and Human Services (HHS), the American Heart Association (AHA) and the American College of Sports Medicine (ACSM), advocate that all subjects should engage in regular physical activity to improve overall health and to reduce risk of various health problems including cardiovascular disease, cancer, osteoporosis and type 2 diabetes [1]. While the promotion of health-related fitness is thereby widespread, less focus is currently being given on the biological influence that physical activity might exert on results of laboratory testing. In particular, we measured the catalytic concentration (activity) of traditional markers of liver injury in 15 athletes performing a half-marathon run endurance running, since little information is available on the kinetics of these markers after this form of endurance exercise.

Section snippets

Materials and methods

The study population consisted of 15 healthy trained Caucasian males, (mean age: 47 years, range: 36–56 years), engaged in specific endurance training for at least 5 years (mean training regimen: 287 ± 25 min/week; maximal oxygen uptake, VO2: 65 ± 5 ml/kg/min). The athletes performed a 21-km, half-marathon, equipped with a heart rate (HR) monitor under competitive conditions (85 ± 3% VO2 max). Baseline blood samples (pre) were collected at fast, after a 48 h rest from the last training, 30 min before the

Results

The results of the present investigation are shown in Table 1. Due to dehydration, the athletes had a substantial decrease in body weight immediately after the race (− 8.8%), which was also accompanied by a modest increase in GGT (+ 6%) and AST (+ 10%), as well as by a more prominent increase in CK (+ 38%), LDH (+ 23%), total (+ 45%) and direct bilirubin (+ 50%). The activity of AST, LDH, total and direct bilirubin persisted increased up to 24 h after the run, whereas that of GGT after 6 h returned to

Discussion

There is only one study assessing the variation of traditional biomarkers of liver injury after endurance physical exercise to the best of our knowledge. Soeder et al. previously investigated 11 males participating in the Berlin marathon 1986 and observed that the activity of CK, LDH, ALT, and AST increased directly after the run or on the three following days, whereas that of GGT decreased directly after the run [3]. Nevertheless, no data are available on the 21-Km distance running, which

Learning points

  • A moderate physical exercise, such as a half-marathon, produces significant changes in the activity of traditional biomarkers of liver injury.

  • These changes should be carefully considered when investigating physically active individuals undergoing laboratory testing.

Conflict of interest

I declare that none of the authors of this paper has any actual or potential conflict of interest including any financial, personal or other relationships with other people or organizations within three years of beginning the submitted work that could inappropriately influence, or be perceived to influence, their work.

References (5)

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