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A Journal on Internal Medicine and Pharmacology


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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2014 May;173(5):283-9

language: English

Effects of an extreme endurance ultra-marathon on musculoskeletal and hematologic functions

Shin K. 1, Jee H. 2, Lee Y. 3, Kim T. K. 4, Kim H. S. 5, Park Y. 6, Kim Y. 6

1 Department of Clinical Laboratory Science, Shinsung University, Chungnam, Republic of Korea;
2 Department of Health & Fitness Management, Namseoul University, Cheonan‑Si, Republic of Korea;
3 Department of Exercise Physiology, Korea National Sport University, Seoul, Republic of Korea;
4 Department of Rehabilitation, Hanyang University College of Medicine, Seoul, Republic of Korea;
5 Department of Rehabilitation, Ilsan Hospital, National Health Insurance Corporation, Goyang‑si, Republic of Korea;
6 Department of Rehabilitation, Sanggye‑Paik Hospital Medicine, Inje University, Seoul, Republic of Korea


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AIM: The aim of this paper was to observe the biological responses of muscles and the liver during a 308 km ultra-marathon race.
METHODS: Blood was drawn from 15 middle-aged amateur runners at the baseline, 100 km, 200 km, and 308 km checkpoints for the analysis of CK, LDH, AST, ALT, γ-GTP, ALP, total bilirubin, direct bilirubin, total protein, and albumin.
RESULTS: CK significantly increased at all checkpoints from baseline, without a significant difference between 200 km and 308 km checkpoints. LDH significantly increased at all checkpoints from baseline, without significant differences at 200 km and 308 km from 100 km, and at 308 km from 200 km. AST significantly increased at all checkpoints from baseline, without a significant difference at 200 km and 308 km. Significant differences were not observed for γ-GTP and ALP at all checkpoints. Total bilirubin significantly increased from 200 km to 308 km, without a significant difference from baseline to 100 km, or from 200 km to 308 km. Direct bilirubin significantly increased at all checkpoints from baseline, without a significant difference between 200 km and 308 km. Total protein and albumin significantly decreased at 200 km and 308 km from baseline, without a significant difference from baseline to 100 km or from 200 km to 308 km.
CONCLUSION: 308 km ultra-marathon induced musculoskeletal damage with a functional decline in the liver resulting in a reduction in protein production and intravascular hemolysis without hepatocellular damage.

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