Chapter 1 - Metabolic markers in sports medicine
Section snippets
Abstract
Physical exercise induces adaptations in metabolism considered beneficial for health. Athletic performance is linked to adaptations, training, and correct nutrition in individuals with genetic traits that can facilitate such adaptations. Intense and continuous exercise, training, and competitions, however, can induce changes in the serum concentrations of numerous laboratory parameters. When these modifications, especially elevated laboratory levels, result outside the reference range, further
Aminotransferases
Aminotransferases (AST, ALT) are commonly analyzed in serum to assess and monitor liver damage and possible viral infections of the liver. ALT is found mainly in the liver but also in smaller amounts in the kidneys, heart, muscles, and pancreas while AST is present in the liver but in considerable amounts also in other tissues including the muscles.
Studies in the general population and blood donors have shown a clear correlation between ALT concentrations and body weight and BMI (weight in
Creatine Kinase
Strenuous overexertion exercise can result in muscle damage evidenced by delayed-onset muscle soreness, strength loss, weakness, tenderness, and increased blood levels of muscle proteins including CK, lactate dehydrogenase (LDH), and myoglobin (Mb) [27]. Exertional rhabdomyolysis is a clinical condition in which excessive muscle damage can lead to renal failure and is typically described in extreme, ultraendurance exercise [28]. CK and other intramuscular proteins are cleared from the blood by
Creatinine
Serum creatinine concentration is the most widely used and commonly accepted measure of renal function in clinical medicine. Reference values of biochemical parameters specific for athletes have never been defined; those used for the general population, including serum creatinine, are routinely applied to athletes. The common reference range for creatinine in the general population is 0.7–1.3 mg/dL (62–115 μmol/L) for adult males, by using Jaffé reaction in automated systems.
In sports medicine,
Uric Acid
Uric acid (UA) is important in sports medicine because it is the terminal product of purine metabolism and the principal antioxidant in human plasma. Purine metabolism is often increased in athletes due to the high animal protein content in their diet and increased cell turnover.
UA is present in concentrations higher than those of ascorbate and accounts for 60% of serum free radical scavenger capacity. During metabolic stress, UA blocks peroxyl radicals and hydroxyl radicals and probably also
Glucose
Physical exercise needs energy. The first source of energy is the glycogen stored in the skeletal muscles and liver. Glycogen is enzymatically cleaved to release glucose molecules which enter the glycolysis pathway. Aerobic and anaerobic glycolysis produces adenosine triphosphate (ATP) utilized by the muscles. Glucose is continuously consumed to supply energy, and its concentration must be maintained constant by glycogen demolition and the intake of food and drink. Constant glucose levels are
Lipid Profile
The benefit of regular physical activity for fitness and prevention of the metabolic syndrome and associated problems and diseases, including lipid metabolism [123], is well established, although the extent of physical activity required to improve general health status is not definitely determined [124]. Blood profile assessment in athletes and physically active subjects, as compared with sedentary subjects, should illustrate the effective benefit of exercise in preventing metabolic diseases.
Bone Metabolism Markers
The behavior of bone metabolism markers in sports medicine has been recently reviewed [146]. Bone metabolism markers are important in the study of bone turnover in athletes and the general population, since physical exercise is recommended for preventing osteoporosis and bone metabolism disorders [147]. Although the use of serum or urinary markers is simpler and safer than radiographic measurement of bone mass density (BMD), high biological variability, analytical pitfalls, and various
Effect of Body-Mass Index on Laboratory Parameters
Several metabolic parameters are related to BMI. The athletic population is not homogeneous: its anthropometrical characteristics clearly differ by type of sport practiced. Muscular mass is obviously a fundamental characteristic of athletes, but BMI values range widely among athletes from various disciplines. Therefore, the interpretation of certain laboratory parameters should take into account the athlete's BMI in order to avoid misclassification and inappropriate further clinical and
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