Aim. The paper aims to analyze and summarize the data about enzyme diagnostics in athletes of different sports. Materials and methods. Creatine kinase (CK) activity was measured in 20 highly skilled male biathletes aged from 18 to 23 years. Fasted blood samples were taken in the morning before exercise and the next day after a 90-minute ski run by a uniform method. Biochemical analysis was performed by using the Architect c4000 and i1000SR (Abbott, USA) automated analyzers with reagents and control materials from the equipment manufacturer. Results. An increase in CK activity in biathletes is observed at the end of the preparatory period, and normalization occurs by the middle of the competitive period. When studying CK activity in 10 male handball players aged from 18 to 21 years the day after training, it was found that the increase in enzyme activity depended on the playing position. Goalkeepers exceeded the norm many times compared to field players. The highest serum CK activity after exercise was observed after prolonged exercise such as extra-long marathon and uphill running, which involved eccentric muscle contractions. In triathletes after competitions (full distance), CK activity increased to 1200 U/L, after 48 hours of recovery it dropped to 400 U/L. Conclusion. Thus, enzyme diagnostics today is a relevant and objective method for assessing the state of health and the muscular system, including organs such as the heart, liver, and brain. Therefore, control over the level of basic enzymes should be carried out regularly in the preparatory period both as part of an in-depth medical examination and if an athlete is suspected of being overtrained or injured.
Введение. При выполнении физической нагрузки большой длительности происходят биохимические сдвиги, которые могут существенно повлиять на состояние здоровья спортсмена. Проблема изменений метаболизма в организме при ультрадлительных нагрузках (более 12 часов) недостаточно изучена, так как количество таких спортсменов небольшое, а соревнования не входят в олимпийскую программу. Цель. Изучить и оценить значимость биохимических изменений при ультрадлительных физических нагрузках с использованием автоматизированных методов исследований. Материалы и методы. Исследовали изменения метаболизма у атлета 56 лет мужского пола, мастера спорта СССР по спортивной ходьбе. В ходе исследования испытуемый выполнял непрерывную 24-часовую физическую нагрузку на профессиональных беговых дорожках. Взятие крови для выполнения биохимических исследований проводили за 24 часа до начала ходьбы, во время нагрузки, через 8, 12 и 20 часов после старта, сразу после финиша и через 2, 4, 6 и 24 часа отдыха. Изучали активность аланинаминотрансферазы, аспартатаминотрансферазы и общей креатинкиназы, уровень мочевины, общего белка, альбумина и общего холестерола, C-реактивного протеина, минеральный состав крови (кальций, хлор, калий и натрий) – на анализаторе Architect c4000. Концентрацию тестостерона, кортизола, витамина D(ОН) и высокочувствительного тропонина I определяли на анализаторе Architect i1000 (Abbott, США). Результаты. После завершения ходьбы незначительно повышается активность аланинаминотрансферазы, уровень мочевины, в 2 раза увеличивается активность аспартатаминотрансферазы. Активность общей креатинкиназы возрастает во время выполнения физической нагрузки и достигает пика сразу после ее завершения; снижение активности энзима происходит через 6 часов после окончания мышечной работы, через 24 часа отдыха активность снижается в 2 раза. Отмечено многократное повышение концентрации С-реактивного протеина после ультрадлительной физической нагрузки и снижение уровней тестостерона и кортизола через 24 часа после завершения ходьбы. Уровень тропонина I максимально повышался через 12 часов выполнения физической нагрузки, и далее его концентрация в крови стабилизировалась. Длительное повышение концентрации сердечного тропонина повышает риск развития аутоиммунного процесса в организме атлета с возможным образованием комплексов «протеин – антитело», которые могут длительно циркулировать в системе кровообращения. Многократное повышение С-реактивного протеина в сыворотке объективно характеризует одно из проявлений развития системного воспалительного процесса в организме атлета во многом в результате токсического действия метаболитов мышечной деятельности. Заключение. Врачи спортивной медицины и специалисты, участвующие в медикобиологическом сопровождении высококвалифицированных спортсменов, должны учитывать и использовать описанные лабораторные изменения в процессе длительных нагрузок и отдыха для сохранения здоровья атлетов. Introduction. Under ultra-endurance exercises, biochemical changes occur that can dramatically affect athletes’ health. The issue of body metabolism changes during ultra- endurance exercises (more than 12 hours) remains understudied, since the number of such athletes is low, and competitions are not included in the Olympic programme. Purpose. To study and evaluate the significance of biochemical changes during ultra- endurance exercise using automated research methods. Materials and methods. Metabolic changes were studied in a 56-year-old male athlete, USSR Master of Sports in race walking. During the study, the subject performed continuous 24-hour physical activity on professional treadmills. Blood sampling for biochemical studies was carried out 24 hours before the start of walking, during exercise, 8, 12, and 20 hours after the start, immediately after the finish, and after 2, 4, 6, and 24 hours of rest. The activity of alanine aminotransferase, aspartate aminotransferase and total creatine kinase, the level of urea, total protein, albumin and total cholesterol, C-reactive protein, blood mineral composition (calcium, chlorine, potassium and sodium) were studied on the analyzer "Architect c4000". The concentration of testosterone, cortisol, vitamin D(OH), and highly sensitive troponin I was determined using "Architect i1000" analyzer (Abbott, USA). Results. After the completion of walking, the activity of alanine aminotransferase and the level of urea slightly increase, while the activity of aspartate aminotransferase increases by 2 times. The activity of total creatine kinase increases during exercise and reaches a peak immediately after its completion; a decrease in enzyme activity occurs in 6 hours after the end of muscle work, and after 24 hours of rest the activity decreases by 2 times. A multiple increase in C-reactive protein concentration after ultra-endurance exercise and a decrease in testosterone and cortisol levels in 24 hours after completion of walking were observed. The level of troponin I increased to the maximum after 12 hours of exercise, and then its concentration in the blood stabilized. A prolonged increase in the concentration of cardiac troponin increases the risk of developing an autoimmune process in the athlete’s body including eventual formation of protein-antibody complexes that can circulate in the systemic blood flow for a long time. A multiple increases in serum C-reactive protein objectively characterise one of manifestations of the systemic inflammatory process development in the athlete’s body, largely as a result of toxic effects of muscle activity metabolites. Conclusion. Sports medicine physicians and specialists involved in medical and biological support of highly qualified athletes should consider and use the described laboratory changes during prolonged exertion and rest periods to maintain the athletes’ health.
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