Effect of Marathon Running on Hematologic and Biochemical Laboratory Parameters, Including Cardiac Markers

Abstract

Participants in marathon races may require medical attention and the performance of laboratory assays. We report the changes in basic biochemical parameters, cardiac markers, CBC counts, and WBC differentials observed in participants in a marathon before, within 4 hours, and 24 hours after a race. The concentrations of glucose, total protein, albumin, uric acid, calcium, phosphorus, serum urea nitrogen, creatinine, bilirubin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, total creatine kinase, creatine kinase-MB, myoglobin, and the anion gap were increased after the race, consistent with the effects of exertional rhabdomyolysis and hemolysis. The increase in WBC counts was due mainly to neutrophilia and monocytosis, with a relative decrease in circulating lymphocytes, consistent with an inflammatory reaction to tissue injury. A significant percentage of laboratory results were outside the standard reference ranges, indicating that modified reference ranges derivedfrom marathon runners might be more appropriatefor this population. We provide a table of modified reference ranges (or expected ranges) for basic biochemical, cardiac, and hematologic laboratory parameters for marathon runners.

The Effect of 6-weeks Military Training on Blood Hematological Parameters in Untrained Recruits in a Military University

“…Increases in WBC count have also been observed in athletes after a marathon run [23]. These increases were attributed to the leukocytosis caused by demargination of WBCs induced by increased blood flow as seen during an inflammatory response to tissue injury [24]. However, effects of exercise on WBC indices may vary.…”

The rationale for pre-race aspirin to protect susceptible runners from sudden cardiac death during marathons: Deconstructing the Pheidippides conundrum

“…Elevated serum creatine kinase as an index of exertional rhabdomyolysis in runners after "hitting the wall" was accompanied by neutrophilia, increased interleukin-6, C-reactive protein and matrix metallo-proteinase-9 [6][7][8][9]. Inflammation by this paradigm may render previously silent low-profile coronary atherosclerotic plaques vulnerable to rupture leading to acute myocardial infarction [10].…”

Análise de parâmetros bioquímicos séricos e urinários em atletas de meia maratona

“…Por exigir uma força excessivamente maior que a necessidade habitual e os sistemas contrá-teis podem se romper estruturalmente (6,(13)(14)(15)(16)(17). Em consequência, uma maior infiltração de neutrófilos é evidenciada, com subsequente liberação de proteínas celulares para a circulação, como, por exemplo, a creatina quinase (13)(14)(15)(16)(17).…”