Laboratory medicine and sports: between Scylla and Charybdis

Abstract

Laboratory medicine is complex and contributes to the diagnosis, therapeutic monitoring and follow-up of acquired and inherited human disorders. The regular practice of physical exercise provides important benefits in heath and disease and sports medicine is thereby receiving growing focus from almost each and every clinical discipline, including laboratory medicine. Sport-laboratory medicine is a relatively innovative branch of laboratory science, which can provide valuable contributions to the diagnosis and follow-up of athletic injuries, and which is acquiring a growing clinical significance to support biomechanics and identify novel genomics and "exercisenomics" patterns that can help identify specific athlete's tendency towards certain types of sport traumas and injuries. Laboratory medicine can also provide sport physicians and coaches with valuable clues about personal inclination towards a certain sport, health status, fitness and nutritional deficiencies of professional, elite and recreational athletes in order to enable a better and earlier prediction of sport injuries, overreaching and overtraining. Finally, the wide armamentarium of laboratory tests represents the milestone for identifying cheating athletes in the strenuous fight against doping in sports.

Preanalytical quality improvement. In pursuit of harmony, on behalf of European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working group for Preanalytical Phase (WG-PRE)

“…The biochemical and hematological parameters are mainly used in sports medicine for evaluating the health status of recreational and professional athletes, for preventing infectious diseases and injuries, for evaluating performances and, finally, for detecting the use of illicit and unethical substances or methods [31].…”

Variation of Red Blood Cell Distribution Width and Mean Platelet Volume after Moderate Endurance Exercise

“…These remarkable variations are often reflected by concomitant changes of a number of laboratory parameters [1]. The accurate identification of such paraphysiologic variations is pivotal in medicine and sports not only to prevent misinterpretation of data and hence to define the real state of health and fitness of the athletes but also to detect the potential use of unfair doping practices and to assist sport physicians in follow-up of athletic injuries [1]. …”

Physical activity - an important preanalytical variable

“…Accordingly, the values of some biomarkers in physically active subjects should be cautiously interpreted, since their results may fall outside the conventional reference ranges, reflecting an adaptation to regular training or changes that have occurred during and/or following strenuous exercise, rather than the presence of a given disease. Short, middle, and long-term exercise, as well as the relative intensity of the physical effort, may influence a broad array of laboratory variables (4). The biological characteristics of the molecule(s), the level of training, the type, intensity and duration of exercise, and the time of recovery after training are factors that markedly influence the amount of extracellular release and clearance from blood of several biomarkers (2).…”