Effect of marathon running on hematologic and biochemical laboratory parameters, including cardiac markers

• Published in: American journal of clinical pathology Vol. 118; no. 6; pp. 856 - 863
• Main Authors: KRATZ, Alexander, LEWANDROWSKI, Kent B, SIEGEL, Arthur J, CHUN, Kelly Y, FLOOD, James G, VAN COTT, Elizabeth M, LEE-LEWANDROWSKI, Elizabeth
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Society of Clinical Pathologists 01.12.2002
• Subjects: Adult; Biological and medical sciences; Biomarkers - blood; Blood Cell Count; Blood Chemical Analysis; Hematologic Tests; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Miscellaneous. Technology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Reference Values; Running - physiology; Human; Reference value; Biochemical analysis; Clinical chemistry; Hematology; Biological marker; Male; Laboratory; Reference values; Sports medicine; Heart disease; Clinical biology; Adult; Female; Parameter; Marathon
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1309/14ty-2tdj-1x0y-1v6v

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.