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Talebi S, Mohammadi H, Zeraattalab-Motlagh S, Arab A, Keshavarz Mohammadian M, Ghoreishy SM, Abbaspour Tehrani Fard M, Amiri Khosroshahi R, Djafarian K. Nutritional interventions for exercise-induced muscle damage: an umbrella review of systematic reviews and meta-analyses of randomized trials. Nutr Rev 2024; 82:639-653. [PMID: 37460208 DOI: 10.1093/nutrit/nuad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
CONTEXT Several meta-analyses have been conducted on the effect of nutritional interventions on various factors related to muscle damage. However, the strength of the evidence and its clinical significance are unclear. OBJECTIVES This umbrella review aimed to provide an evidence-based overview of nutritional interventions for exercise-induced muscle damage (EIMD). DATA SOURCES PubMed, Scopus, and ISI Web of Science were systematically searched up to May 2022. DATA EXTRACTION Systematic reviews and meta-analyses of randomized controlled trials investigating nutritional interventions' effects on recovery following EIMD were included. The certainty of the evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS Fifty-three randomized controlled trial meta-analyses were included, evaluating 24 nutritional interventions on 10 different outcomes. The results revealed a significant effect of hydroxymethylbutyrate (HMB) supplementation and l-carnitine supplementation for reducing postexercise creatine kinase; HMB supplementation for reducing lactate dehydrogenase; branched-chain amino acids and leaf extract supplementation for reducing the delayed onset of muscle soreness; and l-carnitine, curcumin, ginseng, polyphenols, and anthocyanins for reducing muscle soreness, all with moderate certainty of evidence. CONCLUSIONS Supplementation with HMB, l-carnitine, branched-chain amino acids, curcumin, ginseng, leaf extract, polyphenols, and anthocyanins showed favorable effects on some EIMD-related outcomes. PROTOCOL REGISTRATION PROSPERO registration no. CRD42022352565.
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Affiliation(s)
- Sepide Talebi
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sheida Zeraattalab-Motlagh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Seyed Mojtaba Ghoreishy
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Abbaspour Tehrani Fard
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Amiri Khosroshahi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Hacker S, Keck J, Reichel T, Eder K, Ringseis R, Krüger K, Krüger B. Biomarkers in Endurance Exercise: Individualized Regulation and Predictive Value. TRANSLATIONAL SPORTS MEDICINE 2023; 2023:6614990. [PMID: 38654913 PMCID: PMC11022769 DOI: 10.1155/2023/6614990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 04/26/2024]
Abstract
The high interindividual variability of exercise response complicates the efficient use of blood-based biomarkers in sports. To address this problem, a useful algorithm to characterize the individual regulation and predictive value of different candidate markers will be developed. Forty-nine participants completed two identical exercise trials. Blood samples were collected before, immediately after, 3 hours after, and 24 hours after completion of exercise. Plasma concentrations of interleukin (IL-) 1RA, IL-6, IL-8, IL-10, IL-15, creatine kinase (CK), cortisol, c-reactive protein (CRP), lactate dehydrogenase (LDH), and thiobarbituric acid reactive substances (TBARS) were measured. Individualized regulation was analyzed using k-means clustering and a Group Assignment Quality (GAQ) score. Regression trees with a bootstrapped-aggregated approach were used to assess the predictive qualities of the markers. For most of the markers studied, a distinction can be made between individuals who show a stronger or weaker response to a particular endurance training program. The regulation of IL-6, IL-8, IL-10, and CK exhibited a high degree of stability within the individuals. Regarding the predictive power of the markers, for all dependent variables, the most accurate predictions were obtained for cortisol and IL-8 based on the baseline value. For CK, a good prediction of recovery of maximal strength and subjective feeling of exhaustion can be made. For IL-1RA and TBARS, especially their reregulation can be predicted if the baseline level is known. Focusing individual variations in biomarker responses, our results suggest the combined use of IL-6, IL-8, IL-10, and CK for the personalized management of stress and recovery cycles following endurance exercise.
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Affiliation(s)
- Sebastian Hacker
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen, Germany
| | - Johannes Keck
- Nemolab, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen, Germany
| | - Thomas Reichel
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen, Germany
| | - Klaus Eder
- Institute of Animal Nutrition and Nutrition Physiology, Justus-Liebig-University, Giessen, Germany
| | - Robert Ringseis
- Institute of Animal Nutrition and Nutrition Physiology, Justus-Liebig-University, Giessen, Germany
| | - Karsten Krüger
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen, Germany
| | - Britta Krüger
- Nemolab, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen, Germany
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Wang H, Cao X, Li B, Wu H, Ning T, Cao Y. Incidence and predictors of postoperative acute kidney injury in older adults with hip fractures. Arch Gerontol Geriatr 2023; 112:105023. [PMID: 37054535 DOI: 10.1016/j.archger.2023.105023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/31/2023] [Accepted: 04/08/2023] [Indexed: 04/15/2023]
Abstract
OBJECTIVES Main Purpose: To clarify the incidence and predictors of acute kidney injury (AKI) after hip fracture surgery; Secondary Purpose: To investigate the impact of AKI on the length of stay (LOS) and mortality of patients. METHODS We retrospectively evaluated data from 644 hip fracture patients at Peking University First Hospital from 2015 to 2021, and divided the patients into AKI and Non-AKI groups according to whether AKI occurred after surgery. Logistic regression was used to clarify the risk factors for AKI, draw ROC curves, and analyze the odds ratio (OR) for LOS and death at 30 days, 3 months, and 1 year for patients with AKI. RESULTS The prevalence of AKI after hip fracture was 12.1%. Age, BMI, and postoperative brain natriuretic peptide (BNP) levels were risk factors for AKI after hip fracture surgery. The risk of AKI in underweight patients, overweight patients and obese patients was 2.24, 1.89, and 2.58 times. Compared to patients with BNP levels <800 pg/ml, the risk of AKI was 22.34-fold for postoperative BNP levels>1500 pg/ml. The risk of a one-grade increase in LOS was 2.84 times higher in the AKI group and the mortality of patients with AKI were higher. CONCLUSION The incidence of AKI after hip fracture surgery was 12.1%. Advanced age, low BMI, and postoperative high level BNP were risk factors for AKI. Surgeons need to pay more attention to patients with older age, low BMI and high postoperative BNP levels in order to proactively prevent the development of postoperative AKI.
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Affiliation(s)
- Hao Wang
- Department of Orthopedics, Peking University First Hospital, No. 8 Xishiku Street, XiCheng District, Beijing, 100034, China
| | - Xiangyu Cao
- Department of Orthopedics, Peking University Third Hospital, No. 49 Garden Road North, HaiDian District, Beijing, 100191, China
| | - Baoqiang Li
- Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, No.8 Gongren Tiyuchang Nanlu, ChaoYang District, Beijing, 100020, China
| | - Hao Wu
- Department of Orthopedics, Peking University First Hospital, No. 8 Xishiku Street, XiCheng District, Beijing, 100034, China
| | - Taiguo Ning
- Department of Orthopedics, Peking University First Hospital, No. 8 Xishiku Street, XiCheng District, Beijing, 100034, China
| | - Yongping Cao
- Department of Orthopedics, Peking University First Hospital, No. 8 Xishiku Street, XiCheng District, Beijing, 100034, China.
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Kannan G, Batchu P, Naldurtiker A, Dykes GS, Gurrapu P, Kouakou B, Terrill TH, McCommon GW. Habituation to Livestock Trailer and Its Influence on Stress Responses during Transportation in Goats. Animals (Basel) 2023; 13:ani13071191. [PMID: 37048447 PMCID: PMC10093667 DOI: 10.3390/ani13071191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/21/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023] Open
Abstract
This experiment was conducted to determine the effects of habituation to livestock trailers on stress responses in goats transported for long periods. Intact male Spanish goats (12-month old; BW = 31.6 ± 0.34 kg; N = 168) were separated into two treatment (TRT) groups and maintained on two different paddocks. Concentrate supplement was fed to one group inside two livestock trailers (5.0 × 2.3 m each; habituated group, H), while the other group received the concentrate supplement, but not inside the trailers (non-habituated, NH). After 4 weeks of habituation period, goats were subjected to a 10-h transportation stress in four replicates (n = 21 goats/replicate/TRT). Blood samples were collected by a trained individual by jugular venipuncture into vacutainer tubes before loading (Preload), 20 min after loading (0 h), and at 2-h intervals thereafter (Time) for analysis of stress responses. There was a tendency for a TRT effect (p < 0.1) on tyramine and metanephrine concentrations. Phenylethylamine and 5-methoxytryptamine concentrations were significantly greater (p < 0.05) in the H group compared to the NH group. Both dopamine and 5-methoxytryptamine concentrations decreased (p < 0.05) with transportation time; however, TRT × Time interaction effects were not significant. Habituation to trailers may be beneficial in mood and energy stabilization in goats during long-distance transportation.
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Visconti LM, Cotter JA, Schick EE, Daniels N, Viray FE, Purcell CA, Brotman CB, Ruhman KE, Escobar KA. Impact of varying doses of omega-3 supplementation on muscle damage and recovery after eccentric resistance exercise. Metabol Open 2021; 12:100133. [PMID: 34693240 PMCID: PMC8515381 DOI: 10.1016/j.metop.2021.100133] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Exercise-induced muscle damage (EIMD) commonly occurs following intense resistance exercise and is associated with decrements in exercise performance and delayed muscle recovery. Thus, practical methods to attenuate EIMD would prove useful to both training and athletic populations. Omega-3 (n-3) supplementation has been shown to mitigate EIMD with evidence of increasing efficacy at higher doses (up to 6 g/day). However, data of its efficacy in trained individuals is limited. Therefore, this study investigated the effects of 6 and 8 g of n-3 supplementation on markers of muscle damage and muscle recovery after eccentric resistance exercise in resistance-trained males. METHODS Using a double-blind, randomized, placebo-controlled design, 26 resistance trained males (23 ± 4 years; 173.6 ± 20.5 cm; 81.9 ± 9.7 kg; 14.2 ± 3.7% body fat) supplemented with 6 (n=10) or 8 g (n=7) of n-3 polyunsaturated fatty acids, or placebo (n=9) for 33 days. On day 30, participants performed a lower body muscle-damaging eccentric resistance exercise bout. Measures of muscle performance, soreness, and damage were taken pre-exercise on day 30 as well as on days 31-33, including vertical jump height (VJH), perceived muscle soreness (PMS), hip and knee range of motion (ROM), repetitions to fatigue (RTF) at 70% 1-RM, and serum creatine kinase (CK) while participants continued to supplement until day 33. RESULTS There were significant differences in VJH, PMS, and serum CK following the muscle-damaging exercise bout compared to pre-exercise (p<0.05). However, there were no significant (p>0.05) differences between supplementation groups (6 g, 8 g, and placebo) at any time point post-exercise (day 31-33). There were no changes in hip and knee ROM or RTF at any time point or between groups. Vertical jump height and PMS returned to pre-exercise levels despite CK remaining elevated post-exercise. CONCLUSIONS Thirty-three days of 6 and 8 g of n-3 supplementation did not attenuate EIMD or enhance muscle recovery following muscle-damaging eccentric resistance exercise in resistance-trained males. Further research using various n-3 supplementation durations, doses, and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) concentrations may be needed to establish its efficacy in attenuating EIMD, which may vary between trained and untrained individuals. Furthermore, while circulating CK is commonly used to assess muscle damage, elevated CK levels may not reflect muscle recovery status following muscle-damaging exercise.
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Key Words
- Athletic performance
- CK, creatine kinase
- DHA, docosahexaenoic acid
- DOMS, delayed-onset muscle soreness
- Dietary supplements
- EIMD, exercise-induced muscle damage
- EPA, eicosapentaenoic acid
- Fatty acids
- Omega-3
- PMS, perceived muscle soreness
- ROM, range of motion
- RTF, repetitions to fatigue
- Resistance training
- Sports nutritional sciences
- VJH, vertical jump height
- n-3, omega-3
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Affiliation(s)
- Lauren M. Visconti
- Physiology of EXercise & Sport Lab, Department of Kinesiology, California State University Long Beach, Long Beach, CA, 90840, USA
- Southern California University of Health Sciences, Whittier, CA, 90604, USA
| | - Joshua A. Cotter
- Physiology of EXercise & Sport Lab, Department of Kinesiology, California State University Long Beach, Long Beach, CA, 90840, USA
| | - Evan E. Schick
- Physiology of EXercise & Sport Lab, Department of Kinesiology, California State University Long Beach, Long Beach, CA, 90840, USA
| | - Noah Daniels
- Physiology of EXercise & Sport Lab, Department of Kinesiology, California State University Long Beach, Long Beach, CA, 90840, USA
| | - Frederick E. Viray
- Physiology of EXercise & Sport Lab, Department of Kinesiology, California State University Long Beach, Long Beach, CA, 90840, USA
| | - Carson A. Purcell
- Physiology of EXercise & Sport Lab, Department of Kinesiology, California State University Long Beach, Long Beach, CA, 90840, USA
| | - Cate B.R. Brotman
- Physiology of EXercise & Sport Lab, Department of Kinesiology, California State University Long Beach, Long Beach, CA, 90840, USA
| | - Karen E. Ruhman
- Physiology of EXercise & Sport Lab, Department of Kinesiology, California State University Long Beach, Long Beach, CA, 90840, USA
| | - Kurt A. Escobar
- Physiology of EXercise & Sport Lab, Department of Kinesiology, California State University Long Beach, Long Beach, CA, 90840, USA
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Candidate Genes of Regulation of Skeletal Muscle Energy Metabolism in Athletes. Genes (Basel) 2021; 12:genes12111682. [PMID: 34828287 PMCID: PMC8625318 DOI: 10.3390/genes12111682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/13/2021] [Accepted: 10/22/2021] [Indexed: 01/20/2023] Open
Abstract
All biological processes associated with high sports performance, including energy metabolism, are influenced by genetics. DNA sequence variations in such genes, single nucleotide variants (SNVs), could confer genetic advantages that can be exploited to achieve optimal athletic performance. Ignorance of these features can create genetic “barriers” that prevent professional athletes from pursuing a career in sports. Predictive Genomic DNA Profiling reveals single nucleotide variations (SNV) that may be associated with better suitability for endurance, strength and speed sports. (1) Background: To conduct a research on candidate genes associated with regulation of skeletal muscle energy metabolism among athletes. (2) Methods: We have searched for articles in SCOPUS, Web of Science, Google Scholar, Clinical keys, PubMed, e-LIBRARY databases for the period of 2010–2020 using keywords and keywords combinations; (4) Conclusions: Identification of genetic markers associated with the regulation of energy metabolism in skeletal muscles can help sports physicians and coaches develop personalized strategies for selecting children, teenagers and young adults for endurance, strength and speed sports (such as jogging, middle or long distance runs). However, the multifactorial aspect of sport performances, including impact of genetics, epigenetics, environment (training and etc.), is important for personalized strategies for selecting of athletes. This approach could improve sports performance and reduce the risk of sports injuries to the musculoskeletal system.
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Ginevičienė V, Jakaitienė A, Utkus A, Hall ECR, Semenova EA, Andryushchenko LB, Larin AK, Moreland E, Generozov EV, Ahmetov II. CKM Gene rs8111989 Polymorphism and Power Athlete Status. Genes (Basel) 2021; 12:1499. [PMID: 34680894 PMCID: PMC8536047 DOI: 10.3390/genes12101499] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022] Open
Abstract
Multiple genetic variants are known to influence athletic performance. These include polymorphisms of the muscle-specific creatine kinase (CKM) gene, which have been associated with endurance and/or power phenotypes. However, independent replication is required to support those findings. The aim of the present study was to determine whether the CKM (rs8111989, c.*800A>G) polymorphism is associated with power athlete status in professional Russian and Lithuanian competitors. Genomic DNA was collected from 693 national and international standard athletes from Russia (n = 458) and Lithuania (n = 235), and 500 healthy non-athlete subjects from Russia (n = 291) and Lithuania (n = 209). Genotyping for the CKM rs8111989 (A/G) polymorphism was performed using PCR or micro-array analysis. Genotype and allele frequencies were compared between all athletes and non-athletes, and between non-athletes and athletes, segregated according to population and sporting discipline (from anaerobic-type events). No statistically significant differences in genotype or allele frequencies were observed between non-athletes and power athletes (strength-, sprint- and speed/strength-oriented) athletes. The present study reports the non-association of the CKM rs8111989 with elite status in athletes from sports in which anaerobic energy pathways determine success.
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Affiliation(s)
- Valentina Ginevičienė
- Department of Human and Medical Genetics, Institute of Biomedical Science, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania; (V.G.); (A.J.); (A.U.)
| | - Audronė Jakaitienė
- Department of Human and Medical Genetics, Institute of Biomedical Science, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania; (V.G.); (A.J.); (A.U.)
| | - Algirdas Utkus
- Department of Human and Medical Genetics, Institute of Biomedical Science, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania; (V.G.); (A.J.); (A.U.)
| | - Elliott C. R. Hall
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 5AF, UK; (E.C.R.H.); (E.M.)
| | - Ekaterina A. Semenova
- Department of Molecular Biology and Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, 119435 Moscow, Russia; (E.A.S.); (A.K.L.); (E.V.G.)
- Research Institute of Physical Culture and Sport, Volga Region State University of Physical Culture, Sport and Tourism, 420010 Kazan, Russia
| | - Liliya B. Andryushchenko
- Department of Physical Education, Plekhanov Russian University of Economics, 115093 Moscow, Russia;
| | - Andrey K. Larin
- Department of Molecular Biology and Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, 119435 Moscow, Russia; (E.A.S.); (A.K.L.); (E.V.G.)
| | - Ethan Moreland
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 5AF, UK; (E.C.R.H.); (E.M.)
| | - Edward V. Generozov
- Department of Molecular Biology and Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, 119435 Moscow, Russia; (E.A.S.); (A.K.L.); (E.V.G.)
| | - Ildus I. Ahmetov
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 5AF, UK; (E.C.R.H.); (E.M.)
- Department of Molecular Biology and Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, 119435 Moscow, Russia; (E.A.S.); (A.K.L.); (E.V.G.)
- Department of Physical Education, Plekhanov Russian University of Economics, 115093 Moscow, Russia;
- Laboratory of Molecular Genetics, Kazan State Medical University, 420012 Kazan, Russia
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Carneiro A, Viana-Gomes D, Macedo-da-Silva J, Lima GHO, Mitri S, Alves SR, Kolliari-Turner A, Zanoteli E, Neto FRDA, Palmisano G, Pesquero JB, Moreira JC, Pereira MD. Risk factors and future directions for preventing and diagnosing exertional rhabdomyolysis. Neuromuscul Disord 2021; 31:583-595. [PMID: 34193371 DOI: 10.1016/j.nmd.2021.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 12/19/2022]
Abstract
Exertional rhabdomyolysis may occur when an individual is subjected to strenuous physical exercise. It is occasionally associated with myoglobinuria (i.e. "cola-colored" urine) alongside muscle pain and weakness. The pathophysiology of exertional rhabdomyolysis involves striated muscle damage and the release of cellular components into extracellular fluid and bloodstream. This can cause acute renal failure, electrolyte abnormalities, arrhythmias and potentially death. Exertional rhabdomyolysis is observed in high-performance athletes who are subjected to intense, repetitive and/or prolonged exercise but is also observed in untrained individuals and highly trained or elite groups of military personnel. Several risk factors have been reported to increase the likelihood of the condition in athletes, including: viral infection, drug and alcohol abuse, exercise in intensely hot and humid environments, genetic polymorphisms (e.g. sickle cell trait and McArdle disease) and epigenetic modifications. This article reviews several of these risk factors and proposes screening protocols to identify individual susceptibility to exertional rhabdomyolysis as well as the relevance of proteomics for the evaluation of potential biomarkers of muscle damage.
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Affiliation(s)
- Andréia Carneiro
- Departamento de Bioquímica, Instituto de Química, Universidade Federal do Rio de Janeiro, Brazil; Departamento de Química, Diretoria de Sistemas de Armas da Marinha, Marinha do Brazil, Brazil; Departamento de Parasitologia, Universidade de São Paulo, Instituto de Ciencias Biomédicas, Brazil.
| | - Diego Viana-Gomes
- Departamento de Corridas, Universidade Federal do Rio de Janeiro, Escola de Educação Física, Brazil
| | - Janaina Macedo-da-Silva
- Departamento de Parasitologia, Universidade de São Paulo, Instituto de Ciencias Biomédicas, Brazil
| | - Giscard Humberto Oliveira Lima
- Departamento de Biofísica, Universidade Federal de São Paulo, Brazil; Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Italy
| | - Simone Mitri
- Centro de Ecologia Humana e Saúde do Trabalhador, Fundação Oswaldo Cruz, Brazil
| | | | | | - Edmar Zanoteli
- Departamento de Neurologia, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | | | - Giuseppe Palmisano
- Departamento de Parasitologia, Universidade de São Paulo, Instituto de Ciencias Biomédicas, Brazil
| | - João Bosco Pesquero
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Italy
| | | | - Marcos Dias Pereira
- Departamento de Bioquímica, Instituto de Química, Universidade Federal do Rio de Janeiro, Brazil.
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Nye NS, Kasper K, Madsen CM, Szczepanik M, Covey CJ, Oh R, Kane S, Beutler AI, Leggit JC, Deuster PA, O'Connor FG. Clinical Practice Guidelines for Exertional Rhabdomyolysis: A Military Medicine Perspective. Curr Sports Med Rep 2021; 20:169-178. [PMID: 33655999 DOI: 10.1249/jsr.0000000000000822] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
ABSTRACT Exertional rhabdomyolysis (ER) is an uncommon condition with a paucity of evidence-based guidance for diagnosis, management, and return to duty or play. Recently, a clinical practice guideline for diagnosis and management of ER in warfighters was updated by a team of military and civilian physicians and researchers using current scientific literature and decades of experience within the military population. The revision concentrated on challenging and controversial clinical questions with applicability to providers in the military and those in the greater sports medicine community. Specific topics addressed: 1) diagnostic criteria for ER; 2) clinical decision making for outpatient versus inpatient treatment; 3) optimal strategies for inpatient management; 4) discharge criteria; 5) identification and assessment of warfighters/athletes at risk for recurrent ER; 6) an appropriate rehabilitative plan; and finally, 7) key clinical questions warranting future research.
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Affiliation(s)
| | - Korey Kasper
- 559th Trainee Health Squadron, JBSA-Lackland, TX
| | | | | | | | - Robert Oh
- Madigan Army Medical Center, Tacoma, WA
| | - Shawn Kane
- The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Anthony I Beutler
- Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Jeffrey C Leggit
- Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Patricia A Deuster
- Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Francis G O'Connor
- Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Bethesda, MD
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Peinado AB, Alfaro-Magallanes VM, Romero-Parra N, Barba-Moreno L, Rael B, Maestre-Cascales C, Rojo-Tirado MA, Castro EA, Benito PJ, Ortega-Santos CP, Santiago E, Butragueño J, García-de-Alcaraz A, Rojo JJ, Calderón FJ, García-Bataller A, Cupeiro R. Methodological Approach of the Iron and Muscular Damage: Female Metabolism and Menstrual Cycle during Exercise Project (IronFEMME Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020735. [PMID: 33561085 PMCID: PMC7831010 DOI: 10.3390/ijerph18020735] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 12/21/2022]
Abstract
Abstract Background: The increase in exercise levels in the last few years among professional and recreational female athletes has led to an increased scientific interest about sports health and performance in the female athlete population. The purpose of the IronFEMME Study described in this protocol article is to determine the influence of different hormonal profiles on iron metabolism in response to endurance exercise, and the main markers of muscle damage in response to resistance exercise; both in eumenorrheic, oral contraceptive (OC) users and postmenopausal well-trained women. Methods: This project is an observational controlled randomized counterbalanced study. One hundered and four (104) active and healthy women were selected to participate in the IronFEMME Study, 57 of which were eumenorrheic, 31 OC users and 16 postmenopausal. The project consisted of two sections carried out at the same time: iron metabolism (study I) and muscle damage (study II). For the study I, the exercise protocol consisted of an interval running test (eight bouts of 3 min at 85% of the maximal aerobic speed), whereas the study II protocol was an eccentric-based resistance exercise protocol (10 sets of 10 repetitions of plate-loaded barbell parallel back squats at 60% of their one repetition maximum (1RM) with 2 min of recovery between sets). In both studies, eumenorrheic participants were evaluated at three specific moments of the menstrual cycle: early-follicular phase, late-follicular phase and mid-luteal phase; OC users performed the trial at two moments: withdrawal phase and active pill phase. Lastly, postmenopausal women were only tested once, since their hormonal status does not fluctuate. The three-step method was used to verify the menstrual cycle phase: calendar counting, blood test confirmation, and urine-based ovulation kits. Blood samples were obtained to measure sex hormones, iron metabolism parameters, and muscle damage related markers. Discussion: IronFEMME Study has been designed to increase the knowledge regarding the influence of sex hormones on some aspects of the exercise-related female physiology. Iron metabolism and exercise-induced muscle damage will be studied considering the different reproductive status present throughout well-trained females’ lifespan. Trial registration The study was registered at Clinicaltrials.gov NCT04458662 on 2 July 2020.
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Affiliation(s)
- Ana B. Peinado
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Correspondence:
| | - Victor M. Alfaro-Magallanes
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Nuria Romero-Parra
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Laura Barba-Moreno
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Beatriz Rael
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Cristina Maestre-Cascales
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Miguel A. Rojo-Tirado
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Eliane A. Castro
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Sports Sciences and Physical Conditioning, Faculty of Education, Universidad Católica de la Santísima Concepción, 2850 Concepción, Chile
| | - Pedro J. Benito
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | | | | | - Javier Butragueño
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
| | - Antonio García-de-Alcaraz
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Faculty of Educational Sciences, Universidad de Almería, 04120 Almería, Spain
| | - Jesús J. Rojo
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Francisco J. Calderón
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Alberto García-Bataller
- Department of Sports, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Rocío Cupeiro
- LFE Research Group, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (V.M.A.-M.); (N.R.-P.); (L.B.-M.); (B.R.); (C.M.-C.); (M.A.R.-T.); (E.A.C.); (P.J.B.); (J.B.); (A.G.-d.-A.); (J.J.R.); (F.J.C.); (R.C.)
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, 28040 Madrid, Spain
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Del Coso J, Salinero JJ, Lara B, Gallo-Salazar C, Areces F, Herrero D, Puente C. Polygenic Profile and Exercise-Induced Muscle Damage by a Competitive Half-Ironman. J Strength Cond Res 2020; 34:1400-1408. [PMID: 29140910 DOI: 10.1519/jsc.0000000000002303] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Del Coso, J, Salinero, JJ, Lara, B, Gallo-Salazar, C, Areces, F, Herrero, D, and Puente, C. Polygenic profile and exercise-induced muscle damage by a competitive half-ironman. J Strength Cond Res 34(5): 1400-1408, 2020-To date, it is still unknown why some individuals develop higher levels of muscle damage than other individuals, despite participating in exercise with comparable levels of physical intensity. The aim of this investigation was to analyze 7 single-nucleotide polymorphisms (SNPs) that are candidates to explain individual variations in the level of muscle damage attained during a half-ironman competition. Using the model of Williams and Folland (2, 1, and 0 points for optimal, intermediate, and suboptimal genotype), we determined the total genotype score from the accumulated combination of 7 SNPs (ACE = 287bp Ins/Del; ACTN3 = p.R577X; creatine kinase, muscle type = NcoI; insulin-like growth factor 2 = C13790G; interleukin-6 = 174G>C; myosin light chain kinase = C37885A; and tumor necrosis factor-α = 308G>A) in 22 experienced triathletes. Before and after the race, a sample of venous blood was obtained to measure serum markers of muscle damage. Two groups of triathletes were established according to their postcompetition serum CK concentration: low CK responders (n = 10; 377 ± 86 U·L) vs. high CK responders (n = 12; 709 ± 136 U·L). At the end of the race, low CK responders had lower serum myoglobin concentrations (384 ± 243 vs. 597 ± 293 ng·ml, p = 0.04). Although the groups were similar in age, anthropometric characteristics, and training habits, total genotype score was higher in low CK responders than in high CK responders (7.7 ± 1.1 vs. 5.5 ± 1.1 point, p < 0.01). A favorable polygenic profile can contribute to reducing the level of muscle damage developed during endurance exercise.
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Affiliation(s)
- Juan Del Coso
- Sports Sciences Department, Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
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12
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Relationship of body mass index, serum creatine kinase, and acute kidney injury after severe trauma. J Trauma Acute Care Surg 2020; 89:179-185. [PMID: 32282754 DOI: 10.1097/ta.0000000000002714] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Body mass index (BMI) is associated with acute kidney injury (AKI) after trauma, but underlying mechanisms are unclear. Body mass index correlates with both excess adiposity and increased muscle mass. Since the latter could predispose to severe rhabdomyolysis after trauma, we hypothesized that the BMI-AKI association may be partially explained by a direct relationship of BMI with serum creatine kinase (CK). METHODS Prospective cohort study of 463 critically ill patients admitted to a level I trauma center from 2005 to 2015 with Injury Severity Score of >15 and serum CK measured in the first 7 days. We defined AKI by AKI Network creatinine criteria. We used simple linear regression to determine the association of BMI with peak CK and multivariable logistic regression to adjust the BMI-AKI association for peak CK and confounders. RESULTS Median age was 43 years, 350 (76%) were male, 366 (79%) had blunt mechanism, and median Injury Severity Score was 24. Body mass index was associated with peak CK (R = 0.05, p < 0.001). Acute kidney injury developed in 148 patients (32%), and median time to peak CK was 29 hours (interquartile range, 15-56 hours) after presentation. Body mass index was significantly associated with AKI in multivariable models adjusted for age, race, sex, diabetes, injury mechanism and severity, and red blood cell transfusions (odds ratio [OR], 1.31 per 5 kg/m; 95% confidence interval [CI], 1.09-1.58; p = 0.004). Adding peak CK to the model partially attenuated the association of BMI with AKI (OR, 1.26 per 5 kg/m; 95% CI, 1.04-1.52; p = 0.018), and peak CK was also associated with AKI (OR, 1.19 per natural log; 95% CI, 1.00-1.41; p = 0.049). Peak CK remained associated with AKI when restricted to patients with values of <5,000 U/L (OR, 1.31 per natural log; 95% CI, 1.01-1.69; p = 0.043). CONCLUSION Serum CK correlated with BMI and partially attenuated the association of BMI with AKI after major trauma, suggesting that excess muscle injury may contribute to the BMI-AKI association. LEVEL OF EVIDENCE Epidemiologic study, level III.
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13
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Bekkelund SI. Leisure physical exercise and creatine kinase activity. The Tromsø study. Scand J Med Sci Sports 2020; 30:2437-2444. [PMID: 32799358 DOI: 10.1111/sms.13809] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/06/2020] [Accepted: 07/27/2020] [Indexed: 12/30/2022]
Abstract
Creatine kinase (CK) is an enzyme catalyzing energy reaction in muscle cells and has proven to modify cardiovascular risks. The influence of skeletal muscle activity on CK concentrations is a potential study confounder but is mainly reported in connection with sport activities. This study investigated the association between leisure physical exercise and CK and estimated the effect of physical exercise on the CK values. CK and leisure physical exercise defined as intensity, frequency, and duration subsets were measured in the population-based Tromsø study. Comparisons of CK at different exercise levels, multivariate analyses, and relative differences in CK between "never exercise" and "heavy exercise" (moderate or hard exercise ≥2 hours per week) subgroups were analyzed age- and sex-stratified in 12 796 men and women. CK increased significantly with higher levels of physical exercise intensity and frequency in both sexes analyzed by ANOVA. In a multivariate analysis, CK was independently associated with heavy exercise after adjusting for age, BMI, and blood pressure; OR 9.38 (95% CI 5.32-16.53), P < .0001 in men and OR 5.20 (95% CI 2.53-10.69), P < .0001 in women. The differences in CK between physically inactive and participants performing heavy exercise varied between 3.1% (women) and 6.4% (men) and was also larger in participants ≥50 years. In conclusion, CK was positively and independently associated with increasing leisure physical exercise in a general population. CK values associated with exercise were approximately twice as high in men than women, but exercise altered CK only modestly.
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Affiliation(s)
- Svein Ivar Bekkelund
- Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.,Department of Neurology, University Hospital of North Norway, Tromsø, Norway
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14
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Kazman JB, Attipoe S, Kupchak BR, Deuster PA. Caffeine and heat have additive but not interactive effects on physiologic strain: A factorial experiment. J Therm Biol 2020; 89:102563. [PMID: 32364995 DOI: 10.1016/j.jtherbio.2020.102563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 11/26/2022]
Abstract
This study tested the interactive effects of heat and caffeine on exercise-induced physiological strain by using a 2x2 within-subjects factorial design. Thirty-five physically fit Caucasians underwent a bout of exercise under four conditions wherein ambient conditions (heat vs no heat) and caffeine (placebo vs caffeine; double-blinded) were manipulated. Exercise consisted of a 60-min walk and 5-min step/squat test while wearing weighted backpack. Primary outcomes include measures of physiologic strain (Core temperature [Tr] and heart rate [HR]). Secondary measures included blood pressure, markers of sweat loss, and creatine kinase (CK). Repeated measures models were created to evaluate the individual and combined effects of heat and caffeine. Key results indicated that heat and caffeine significantly increased Tr and HR after walking and stair-stepping. No significant heat by caffeine interactions were detected, and caffeine's main effects were relatively low (≤0.17 °C for Tr and ≤6.6 bpm for HR). Of note, heat and caffeine exhibited opposite effects on blood pressure: caffeine increased both systolic and diastolic blood pressure (by 6-7 mmHg) and heat decreased them (by 4-6 mm Hg; ps < 0.05). In summary, heat and caffeine affected physiologic strain during exercise but exhibited no synergistic effects. In contrast, neither factor affected muscle damage. Clinical implications for heat illness risk in the military are discussed.
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Affiliation(s)
- Josh B Kazman
- Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, USA.
| | - Selasi Attipoe
- Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, USA; College of Public Health, Ohio State University, USA
| | - Brian R Kupchak
- Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, USA
| | - Patricia A Deuster
- Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, USA
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15
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Sierra APR, Lima GHO, da Silva ED, Maciel JFDS, Benetti MP, de Oliveira RA, Martins PFDO, Kiss MAP, Ghorayeb N, Newsholme P, Pesquero JB, Cury-Boaventura MF. Angiotensin-Converting Enzyme Related-Polymorphisms on Inflammation, Muscle and Myocardial Damage After a Marathon Race. Front Genet 2019; 10:984. [PMID: 31708962 PMCID: PMC6823274 DOI: 10.3389/fgene.2019.00984] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 09/17/2019] [Indexed: 11/13/2022] Open
Abstract
Muscle damage is one of the most important factors that affect muscle fatigue during endurance exercise. Recent evidence suggests that the renin–angiotensin system impacts on skeletal muscle wasting. The aim of this study was to determine association between the AGT Met235Thr, ACE I/D and BDKRB2 −9/+9 polymorphisms with inflammation, myocardial and muscle injury induced by endurance exercise. Eighty-one Brazilian male runners participated in this study and completed the International Marathon of Sao Paulo. Muscle and myocardial damage markers (alanine transaminase, ALT, aspartate transaminase, AST, lactic dehydrogenase, LDH, creatine kinase, CK, Troponin, pro BNP, myoglobin, and CK-MB) and inflammatory mediators (IL-6, IL-8, IL-10, IL12p70, IL1β, and TNF-α) were determined one day before, immediately after, one day after, and three days after the event. Muscle damage was also determined fifteen days after race and angiotensinogen (AGT) Met235Thr, angiotensin-converting enzyme (ACE) I/D, and Bradykinin B2 receptor (BDKRB2) −9/+9 polymorphisms were determined. Marathon race participation induced an increase in all muscle damage and inflammatory markers evaluated (p < 0.0001). The muscle damage markers, troponin and pro BNP, CK and LDH and inflammatory markers, IL-6, IL-8, IL-1β and IL-10 were also higher in ACE II genotype immediately after race, compared to DD genotype. The percentage of runners higher responders (>500U/I) to CK levels was higher for II genotypes (69%) compared to DD and ID genotypes (38% and 40%, respectively) immediately after. Troponin, pro BNP and IL-1β, IL-8 levels were also elevated in AGT MM genotype compared to TT genotype athletes after and/or one day after race. BDKRB2 −9/−9 had pronounced response to LDH, CK, CK-MB and ALT and AST activities, myoglobin, troponin, IL-6, IL-8 levels immediately, one day and/or three days after race. The percentage of runners higher responders (>500U/I) to CK levels was greater for −9−9 and −9+9 genotypes (46 and 48%, respectively) compared to +9+9 genotypes (31%) immediately after. ACE II, AGT MM, and BDKRB2 −9−9 genotypes may increase the susceptibility to inflammation, muscle injury after endurance exercise and could be used to predict the development of clinical conditions associated with muscle damage and myocardial injury.
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Affiliation(s)
- Ana Paula Rennó Sierra
- School of Physical Education and Sport, University of São Paulo, Sao Paulo, Brazil.,Sports Cardiology Department, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil
| | | | - Elton Dias da Silva
- Department of Biophysics, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | | | | | | | | | - Nabil Ghorayeb
- Sports Cardiology Department, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil
| | - Philip Newsholme
- School of Pharmacy and Biomedical Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
| | - João Bosco Pesquero
- Department of Biophysics, Federal University of Sao Paulo, Sao Paulo, Brazil
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Tanabe Y, Chino K, Sagayama H, Lee HJ, Ozawa H, Maeda S, Takahashi H. Effective Timing of Curcumin Ingestion to Attenuate Eccentric Exercise-Induced Muscle Soreness in Men. J Nutr Sci Vitaminol (Tokyo) 2019; 65:82-89. [PMID: 30814417 DOI: 10.3177/jnsv.65.82] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Curcumin is known to have potent anti-inflammatory effects. We have reported that acute curcumin ingestion attenuates eccentric exercise-induced muscle damage. This study aimed to examine the effect of curcumin ingestion timing (before or after exercise) on the changes in muscle damage markers after eccentric exercise. In this randomized, single-blind, parallel design study, 24 healthy young men performed 30 maximal isokinetic (120º/s) eccentric contractions of the elbow flexors using an isokinetic dynamometer. Subjects were randomly assigned to ingest 180 mg/d of oral curcumin either 7 d before (PRE) or 4 d after exercise (POST) or 180 mg/d of oral placebo 4 d after exercise (CON). The maximal voluntary contraction (MVC) torque of the elbow flexors, elbow joint range of motion (ROM), muscle soreness, and serum creatine kinase (CK) activity were measured before, immediately after, and 1-4 d after exercise. Changes in these variables were compared over time. In the POST group, ROM were higher at 3-4 d and muscle soreness was lower at 3 d after exercise compared with the CON group (p<0.05). However, in the PRE group, there were no significant differences compared with the CON group in changes in ROM and muscle soreness. Meanwhile, there were no significant differences among the groups in terms of changes in MVC torque and serum CK activity. Our results suggest that curcumin ingestion after exercise had a more beneficial effect in attenuating muscle soreness.
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Affiliation(s)
- Yoko Tanabe
- Department of Sport Research, Japan Institute of Sports Sciences
| | - Kentaro Chino
- Department of Sport Research, Japan Institute of Sports Sciences
| | | | | | | | - Seiji Maeda
- Faculty of Health and Sport Sciences, University of Tsukuba
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Zehsaz F, Safabakhsh AH, Farhangi N, Keynezhad N, Monfaredan A, Ghahramani M. Do ACE and CKMM gene variations have potent effects on physical performance in inactive male adolescents? Mol Biol Rep 2019; 46:1835-1843. [PMID: 30710235 DOI: 10.1007/s11033-019-04636-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 01/22/2019] [Indexed: 10/27/2022]
Abstract
We studied to ascertain whether the ACE and/or CKMM genotypes independently influence the baseline level of some sport performances in 613 inactive male adolescents (mean ± SD age: 13.24 ± 0.28 years). All DNA samples were extracted and genotyped for ACE I/D and CKMM A/G polymorphisms using a PCR based procedure. One-way analysis of covariance was used to examine the discrepancies in the research phenotypes among various ACE and CKMM polymorphisms. The comparisons of genotype and allele frequencies between adolescents with the best and the worst performances were calculated and analyzed by the Chi square test. All procedures were approved by Medical University Ethics Committee. Written informed consent signed and approved by all subject`s parents were obtained. We observed the effect of the ACE and CKMM polymorphisms on VO2max (P = 0.001 & P = 0.001 respectively). ACE and CKMM genotypes differed between groups (< 90th vs. ≥ 90) in the multi-stage 20 m shuttle run (P = 0.001 and 0.001). ACE allele frequencies differed between groups (< 90th vs. ≥ 90) in the multi-stage 20-m shuttle run (P = 0.001). This study suggests that the ACE and CKMM polymorphisms influence the endurance performance phenotype in non-trained adolescent males.
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Affiliation(s)
- Farzad Zehsaz
- Department of Physical Education and Sport Sciences, Tabriz Branch, Islamic Azad University, Tabriz, Iran.
| | - Amir Hamzeh Safabakhsh
- Department of Physical Education and Sport Sciences, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | - Negin Farhangi
- Department of Physical Education and Sport Sciences, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | - Narmin Keynezhad
- Department of Physical Education and Sport Sciences, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | - Amir Monfaredan
- Department of Hematology, Faculty of Medicine, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | - Mehri Ghahramani
- Department of Physical Education and Sport Sciences, Tabriz Branch, Islamic Azad University, Tabriz, Iran
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Creatine Phosphokinase and Urea as Biochemical Markers of Muscle Injuries in Professional Football Players. Asian J Sports Med 2018. [DOI: 10.5812/asjsm.60386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Pickering C, Kiely J. Hamstring injury prevention: A role for genetic information? Med Hypotheses 2018; 119:58-62. [DOI: 10.1016/j.mehy.2018.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 06/24/2018] [Accepted: 07/11/2018] [Indexed: 01/19/2023]
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20
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Radojewski M, Podgórski T, Pospieszna B, Kryściak J, Śliwicka E, Karolkiewicz J. Skeletal Muscle Cell Damage Indicators in Volleyball Players after the Competitive Phase of the Annual Training Cycle. J Hum Kinet 2018; 62:81-90. [PMID: 29922380 PMCID: PMC6006534 DOI: 10.1515/hukin-2017-0160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of the study was to evaluate the impact of the competitive phase on physiological and metabolic indices and selected markers of skeletal muscle damage in male volleyball players. The study group consisted of 24 young male volleyball players. During the study, participants underwent two series of measurements, before and after the competitive phase of the annual training cycle. In both study terms, players performed an incremental treadmill running test to determine their ventilatory threshold and maximal oxygen uptake. Venous and capillary blood samples were taken for biochemical analysis. There was no significant difference in the physical fitness level, values of biochemical variables and the level of antioxidant status in the surveyed athletes between the two study terms. Significant changes within skeletal muscle damage markers were observed between the beginning and the end of the competitive period: an increase in the concentration of cellular DNA damage products (8-hydroxy-2'-deoxyguanosine; p < 0.0001) and a decrease in muscle activity of creatine kinase (p<0.05). In spite of the increment in cell damage markers, the unaffected level of physiological and biochemical markers may indicate that the experienced cell destruction did not negatively affect the level of physical fitness. When designing the annual training plan, coaches and athletes need to take into consideration that temporary physiological states - oxidative stress and inflammation - may be required to attain training adaptation.
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Affiliation(s)
- Mateusz Radojewski
- Department of Biomedical Foundations of Physical Activity, University School of Physical Education in Poznań, Poznań, Poland
| | - Tomasz Podgórski
- Department of Biomedical Foundations of Physical Activity, University School of Physical Education in Poznań, Poznań, Poland
| | - Barbara Pospieszna
- Department of Tourism and Recreation, Adam Mickiewicz University in Poznań, Poznań, Poland
| | - Jakub Kryściak
- Department of Biomedical Foundations of Physical Activity, University School of Physical Education in Poznań, Poznań, Poland
| | - Ewa Śliwicka
- Department of Biomedical Foundations of Physical Activity, University School of Physical Education in Poznań, Poznań, Poland
| | - Joanna Karolkiewicz
- Department of Biomedical Foundations of Physical Activity, University School of Physical Education in Poznań, Poznań, Poland
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21
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Abstract
Exertional (exercise-induced) rhabdomyolysis is a potentially life threatening condition that has been the subject of research, intense discussion, and media attention. The causes of rhabdomyolysis are numerous and can include direct muscle injury, unaccustomed exercise, ischemia, extreme temperatures, electrolyte abnormalities, endocrinologic conditions, genetic disorders, autoimmune disorders, infections, drugs, toxins, and venoms. The objective of this article is to review the literature on exertional rhabdomyolysis, identify precipitating factors, and examine the role of the dietary supplement creatine monohydrate. PubMed and SPORTDiscus databases were searched using the terms rhabdomyolysis, muscle damage, creatine, creatine supplementation, creatine monohydrate, and phosphocreatine. Additionally, the references of papers identified through this search were examined for relevant studies. A meta-analysis was not performed. Although the prevalence of rhabdomyolysis is low, instances still occur where exercise is improperly prescribed or used as punishment, or incomplete medical history is taken, and exertional rhabdomyolysis occurs. Creatine monohydrate does not appear to be a precipitating factor for exertional rhabdomyolysis. Healthcare professionals should be able to recognize the basic signs of exertional rhabdomyolysis so prompt treatment can be administered. For the risk of rhabdomyolysis to remain low, exercise testing and prescription must be properly conducted based on professional standards.
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Affiliation(s)
- Eric S Rawson
- Department of Health, Nutrition and Exercise Science, Messiah College, One College Avenue Suite 4501, Mechanicsburg, PA, 17055, USA.
| | | | - Mark A Tarnopolsky
- Department of Pediatrics and Medicine, McMaster University, Hamilton, ON, Canada
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Manspeaker S, Henderson K, Riddle D. Treatment of exertional rhabdomyolysis in athletes: a systematic review. ACTA ACUST UNITED AC 2018; 14:117-47. [PMID: 27532656 DOI: 10.11124/jbisrir-2016-001879] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Exertional rhabdomyolysis (ER) is the breakdown of skeletal muscle tissue following intense physical activity that results in impairment of the cell membrane, which allows intracellular contents to be released into the bloodstream. Signs and symptoms include myalgia, myoglobinuria and increased creatine kinase (CK) levels. Athletes are vulnerable to this condition due to their increased level of physical activity. The severity and effects of this condition vary between individuals; however, all athletes are at risk of significant muscle damage, renal failure and perhaps death if not recognized and treated quickly. Effective methods for treatment and return to activity following this condition should be established. OBJECTIVES The objective of this review was to identify effective treatment methods associated with ER in athletes. INCLUSION CRITERIA TYPES OF PARTICIPANTS Adult and adolescent patients (15 years of age and older) in the athletic population who have been diagnosed with ER. TYPES OF INTERVENTIONS Fluid resuscitation/replacement or other treatment methods that aim to improve CK levels and decrease myoglobinuria and treat ER. TYPES OF STUDIES Due to the absence of randomized control trials, the quantitative component of the review considered descriptive studies, case series and individual case reports for inclusion. OUTCOMES PRIMARY OUTCOMES CK and myoglobinuria levels. SECONDARY OUTCOMES length of hospital stay; length of time from diagnosis to premorbid levels of physical activity. SEARCH STRATEGY A comprehensive search of the following databases with no date limitation was conducted: CINAHL, PubMed, ProQuest, Embase, SPORTDiscus and Physical Education Index. Results were limited to those available in English. METHODOLOGICAL QUALITY Two independent reviewers evaluated the retrieved articles for methodological quality using the standardized critical appraisal instrument from the Joanna Briggs Institute Meta-Analysis of Statistics and Review Instruments. DATA EXTRACTION Data were extracted from the articles by two independent reviewers using the standardized Joanna Briggs Institute extraction tool. DATA SYNTHESIS Narrative and tabular synthesis. RESULTS Fourteen studies with a combined total of 53 participants were included. Aggressive intravenous (IV) fluid resuscitation was found to be the most commonly utilized treatment method for decreasing CK levels and resolving myoglobinuria. The addition of compounds within the IV fluid varied between studies. CONCLUSION Due to the types of included studies and variation in reported treatment methods and outcomes for ER among athletes, effectiveness of treatment could not be determined. The limited evidence available indicates that IV fluid replacement, specifically normal saline, is the most commonly reported treatment for decreasing CK levels and myoglobinuria following ER. It appears that normal saline may be combined with other compounds including sodium bicarbonate, sodium chloride or potassium chloride to achieve reduction of CK levels and myoglobinuria. Clinically, early IV fluid replacement appears to be delivered at a rate of approximately 400 ml/hour, with adjustments ranging between 200 and 1000 ml/hour, depending on severity and volume states. Hospitalization time varies, depending on severity of condition, and return to activity is widely inconsistent among the athletic population.
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Affiliation(s)
- Sarah Manspeaker
- 1Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA 2Texas Christian University Center for Evidence-based Practice and Research: a Collaborating Center of the Joanna Briggs Institute, Fort Worth, Texas, USA 3Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, Florida, USA 4Nursing, Texas Christian University: a Collaborating Center of the Joanna Briggs Institute, Fort Worth, Texas, USA
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23
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Manojlović V, Erčulj F. Using blood lactate concentration to predict muscle damage and jump performance response to maximal stretch-shortening cycle exercise. J Sports Med Phys Fitness 2018; 59:581-586. [PMID: 29619805 DOI: 10.23736/s0022-4707.18.08346-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND It is well known that eccentric muscle contractions induce delayed onset muscle soreness (DOMS) and exertional rhabdomyolysis (ERB), both of which are related to high blood levels of muscle damage markers after exercise. Creatine kinase (CK) is, together with some other markers (i.e. myoglobin, α-actin, skeletal troponin), widely used in determination of muscle damage. Moreover, DOMS after eccentric exercise has been shown to be associated with altered blood lactate concentration after subsequent submaximal or maximal cycling exercise. However, it is unknown whether blood lactate can predict muscle damage levels after maximal stretch-shortening cycle (SSC) exercise, as due to the differences in types of contractions between the eccentric and SSC protocol. Additionally, we determined the association between blood lactate concentration and CMJ performance after such a protocol. METHODS Forty-three healthy, physically active young men completed a plyometric training session consisting of maximal countermovement jumps (CMJ) to failure. The blood creatine kinase (CK), myoglobin (Mb) and aspartate aminotransferase (AST) samples were taken pre- and 48 hours post-exercise. Blood lactate concentration was determined directly post-exercise. RESULTS There was a significant correlation between blood lactate concentration (post) and blood CK (P=0.027), Mb (P=0.007) and AST (P=0.024) (48 hours post), which means that higher blood lactate concentration is associated with higher muscle damage values after exercise. No correlation was found between blood lactate concentration (post) and performance loss which was expressed by the decrease in maximum CMJ height 5 minutes post-exercise. CONCLUSIONS Blood lactate concentration could be used as a predictor of muscle damage levels after maximal SSC exercise, which supports the results found in other studies, although after eccentric exercise. However, it cannot predict acute performance loss in jump height.
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Affiliation(s)
| | - Frane Erčulj
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia -
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24
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A meta-analysis of the association of CKM gene rs8111989 polymorphism with sport performance. Biol Sport 2018; 34:323-330. [PMID: 29472734 PMCID: PMC5819473 DOI: 10.5114/biolsport.2017.69819] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/13/2017] [Accepted: 04/12/2017] [Indexed: 02/07/2023] Open
Abstract
The muscle-specific creatine kinase (CKM) A/G variants (rs8111989) have been associated with skeletal muscle performance in humans; they are correlated with physical performance and contribute to differences in the maximum oxygen uptake (VO2max) responses during power or endurance training. However, there is not enough definitive evidence to demonstrate whether the A and G allelic variants of the CKM gene rs8111989 are indeed genetic factors that can influence human physical performance. In our study, we identified 9 articles on CKM in a literature search, and conducted two meta-analyses on the CKM rs8111989 A/G allele or genotype differences between power or endurance athletes and general controls. We found that the power athletes had a significantly higher frequency of the G allele (OR, 1.14; 95% CI, 1.02-1.28, P=0.03) and GG genotype (OR, 1.54; 95% CI, 1.24-1.91, P<0.0001) compared to controls, but there was no significant difference for the endurance athletes (G allele, OR, 0.95, 95%CI, 0.85-1.06, P=0.34; GG genotype, OR, 1.00, 95%CI, 0.78-1.27, P=1.00). The results provide additional evidence to support the notion that human physical performance might be influenced by genetic profiles, especially in power sports.
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25
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Doeven SH, Brink MS, Kosse SJ, Lemmink KAPM. Postmatch recovery of physical performance and biochemical markers in team ball sports: a systematic review. BMJ Open Sport Exerc Med 2018. [PMID: 29527320 PMCID: PMC5841509 DOI: 10.1136/bmjsem-2017-000264] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Insufficient postmatch recovery in elite players may cause an increased risk of injuries, illnesses and non-functional over-reaching. Objective To evaluate postmatch recovery time courses of physical performance and biochemical markers in team ball sport players. Study design Systematic review. Data sources PubMed and Web of Science. Eligibility criteria for selecting studies This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Critical Review Form for Quantitative Studies was used to evaluate quality. Studies were included if they met the following criteria: (1) original research evaluated players’ physical recovery postmatch; (2) team/intermittent sports; and (3) at least two postmeasurements were compared with baseline values. Results Twenty-eight studies were eligible. Mean methodological quality was 11.2±1.11. Most used performance tests and biochemical markers were the countermovement jump test, sprint tests and creatine kinase (CK), cortisol (C) and testosterone (T), respectively. Summary/conclusions The current evidence demonstrates that underlying mechanisms of muscle recovery are still in progress while performance recovery is already reached. CK recovery time courses are up to ≥72 hours. Soccer and rugby players need more time to recover for sprint performance, CK and C in comparison to other team ball sports. There are more high-quality studies needed regarding recovery in various team sports and recovery strategies on an individual level should be evaluated. Clinical relevance Ongoing insufficient recovery can be prevented by the use of the presented recovery time courses as specific practical recovery guidelines.
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Affiliation(s)
- Steven H Doeven
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, The Netherlands.,School of Sport Studies, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Michel S Brink
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Silke J Kosse
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Koen A P M Lemmink
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, The Netherlands
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26
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Bekkelund SI, Jorde R. Creatine kinase in relation to body fat in a Caucasian overweight and obese population. Scandinavian Journal of Clinical and Laboratory Investigation 2017; 78:43-48. [PMID: 29258351 DOI: 10.1080/00365513.2017.1408140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We investigated the association between serum creatine kinase (CK) and body fat mass in an overweight and obese population. In this cross-sectional study, 454 Caucasian overweight and obese individuals recruited from a medical outpatient clinic and via newspaper advertising underwent dual-energy X-ray absorptiometry (DEXA). Serum CK was obtained along with supplementary blood samples. This report is based on a secondary analysis from a previous randomized controlled trial treating obesity with vitamin D3. Serum CK correlated negatively with body fat mass in men (r = -.18, p = .025) but not in women (r = -.11, p = .069). An insignificant negative trend for logCK across quartiles of fat mass in men was found (p = .098). CK did not associate significantly with lean mass, but lean mass correlated positively with fat mass in both groups (p < .0001). In a multivariate model, serum CK was inversely and independently related to fat mass in men. Fat mass decreased with 7.83 kg per unit logCK increase when adjusted for age and lean mass (95% CI -12.3 to -3.3, p = .001). These data support the view that circulating CK interacts with obesity in a favourable way independent of its muscular connection in men. CK was not associated with fat mass in women.
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Affiliation(s)
- Svein I Bekkelund
- a Department of Neurology and Neurophysiology , University Hospital of North Norway , Tromsø , Norway.,b Department of Clinical Medicine , UiT - The Arctic University of Norway , Tromsø , Norway
| | - Rolf Jorde
- b Department of Clinical Medicine , UiT - The Arctic University of Norway , Tromsø , Norway.,c Division of Internal Medicine , University Hospital of North Norway , Tromsø , Norway
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27
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Alaygut D, Torun Bayram M, Kasap B, Soylu A, Türkmen M, Kavukcu S. Rhabdomyolysis with different etiologies in childhood. World J Clin Pediatr 2017; 6:161-168. [PMID: 29184760 PMCID: PMC5691034 DOI: 10.5409/wjcp.v6.i4.161] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 03/21/2017] [Accepted: 07/24/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate different etiologies and management of the rhabdomyolysis in children.
METHODS Eight pediatric rhabdomyolysis cases who applied to the Dokuz Eylul University Faculty of Medicine Department of Pediatric Nephrology with different etiologies between January 2004 and January 2012 were evaluated in terms of age, gender, admission symptoms, physical examination findings, factors provoking rhabdomyolysis, number of rhabdomyolysis attacks, laboratory results, family history and the final diagnosis received after the treatment.
RESULTS Average diagnosis ages of eight cases were 129 (24-192) ± 75.5 mo and five of them were girls. All of them had applied with the complaint of muscle pain, calf pain, and dark color urination. Infection (pneumonia) and excessive physical activity were the most important provocative factors and excessive licorice consumption was observed in one case. In 5 cases, acute kidney injury was determined and two cases needed hemodialysis. As a result of the further examinations; the cases had received diagnoses of rhabdomyolysis associated with mycoplasma pneumoniae, sepsis associated rhabdomyolysis, licorice-induced hypokalemic rhabdomyolysis, carnitine palmitoyltransferase II deficiency, very long-chain acyl-CoA dehydrogenase deficiency, congenital muscular dystrophy and idiopathic paroxysmal rhabdomyolysis (Meyer-Betz syndrome).
CONCLUSION It is important to distinguish the sporadic and recurrent rhabdomyolysis cases from each other. Recurrent rhabdomyolysis cases should follow up more regardful and attentive.
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Affiliation(s)
- Demet Alaygut
- Department of Pediatric Nephrology, Dokuz Eylul University Faculty of Medicine, 35340 İnciralti İzmir, Turkey
| | - Meral Torun Bayram
- Department of Pediatric Nephrology, Dokuz Eylul University Faculty of Medicine, 35340 İnciralti İzmir, Turkey
| | - Belde Kasap
- Department of Pediatric Nephrology, Dokuz Eylul University Faculty of Medicine, 35340 İnciralti İzmir, Turkey
| | - Alper Soylu
- Department of Pediatric Nephrology, Dokuz Eylul University Faculty of Medicine, 35340 İnciralti İzmir, Turkey
| | - Mehmet Türkmen
- Department of Pediatric Nephrology, Dokuz Eylul University Faculty of Medicine, 35340 İnciralti İzmir, Turkey
| | - Salih Kavukcu
- Department of Pediatric Nephrology, Dokuz Eylul University Faculty of Medicine, 35340 İnciralti İzmir, Turkey
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28
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Hicks KM, Onambele-Pearson GL, Winwood K, Morse CI. Muscle-Tendon Unit Properties during Eccentric Exercise Correlate with the Creatine Kinase Response. Front Physiol 2017; 8:657. [PMID: 28974931 PMCID: PMC5610718 DOI: 10.3389/fphys.2017.00657] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 08/17/2017] [Indexed: 11/13/2022] Open
Abstract
Aim: The aim of this paper was to determine whether; (1) patella tendon stiffness, (2) the magnitude of vastus lateralis fascicle lengthening, and (3) eccentric torque correlate with markers of exercise induced muscle damage. Method: Combining dynamometry and ultrasonography, patella tendon properties and vastus lateralis architectural properties were measured pre and during the first of six sets of 12 maximal voluntary eccentric knee extensions. Maximal isometric torque loss and creatine kinase activity were measured pre-damage (-48 h), 48, 96, and 168 h post-damage as markers of exercise-induced muscle damage. Results: A significant increase in creatine kinase (883 ± 667 UL) and a significant reduction in maximal isometric torque loss (21%) was reported post-eccentric contractions. Change in creatine kinase from pre to peak significantly correlated with the relative change in vastus lateralis fascicle length during eccentric contractions (r = 0.53, p = 0.02) and with eccentric torque (r = 0.50, p = 0.02). Additionally, creatine kinase tended to correlate with estimated patella tendon lengthening during eccentric contractions (p < 0.10). However, creatine kinase did not correlate with resting measures of patella tendon properties or vastus lateralis properties. Similarly, torque loss did not correlate with any patella tendon or vastus lateralis properties at rest or during eccentric contractions. Conclusion: The current study demonstrates that the extent of fascicle strain during eccentric contractions correlates with the magnitude of the creatine kinase response. Although at rest, there is no relationship between patella tendon properties and markers of muscle damage; during eccentric contractions however, the patella tendon may play a role in the creatine kinase response following EIMD.
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Affiliation(s)
- Kirsty M Hicks
- Department of Sport, Exercise & Rehabilitation, Northumbria UniversityNewcastle Upon Tyne, United Kingdom.,Department of Exercise and Sport Science, Health Exercise and Active Living Research Centre, Manchester Metropolitan UniversityCrewe, United Kingdom
| | - Gladys L Onambele-Pearson
- Department of Exercise and Sport Science, Health Exercise and Active Living Research Centre, Manchester Metropolitan UniversityCrewe, United Kingdom
| | - Keith Winwood
- Department of Exercise and Sport Science, Health Exercise and Active Living Research Centre, Manchester Metropolitan UniversityCrewe, United Kingdom.,School of Healthcare Science, Manchester Metropolitan UniversityManchester, United Kingdom
| | - Christopher I Morse
- Department of Exercise and Sport Science, Health Exercise and Active Living Research Centre, Manchester Metropolitan UniversityCrewe, United Kingdom
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29
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Malhotra S, Preet K, Tomar A, Rawat S, Singh S, Singh I, Varte LR, Chatterjee T, Pal MS, Sarkar S. Polygenic study of endurance-associated genetic markers ACE I/D, ACTN3 Arg(R)577Ter(X), CKMM A/G NcoI and eNOS Glu(G)298Asp(T) in male Gorkha soldiers. SPORTS MEDICINE-OPEN 2017; 3:17. [PMID: 28444615 PMCID: PMC5405041 DOI: 10.1186/s40798-017-0085-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 04/14/2017] [Indexed: 12/13/2022]
Abstract
Background Gorkhas, a sub-mountainous population of the Himalayan region, are known for strength and bravery. In the present study when “Gorkha” is used without brackets, we are mentioning Gorkhas of Tibeto-Burman origin. Physical capability, strength and endurance are important components of fitness associated with genetic traits. The aim of this study was to examine the endurance potential of male Gorkha soldiers, based on endurance-related genetic markers ACE I/D, ACTN3 Arg (R)577Ter(X), CKMM A/G NcoI and eNOS Glu(G)298Asp(T). Methods Genotypic and allelic frequencies were determined in 374 male Gorkha soldiers (Tibeto-Burman). These frequencies were compared with frequencies obtained from Gorkha (Indo-Aryan), high-altitude natives (Tibeto-Burman) and Indian lowlanders (Indo-Aryan). “Total genotype score” (TGS) was calculated from accumulated combination of polymorphisms with maximum value “100” for theoretically “optimal” polygenic score. Probability of occurrence of “optimal” endurance profile was also determined. Results ACE II genotypic frequency was highest in Tamangs followed by Gurungs, Rais, Limbus and Magars. No statistical difference in genotypic and allelic frequency of ACTN3 Arg(R)577Ter(X) was noted within the groups. Rais showed the highest CKMM A allele frequency (0.908) compared to other Gorkha (Tibeto-Burman) groups. Limbus and Tamangs showed the highest eNOS G allele frequency (0.938 and 0.915, respectively) compared to that of other groups. Probability of male Gorkha soldiers possessing a theoretically optimal polygenic endurance profile for four candidate polymorphisms was ~3.35% (1 in 30). Four percent of the population of male Gorkha soldiers (15 in 374) exhibited an optimal TGS 100, and 16% exhibited TGS 87 for endurance compared to male Indian soldiers belonging to the lowland (Indo-Aryan) and Gorkha (Indo-Aryan) populations suggesting an overall more “favourable” polygenic profile in the male Gorkha soldier (Tibeto-Burman) population. Conclusions This study presents evidence of higher frequency of endurance-associated genes in the Gorkhas implying thereby that such genetically endowed individuals from the population may be selected and trained for achieving excellence in endurance-related elite sports activities. Electronic supplementary material The online version of this article (doi:10.1186/s40798-017-0085-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Seema Malhotra
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence. Government of India, Lucknow Road, Delhi, 110054, India
| | - Kiran Preet
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence. Government of India, Lucknow Road, Delhi, 110054, India
| | - Arvind Tomar
- Defence Research and Development Establishment (DRDE). Ministry of Defence, Government of India, Jhansi Road, Gwalior, 474002, Madhya Pradesh, India
| | - Shweta Rawat
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence. Government of India, Lucknow Road, Delhi, 110054, India
| | - Sayar Singh
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence. Government of India, Lucknow Road, Delhi, 110054, India
| | - Inderjeet Singh
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence. Government of India, Lucknow Road, Delhi, 110054, India
| | - L Robert Varte
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence. Government of India, Lucknow Road, Delhi, 110054, India
| | - Tirthankar Chatterjee
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence. Government of India, Lucknow Road, Delhi, 110054, India
| | - M S Pal
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence. Government of India, Lucknow Road, Delhi, 110054, India
| | - Soma Sarkar
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence. Government of India, Lucknow Road, Delhi, 110054, India.
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30
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Comparison of Muscle-Specific Creatine Kinase (CK-MM) Gene Polymorphism (rs8111989) Among Professional, Amateur Athletes and Non-athlete Karatekas. Asian J Sports Med 2017. [DOI: 10.5812/asjsm.43210] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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31
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Del Coso J, Valero M, Salinero JJ, Lara B, Gallo-Salazar C, Areces F. Optimum polygenic profile to resist exertional rhabdomyolysis during a marathon. PLoS One 2017; 12:e0172965. [PMID: 28257486 PMCID: PMC5336235 DOI: 10.1371/journal.pone.0172965] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/13/2017] [Indexed: 12/27/2022] Open
Abstract
Purpose Exertional rhabdomyolysis can occur in individuals performing various types of exercise but it is unclear why some individuals develop this condition while others do not. Previous investigations have determined the role of several single nucleotide polymorphisms (SNPs) to explain inter-individual variability of serum creatine kinase (CK) concentrations after exertional muscle damage. However, there has been no research about the interrelationship among these SNPs. The purpose of this investigation was to analyze seven SNPs that are candidates for explaining individual variations of CK response after a marathon competition (ACE = 287bp Ins/Del, ACTN3 = p.R577X, CKMM = NcoI, IGF2 = C13790G, IL6 = 174G>C, MLCK = C37885A, TNFα = 308G>A). Methods Using Williams and Folland’s model, we determined the total genotype score from the accumulated combination of these seven SNPs for marathoners with a low CK response (n = 36; serum CK <400 U·L-1) vs. marathoners with a high CK response (n = 31; serum CK ≥400 U·L-1). Results At the end of the race, low CK responders had lower serum CK (290±65 vs. 733±405 U·L-1; P<0.01) and myoglobin concentrations (443±328 vs. 1009±971 ng·mL-1, P<0.01) than high CK responders. Although the groups were similar in age, anthropometric characteristics, running experience and training habits, total genotype score was higher in low CK responders than in high CK responders (5.2±1.4 vs. 4.4±1.7 point, P = 0.02). Conclusion Marathoners with a lower CK response after the race had a more favorable polygenic profile than runners with high serum CK concentrations. This might suggest a significant role of genetic polymorphisms in the levels of exertional muscle damage and rhabdomyolysis. Yet other SNPs, in addition to exercise training, might also play a role in the values of CK after damaging exercise.
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Affiliation(s)
- Juan Del Coso
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
- * E-mail:
| | - Marjorie Valero
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
| | - Juan José Salinero
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
| | - Beatriz Lara
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
| | | | - Francisco Areces
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
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Harper LD, Hunter R, Parker P, Goodall S, Thomas K, Howatson G, West DJ, Stevenson E, Russell M. Test-Retest Reliability of Physiological and Performance Responses to 120 Minutes of Simulated Soccer Match Play. J Strength Cond Res 2016; 30:3178-3186. [DOI: 10.1519/jsc.0000000000001400] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Scalco RS, Snoeck M, Quinlivan R, Treves S, Laforét P, Jungbluth H, Voermans NC. Exertional rhabdomyolysis: physiological response or manifestation of an underlying myopathy? BMJ Open Sport Exerc Med 2016; 2:e000151. [PMID: 27900193 PMCID: PMC5117086 DOI: 10.1136/bmjsem-2016-000151] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2016] [Indexed: 12/14/2022] Open
Abstract
Exertional rhabdomyolysis is characterised by muscle breakdown associated with strenuous exercise or normal exercise under extreme circumstances. Key features are severe muscle pain and sudden transient elevation of serum creatine kinase (CK) levels with or without associated myoglobinuria. Mild cases may remain unnoticed or undiagnosed. Exertional rhabdomyolysis is well described among athletes and military personnel, but may occur in anybody exposed to unaccustomed exercise. In contrast, exertional rhabdomyolysis may be the first manifestation of a genetic muscle disease that lowers the exercise threshold for developing muscle breakdown. Repeated episodes of exertional rhabdomyolysis should raise the suspicion of such an underlying disorder, in particular in individuals in whom the severity of the rhabdomyolysis episodes exceeds the expected response to the exercise performed. The present review aims to provide a practical guideline for the acute management and postepisode counselling of patients with exertional rhabdomyolysis, with a particular emphasis on when to suspect an underlying genetic disorder. The pathophysiology and its clinical features are reviewed, emphasising four main stepwise approaches: (1) the clinical significance of an acute episode, (2) risks of renal impairment, (3) clinical indicators of an underlying genetic disorders and (4) when and how to recommence sport activity following an acute episode of rhabdomyolysis. Genetic backgrounds that appear to be associated with both enhanced athletic performance and increased rhabdomyolysis risk are briefly reviewed.
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Affiliation(s)
- Renata S Scalco
- MRC Centre for Neuromuscular Diseases , Institute of Neurology, University College London , London , UK
| | - Marc Snoeck
- MH-investigation Unit, Department of Anesthesia , Canisius-Wilhelmina Hospital , Nijmegen , The Netherlands
| | - Ros Quinlivan
- MRC Centre for Neuromuscular Diseases , Institute of Neurology, University College London , London , UK
| | - Susan Treves
- Departments of Anesthesia and of Biomedicine, Basel University Hospital, Basel, Switzerland; Department of Life Sciences, General Pathology Section, University of Ferrara, Ferrara, Italy
| | - Pascal Laforét
- Institut de Myologie, Hôpital Pitié-Salpêtrière , Paris , France
| | - Heinz Jungbluth
- Department of Paediatric Neurology-Neuromuscular Service, Evelina Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK; Randall Division of Cell and Molecular Biophysics, Muscle Signalling Section, London, UK; Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Nicol C Voermans
- Department of Neurology , Radboud University Medical Centre , Nijmegen , The Netherlands
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Coelho DB, Cabido CET, Ciminelli VAL, Coelho LGM, Becker LK, Oliveira ECD, Pereira ER, Marins JCB, Garcia ES. Comparison of different ways of expressing creatine kinase concentration of soccer players during a competitive season. MOTRIZ: REVISTA DE EDUCACAO FISICA 2016. [DOI: 10.1590/s1980-6574201600030006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Baumert P, Lake MJ, Stewart CE, Drust B, Erskine RM. Genetic variation and exercise-induced muscle damage: implications for athletic performance, injury and ageing. Eur J Appl Physiol 2016; 116:1595-625. [PMID: 27294501 PMCID: PMC4983298 DOI: 10.1007/s00421-016-3411-1] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 06/03/2016] [Indexed: 02/06/2023]
Abstract
Prolonged unaccustomed exercise involving muscle lengthening (eccentric) actions can result in ultrastructural muscle disruption, impaired excitation-contraction coupling, inflammation and muscle protein degradation. This process is associated with delayed onset muscle soreness and is referred to as exercise-induced muscle damage. Although a certain amount of muscle damage may be necessary for adaptation to occur, excessive damage or inadequate recovery from exercise-induced muscle damage can increase injury risk, particularly in older individuals, who experience more damage and require longer to recover from muscle damaging exercise than younger adults. Furthermore, it is apparent that inter-individual variation exists in the response to exercise-induced muscle damage, and there is evidence that genetic variability may play a key role. Although this area of research is in its infancy, certain gene variations, or polymorphisms have been associated with exercise-induced muscle damage (i.e. individuals with certain genotypes experience greater muscle damage, and require longer recovery, following strenuous exercise). These polymorphisms include ACTN3 (R577X, rs1815739), TNF (-308 G>A, rs1800629), IL6 (-174 G>C, rs1800795), and IGF2 (ApaI, 17200 G>A, rs680). Knowing how someone is likely to respond to a particular type of exercise could help coaches/practitioners individualise the exercise training of their athletes/patients, thus maximising recovery and adaptation, while reducing overload-associated injury risk. The purpose of this review is to provide a critical analysis of the literature concerning gene polymorphisms associated with exercise-induced muscle damage, both in young and older individuals, and to highlight the potential mechanisms underpinning these associations, thus providing a better understanding of exercise-induced muscle damage.
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Affiliation(s)
- Philipp Baumert
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Mark J Lake
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Claire E Stewart
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Barry Drust
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Robert M Erskine
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK.
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Hicks KM, Onambélé GL, Winwood K, Morse CI. Muscle Damage following Maximal Eccentric Knee Extensions in Males and Females. PLoS One 2016; 11:e0150848. [PMID: 26986066 PMCID: PMC4795791 DOI: 10.1371/journal.pone.0150848] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 02/19/2016] [Indexed: 11/19/2022] Open
Abstract
Aim To investigate whether there is a sex difference in exercise induced muscle damage. Materials and Method Vastus Lateralis and patella tendon properties were measured in males and females using ultrasonography. During maximal voluntary eccentric knee extensions (12 reps x 6 sets), Vastus Lateralis fascicle lengthening and maximal voluntary eccentric knee extensions torque were recorded every 10° of knee joint angle (20–90°). Isometric torque, Creatine Kinase and muscle soreness were measured pre, post, 48, 96 and 168 hours post damage as markers of exercise induced muscle damage. Results Patella tendon stiffness and Vastus Lateralis fascicle lengthening were significantly higher in males compared to females (p<0.05). There was no sex difference in isometric torque loss and muscle soreness post exercise induced muscle damage (p>0.05). Creatine Kinase levels post exercise induced muscle damage were higher in males compared to females (p<0.05), and remained higher when maximal voluntary eccentric knee extension torque, relative to estimated quadriceps anatomical cross sectional area, was taken as a covariate (p<0.05). Conclusion Based on isometric torque loss, there is no sex difference in exercise induced muscle damage. The higher Creatine Kinase in males could not be explained by differences in maximal voluntary eccentric knee extension torque, Vastus Lateralis fascicle lengthening and patella tendon stiffness. Further research is required to understand the significant sex differences in Creatine Kinase levels following exercise induced muscle damage.
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Affiliation(s)
- K. M. Hicks
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-Upon-Tyne, United Kingdom
- Institute for Performance Research, Department of Exercise and Sport Science, Manchester Metropolitan University Cheshire, Manchester, United Kingdom
- * E-mail:
| | - G. L. Onambélé
- Institute for Performance Research, Department of Exercise and Sport Science, Manchester Metropolitan University Cheshire, Manchester, United Kingdom
| | - K. Winwood
- Institute for Performance Research, Department of Exercise and Sport Science, Manchester Metropolitan University Cheshire, Manchester, United Kingdom
| | - C. I. Morse
- Institute for Performance Research, Department of Exercise and Sport Science, Manchester Metropolitan University Cheshire, Manchester, United Kingdom
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Evaluation of a 7-Gene Genetic Profile for Athletic Endurance Phenotype in Ironman Championship Triathletes. PLoS One 2015; 10:e0145171. [PMID: 26716680 PMCID: PMC4696732 DOI: 10.1371/journal.pone.0145171] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 11/30/2015] [Indexed: 02/01/2023] Open
Abstract
Polygenic profiling has been proposed for elite endurance performance, using an additive model determining the proportion of optimal alleles in endurance athletes. To investigate this model’s utility for elite triathletes, we genotyped seven polymorphisms previously associated with an endurance polygenic profile (ACE Ins/Del, ACTN3 Arg577Ter, AMPD1 Gln12Ter, CKMM 1170bp/985+185bp, HFE His63Asp, GDF8 Lys153Arg and PPARGC1A Gly482Ser) in a cohort of 196 elite athletes who participated in the 2008 Kona Ironman championship triathlon. Mean performance time (PT) was not significantly different in individual marker analysis. Age, sex, and continent of origin had a significant influence on PT and were adjusted for. Only the AMPD1 endurance-optimal Gln allele was found to be significantly associated with an improvement in PT (model p = 5.79 x 10−17, AMPD1 genotype p = 0.01). Individual genotypes were combined into a total genotype score (TGS); TGS distribution ranged from 28.6 to 92.9, concordant with prior studies in endurance athletes (mean±SD: 60.75±12.95). TGS distribution was shifted toward higher TGS in the top 10% of athletes, though the mean TGS was not significantly different (p = 0.164) and not significantly associated with PT even when adjusted for age, sex, and origin. Receiver operating characteristic curve analysis determined that TGS alone could not significantly predict athlete finishing time with discriminating sensitivity and specificity for three outcomes (less than median PT, less than mean PT, or in the top 10%), though models with the age, sex, continent of origin, and either TGS or AMPD1 genotype could. These results suggest three things: that more sophisticated genetic models may be necessary to accurately predict athlete finishing time in endurance events; that non-genetic factors such as training are hugely influential and should be included in genetic analyses to prevent confounding; and that large collaborations may be necessary to obtain sufficient sample sizes for powerful and complex analyses of endurance performance.
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Contreras-Sesvold C, Revenis BD, O'Connor FG, Deuster PA. Association of Plasma Heat Shock Protein 70, Interleukin 6, and Creatine Kinase Concentrations in a Healthy, Young Adult Population. J Biomark 2015; 2015:967120. [PMID: 26664829 PMCID: PMC4667024 DOI: 10.1155/2015/967120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 09/07/2015] [Accepted: 10/13/2015] [Indexed: 11/18/2022] Open
Abstract
Variations of baseline plasma concentrations of creatine kinase (CK), heat shock protein 70 (HSP70), and interleukin 6 (IL-6) have been reported. We report categorical associations which may influence these protein levels. Methods. Blood was harvested for DNA and plasma protein analysis from 567 adults. Mean protein levels of CK, HSP70, and IL-6 were compared by sex, ethnicity, genetic variants-CKMM Nco1 (rs1803285), HSPA1B +A1538G (rs1061581), and IL6 G-174C (rs1800795)-self-reported history of exercise, oral contraceptive use, and dietary supplement use. Results. SNP major allele frequencies for CKMM, HSPA1B, and IL6 were 70% A, 57% A, and 60%. Mean CK statistically differed by sex, ethnicity, oral contraceptives, and caffeine. Plasma HSP70 differed by caffeine and protein. Mean IL-6 concentration differed by sex, ethnicity, and genotype. Plasma IL-6 was significantly lower (29%) in males (1.92 ± 0.08 pg/mL) and higher (29%) among African Americans (2.85 ± 0.50 pg/mL) relative to the others. IL6 G-174C GG genotype (2.23 ± 0.14 pg/mL) was 19% greater than CG or CC genotypes. Conclusion. Differences in baseline CK and IL-6 plasma protein concentrations are associated with genetics, sex, ethnicity, and the use of oral contraceptives, caffeine, and protein supplements in this young and athletic population.
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Affiliation(s)
- Carmen Contreras-Sesvold
- Human Performance Laboratory, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Bradley D. Revenis
- Human Performance Laboratory, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Francis G. O'Connor
- Human Performance Laboratory, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Patricia A. Deuster
- Human Performance Laboratory, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
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Asplund CA, O'Connor FG. Challenging Return to Play Decisions: Heat Stroke, Exertional Rhabdomyolysis, and Exertional Collapse Associated With Sickle Cell Trait. Sports Health 2015; 8:117-25. [PMID: 26896216 PMCID: PMC4789928 DOI: 10.1177/1941738115617453] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Context: Sports medicine providers frequently return athletes to play after sports-related injuries and conditions. Many of these conditions have guidelines or medical evidence to guide the decision-making process. Occasionally, however, sports medicine providers are challenged with complex medical conditions for which there is little evidence-based guidance and physicians are instructed to individualize treatment; included in this group of conditions are exertional heat stroke (EHS), exertional rhabdomyolysis (ER), and exertional collapse associated with sickle cell trait (ECAST). Evidence Acquisition: The MEDLINE (2000-2015) database was searched using the following search terms: exertional heat stroke, exertional rhabdomyolysis, and exertional collapse associated with sickle cell trait. References from consensus statements, review articles, and book chapters were also utilized. Study Design: Clinical review. Level of Evidence: Level 4. Results: These entities are unique in that they may cause organ system damage capable of leading to short- or long-term detriments to physical activity and may not lend to complete recovery, potentially putting the athlete at risk with premature return to play. Conclusion: With a better understanding of the pathophysiology of EHS, ER, and ECAST and the factors associated with recovery, better decisions regarding return to play may be made.
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Affiliation(s)
- Chad A Asplund
- Athletic Medicine, Division of Health Services, Health and Kinesiology, Georgia Southern University, Statesboro, Georgia
| | - Francis G O'Connor
- Military and Emergency Medicine, Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Kim J, Lee J. The relationship of creatine kinase variability with body composition and muscle damage markers following eccentric muscle contractions. J Exerc Nutrition Biochem 2015; 19:123-9. [PMID: 26244131 PMCID: PMC4523802 DOI: 10.5717/jenb.2015.15061910] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 06/08/2015] [Accepted: 06/19/2015] [Indexed: 11/06/2022] Open
Abstract
[Purpose] The purpose of the study was to investigate the relationship between CK variability and body composition and muscle damage markers following eccentric exercise. [Methods] Total 119 healthy male subjects were recruited to perform 50 eccentric contractions consisted of 2 sets of 25 contractions. Then, blood creatine kinase (CK) activity was analyzed to divide into three groups based on their CK activity levels. Maximum isometric strength (MIS), muscle soreness (SOR) and body composition data were obtained before and after exercise. [Results] The results showed that high CK responders had a significant decrease in MIS (p<0.001) and greater SOR (p<0.01) following eccentric exercise compared to low CK responders. Percent body fat was also higher in high responders compared to low responders (p=0.014). Peak CK activity was significantly correlated with MIS and SOR but no correlation with % body fat, muscle mass, and body mass index. [Conclusion] CK variability following eccentric exercise is closely related to MIS and SOR and % body fat may be a potent factor for CK variability.
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Affiliation(s)
- Jooyoung Kim
- College of Physical Education, Kookmin University, Seoul, Republic of Korea
| | - Joohyung Lee
- College of Physical Education, Kookmin University, Seoul, Republic of Korea
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Scalco RS, Gardiner AR, Pitceathly RD, Zanoteli E, Becker J, Holton JL, Houlden H, Jungbluth H, Quinlivan R. Rhabdomyolysis: a genetic perspective. Orphanet J Rare Dis 2015; 10:51. [PMID: 25929793 PMCID: PMC4522153 DOI: 10.1186/s13023-015-0264-3] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 04/09/2015] [Indexed: 01/19/2023] Open
Abstract
Rhabdomyolysis (RM) is a clinical emergency characterized by fulminant skeletal muscle damage and release of intracellular muscle components into the blood stream leading to myoglobinuria and, in severe cases, acute renal failure. Apart from trauma, a wide range of causes have been reported including drug abuse and infections. Underlying genetic disorders are also a cause of RM and can often pose a diagnostic challenge, considering their marked heterogeneity and comparative rarity. In this paper we review the range of rare genetic defects known to be associated with RM. Each gene has been reviewed for the following: clinical phenotype, typical triggers for RM and recommended diagnostic approach. The purpose of this review is to highlight the most important features associated with specific genetic defects in order to aid the diagnosis of patients presenting with hereditary causes of recurrent RM.
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Affiliation(s)
- Renata Siciliani Scalco
- MRC Centre for Neuromuscular Diseases and Department of Molecular Neuroscience, University College London (UCL) Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK. .,Department of Neurology, HSL, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil. .,CAPES Foundation, Ministry of Education of Brazil, Brasilia, DF, Brazil.
| | - Alice R Gardiner
- MRC Centre for Neuromuscular Diseases and Department of Molecular Neuroscience, University College London (UCL) Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK.
| | - Robert Ds Pitceathly
- MRC Centre for Neuromuscular Diseases and Department of Molecular Neuroscience, University College London (UCL) Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK. .,Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London (KCL), London, UK.
| | - Edmar Zanoteli
- Department of Neurology, School of Medicine, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
| | - Jefferson Becker
- Department of Neurology, HSL, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Janice L Holton
- MRC Centre for Neuromuscular Diseases and Department of Molecular Neuroscience, University College London (UCL) Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK.
| | - Henry Houlden
- MRC Centre for Neuromuscular Diseases and Department of Molecular Neuroscience, University College London (UCL) Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK.
| | - Heinz Jungbluth
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London (KCL), London, UK. .,Department of Paediatric Neurology, Evelina Children's Hospital, Guy's & St Thomas NHS Foundation Trust, London, UK. .,Randall Division for Cell and Molecular Biophysics, Muscle Signalling Section, King's College London, London, UK.
| | - Ros Quinlivan
- MRC Centre for Neuromuscular Diseases and Department of Molecular Neuroscience, University College London (UCL) Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK. .,Dubowitz Neuromuscular Centre, Great Ormond Street Hospital, London, UK.
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Abstract
Rugby league is a team sport in which players engage in repeated high-intensity exercise involving frequent collisions. Recent research, much of which has involved global positioning system (GPS) technology, has provided coaches and sport scientists with a deeper understanding of match demands, particularly at the elite level. This has allowed for the development of training programmes that prepare players for the most intense contact and running demands likely to be experienced in competition. At the elite level, rugby league players have well-developed aerobic and anaerobic endurance, muscular strength and power, reactive agility, and speed. Upper- and lower-body strength and aerobic power are associated with a broad range of technical and sport-specific skills, in addition to a lower risk of injury. Significant muscle damage (as estimated from creatine kinase concentrations) and fatigue occurs as a result of match-play; while muscle function and perceptual fatigue generally return to baseline 48 h following competition, increases in plasma concentrations of creatine kinase can last for up to 5 days post-match. Well-developed physical qualities may minimise post-match fatigue and facilitate recovery. Ultimately, the literature highlights that players require a broad range of physical and technical skills developed through specific training. This review evaluates the demands of the modern game, drawing on research that has used GPS technology. These findings highlight that preparing players based on the average demands of competition is likely to leave them underprepared for the most demanding passages of play. As such, coaches should incorporate drills that replicate the most intense repeated high-intensity demands of competition in order to prepare players for the worst-case scenarios expected during match-play.
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Affiliation(s)
- Rich D Johnston
- School of Exercise Science, Australian Catholic University, 1100 Nudgee Road, Brisbane, QLD, 4014, Australia,
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Eider J, Ahmetov II, Fedotovskaya ON, Moska W, Cieszczyk P, Zarebska A, Czubek Z, Klocek T, Stepien-Slodkowska M, Maciejewska-Karlowska A, Sawczuk M. CKM gene polymorphism in Russian and Polish rowers. RUSS J GENET+ 2015. [DOI: 10.1134/s1022795415030023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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CKM Gene G (Ncoi-) Allele Has a Positive Effect on Maximal Oxygen Uptake in Caucasian Women Practicing Sports Requiring Aerobic and Anaerobic Exercise Metabolism. J Hum Kinet 2013; 39:137-45. [PMID: 24511349 PMCID: PMC3916923 DOI: 10.2478/hukin-2013-0076] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The search for genes with a positive influence on physical fitness is a difficult process. Physical fitness is a trait determined by multiple genes, and its genetic basis is then modified by numerous environmental factors. The present study examines the effects of the polymorphism of creatine kinase (CKM) gene on VO2max – a physiological index of aerobic capacity of high heritability. The study sample consisted of 154 men and 85 women, who were students of the University School of Physical Education in Poznań and athletes practicing various sports, including members of the Polish national team. The study revealed a positive effect of a rare G (NcoI−) allele of the CKM gene on maximal oxygen uptake in Caucasian women practicing sports requiring aerobic and anaerobic exercise metabolism. Also a tendency was noted in individuals with NcoI−/− (GG) and NcoI−/+ (GA) genotypes to reach higher VO2max levels.
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45
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Hyldahl RD, Hubal MJ. Lengthening our perspective: Morphological, cellular, and molecular responses to eccentric exercise. Muscle Nerve 2013; 49:155-70. [DOI: 10.1002/mus.24077] [Citation(s) in RCA: 180] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 08/23/2013] [Accepted: 08/26/2013] [Indexed: 12/25/2022]
Affiliation(s)
- Robert D. Hyldahl
- Department of Exercise Science; 106 Smith Fieldhouse; Brigham Young University; Provo Utah 84003 USA
| | - Monica J. Hubal
- Research Center for Genetic Medicine; Children's National Medical Center; Washington DC USA
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Machado M, Pereira R, Willardson JM. Short intervals between sets and individuality of muscle damage response. J Strength Cond Res 2013; 26:2946-52. [PMID: 22158093 DOI: 10.1519/jsc.0b013e318243fdb5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined creatine kinase (CK) activity after resistance exercise sessions in subjects classified as high (HiR), medium (MeR), or low responders (LoR). Two resistance exercise sessions were performed that each involved 4 sets of the biceps curl at 85% of a 1 repetition maximum (1RM) and either 1- or 3-minute rest intervals between sets. High responders and MeR demonstrated significantly greater CK activity after the 1-minute session vs. the 3-minute session. Therefore, the HiR and MeR subjects exhibited less tolerance to resting 1 minute between sets, whereas the CK activity was not significantly different between rest intervals for the LoR subjects. The application of these findings indicates the need to vary the length of the rest interval between sets with the understanding that individuals exhibit varying recuperative abilities and some might be less tolerant of shorter rest intervals between sets.
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Affiliation(s)
- Marco Machado
- Laboratory of Human Movements Studies, University Foundation of Itaperuna (FUNITA), Itaperuna, Brazil.
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Abstract
IMPORTANCE Rhabdomyolysis ranges in severity from asymptomatic elevations in creatine phosphokinase levels to a life-threatening disorder characterized by severe acute kidney injury requiring hemodialysis or continuous renal replacement therapy (RRT). OBJECTIVE To develop a risk prediction tool to identify patients at greatest risk of RRT or in-hospital mortality. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study of 2371 patients admitted between January 1, 2000, and March 31, 2011, to 2 large teaching hospitals in Boston, Massachusetts, with creatine phosphokinase levels in excess of 5000 U/L within 3 days of admission. The derivation cohort consisted of 1397 patients from Massachusetts General Hospital, and the validation cohort comprised 974 patients from Brigham and Women's Hospital. MAIN OUTCOMES AND MEASURES The composite of RRT or in-hospital mortality. RESULTS The causes and outcomes of rhabdomyolysis were similar between the derivation and validation cohorts. In total, the composite outcome occurred in 19.0% of patients (8.0% required RRT and 14.1% died during hospitalization). The highest rates of the composite outcome were from compartment syndrome (41.2%), sepsis (39.3%), and following cardiac arrest (58.5%). The lowest rates were from myositis (1.7%), exercise (3.2%), and seizures (6.0%). The independent predictors of the composite outcome were age, female sex, cause of rhabdomyolysis, and values of initial creatinine, creatine phosphokinase, phosphate, calcium, and bicarbonate. We developed a risk-prediction score from these variables in the derivation cohort and subsequently applied it in the validation cohort. The C statistic for the prediction model was 0.82 (95% CI, 0.80-0.85) in the derivation cohort and 0.83 (0.80-0.86) in the validation cohort. The Hosmer-Lemeshow P values were .14 and .28, respectively. In the validation cohort, among the patients with the lowest risk score (<5), 2.3% died or needed RRT. Among the patients with the highest risk score (>10), 61.2% died or needed RRT. CONCLUSIONS AND RELEVANCE Outcomes from rhabdomyolysis vary widely depending on the clinical context. The risk of RRT or in-hospital mortality in patients with rhabdomyolysis can be estimated using commonly available demographic, clinical, and laboratory variables on admission.
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Affiliation(s)
- Gearoid M McMahon
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts2Framingham Heart Study, National Heart, Lung, and Blood Institute, and Center for Population Studies, Framingham, Massachusetts
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Pokrywka A, Kaliszewski P, Majorczyk E, Zembroń-Łacny A. Genes in sport and doping. Biol Sport 2013; 30:155-61. [PMID: 24744482 PMCID: PMC3944571 DOI: 10.5604/20831862.1059606] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2013] [Indexed: 11/19/2022] Open
Abstract
Genes control biological processes such as muscle production of energy, mitochondria biogenesis, bone formation, erythropoiesis, angiogenesis, vasodilation, neurogenesis, etc. DNA profiling for athletes reveals genetic variations that may be associated with endurance ability, muscle performance and power exercise, tendon susceptibility to injuries and psychological aptitude. Already, over 200 genes relating to physical performance have been identified by several research groups. Athletes’ genotyping is developing as a tool for the formulation of personalized training and nutritional programmes to optimize sport training as well as for the prediction of exercise-related injuries. On the other hand, development of molecular technology and gene therapy creates a risk of non-therapeutic use of cells, genes and genetic elements to improve athletic performance. Therefore, the World Anti-Doping Agency decided to include prohibition of gene doping within their World Anti-Doping Code in 2003. In this review article, we will provide a current overview of genes for use in athletes’ genotyping and gene doping possibilities, including their development and detection techniques.
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Grealy R, Smith CL, Chen T, Hiller D, Haseler LJ, Griffiths LR. The genetics of endurance: Frequency of the ACTN3 R577X variant in Ironman World Championship athletes. J Sci Med Sport 2013; 16:365-71. [DOI: 10.1016/j.jsams.2012.08.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 08/29/2012] [Accepted: 08/31/2012] [Indexed: 10/27/2022]
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Genetic polymorphisms associated with exertional rhabdomyolysis. Eur J Appl Physiol 2013; 113:1997-2004. [PMID: 23543093 DOI: 10.1007/s00421-013-2622-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 02/27/2013] [Indexed: 01/09/2023]
Abstract
Exertional rhabdomyolysis (ER) occurs in young, otherwise healthy, individuals principally during strenuous exercise, athletic, and military training. Although many risk factors have been offered, it is unclear why some individuals develop ER when participating in comparable levels of physical exertion under identical environmental conditions and others do not. This study investigated possible genetic polymorphisms that might help explain ER. DNA samples derived from a laboratory-based study of persons who had never experienced an episode of ER (controls) and clinical ER cases referred for testing over the past several years were analyzed for single nucleotide polymorphisms (SNPs) in candidate genes. These included angiotensin I converting enzyme (ACE), α-actinin-3 (ACTN3), creatine kinase muscle isoform (CKMM), heat shock protein A1B (HSPA1B), interleukin 6 (IL6), myosin light chain kinase (MYLK), adenosine monophosphate deaminase 1 (AMPD1), and sickle cell trait (HbS). Population included 134 controls and 47 ER cases. The majority of ER cases were men (n = 42/47, 89.4 %); the five women with ER were Caucasian. Eighteen African Americans (56.3 %) were ER cases. Three SNPs were associated with ER: CKMM Ncol, ACTN3 R577X, and MYLK C37885A. ER cases were 3.1 times more likely to have the GG genotype of CKMM (odds ratio/OR = 3.1, confidence interval/CI 1.33-7.10), 3.0 times for the XX genotype of ACTN3 SNP (OR = 2.97, CI 1.30-3.37), and 5.7 times for an A allele of MYLK (OR = 21.35, CI 2.60-12.30). All persons with HbS were also ER cases. Three distinct polymorphisms were associated with ER. Further work will be required to replicate these findings and determine the mechanism(s) whereby these variants might confer susceptibility.
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