Exertional Rhabdomyolysis during a 246-km Continuous Running Race
SKENDERI, K. P., S. A. KAVOURAS, C. A. ANASTASIOU, N. YIANNAKOURIS and A. MATALAS. Exertional Rhabdomyolysis during a 246-km Continuous Running Race. Med. Sci. Sports Exerc., Vol. 38, No. 6, pp. 1054 – 1057, 2006. Background: To evaluate the effect of continuous, moderate-intensity ultraendurance running exercise on skeletal muscle and hepatic damage, as indicated by serum enzyme activity measured immediately following the race. Methods: Thirty-nine runners of the Spartathlon race (a 246-km continuous race from Athens to Sparta, Greece) who managed to complete the race within the 36-h limit participated in this study. Mean finishing time of the study participants was 33.3 T 0.5 h and their average age, height, and body mass were 41 T 1 yr, 174 T 1 cm, and 67.5 T 1.1 kg, respectively. Blood samples, taken a day before and immediately after completion of the race, were assayed for the following variables: creatine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyltransferase (F-GT). Results: A dramatic increase in most of muscle and liver damage indicators was observed. The mean values for CK, LDH, AST, and ALT after the race were 43,763 T 6,764, 2,300 T 285, 1,182 T 165, and 264 T 37 IUILj1, respectively. These values were 29,384 T 4,327, 585 T 89, 5,615 T 902, and 1,606 T 331% higher than the corresponding values before the race (P G 0.001) for CK, LDH, AST, and ALT, respectively. However, there was not a significant increase in F-GT levels. Conclusion: Muscle and liver damage indicators were elevated at the highest level ever reported as a result of prolonged exercise, although no severe symptoms that required hospitalization were observed in any of the participants. The data suggest that even moderate-intensity exercise of prolonged duration can induce asymptomatic exertional rhabdomyolysis. Key Words: CREATINE KINASE, LACTATE DEHYDROGENASE, SPARTATHLON, ULTRAENDURANCE EXERCISE
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