Comparison of Changes in Glucose and Lipid Parameters Associated with Three Types of Long-Distance Running / 대한스포츠의학회지

Purpose@#The purpose of this study was to evaluate biochemical markers of blood glucose and blood lipids associated with extreme long-distance running races (marathon, 100 km, 308 km). @*Methods@#The participants were 45 middle-aged male runners: 15 corresponding to each distance. All participants performed graded exercise tests before the races. Blood glucose, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were analyzed by blood collection before and after the races to identify differences between the groups and before and after the races. @*Results@#No differences were found in blood glucose levels before and after all races, as well as between the groups. TC levels decreased only after the 308-km race, and this decrease was lower than the differences after the marathon and 100-km races. TG levels decreased after all three races and were lower after the 100-km and 308-km races than that after the marathon race. HDL-C levels showed no differences after the marathon race but increased after the 100-km and 308-km races, with higher levels after the 308-km race than those after the marathon and 100-km races. LDL-C levels increased after the marathon race, but decreased after the 308-km race, with lower levels after the 308-km race than those after the marathon and 100-km races. @*Conclusion@#The 308-km race was associated with decreases in TC, TG, and LDL-C levels and an increase in HDL-C levels, indicating that exercise time may have a positive effect on lipid metabolism rather than exercise intensity.

Apolipoprotein E Genotype and Expression Correlated with Hepatitis C Virus Genotype and Infection

The hepatitis C virus (HCV) is a globally prevalent human pathogen that causes persistent liver infections in most infected individuals. Several studies reported that HCV particles are enriched in apolipoprotein E (apoE) and that apoE is required for HCV infectivity and production. However, the relationship between apoE gene polymorphisms and HCV genotypes in patients with HCV is less well understood. The aim of this study was to investigate the association between apoE gene polymorphism and HCV genotypes in patients. The HCV genotypes were identified among the 124 patients infected with HCV, and the genetic characteristics of the HCV genotype were analyzed. In addition, the results of the clinical laboratory test were comparatively analyzed according to the classified genotypes. Both HCV 1b (n=80) and 2a (n=42) patients had higher AFP, AST, ALT, ALP, γ-GTP, apoB, and apoE values compared with the normal control group. In particular, apoB and apoE levels were statistically significantly higher in the HCV 2a patients (P<0.05) and apoE levels were significantly higher in the HCV 1b patients (P<0.000). According to the results the patients with HCV genotype 1b showed higher values of liver damage related indicators and apoB expression than the patients with HCV genotype 2a. The fat related indicators and apoE expression were not different between the two major HCV genotypes (2a and 1b). We anticipate that the apoE ε3 allele is the most common type in HCV genotype 1b (89.2%) and 2a (91.7%). As a result of apoE genotyping, we confirmed an association with HCV infection and the apoE ε3 allele. However, the ratios of the apoE ε3 allele among the patients with genotype 1b and 2a were similar to each other.

Effects of Super-Ultramarathon Races (622 km) on Cardiac Bio-Markers and Markers of Muscle Damage / 대한스포츠의학회지

PURPOSE: Changes in serum biomarkers of cardiac and muscle damage have been studied in ultra-marathon runners for distances up to 308 km. We investigated these biomarker changes following a 622-km super-ultramarathon race. METHODS: A group of men with a mean age of 52.7±4.8 years participated. Blood samples were obtained pre-race, during the race, and post-race, to analyze the aforementioned biomarkers. RESULTS: Creatine kinase and creatine kinase-MB (CK-MB) levels increased during the race, and both steadily declined post-race with CK-MB declining at a slower rate. Lactic acid dehydrogenase levels overall were increased over pre-race levels. White blood cell counts increased during the race. Red blood cell decreased from pre-race to 300 km and 622 km. Platelet increased only in the recovery period. High-sensitivity C-reactive protein levels were increased throughout the race and at day 3 compared to pre-race levels. Cardiac troponin I (cTnI) levels increased during the race. N-terminal pro b-type natriuretic peptide (NT-proBNP) levels increased during the race. CONCLUSION: The rise in cTnI was not clinically significant, and highly elevated NT-proBNP levels during the race indicates that myocardial burden rose linearly as running distance increased. However, no clinical risk was found as most of the markers returned to normal range during the recovery.

Effect of Ultramarathon on the Anterior Pituitary and Thyroid Hormones / 대한스포츠의학회지

PURPOSE: The purpose of this research is to study changes in pituitary hormone in anterior lobe and thyroid hormone before, after, and during recovery time in severe 100 km ultramarathon. METHODS: Healthy middle-aged runners (age, 52.0±4.8 years) participated in the test. Grade exercise test is done, and then blood is taken from those participants before and after completing 100 km ultramarathon at the intervals of 24 hours (1 day), 72 hours (3 days), and 120 hours (5 days) to analyze their luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), and free thyroxine (Free T4). RESULTS: For LH, it decreased more significantly at 100 km than pre-race. However, after 1 day result increased more than that of 100 km. At 3 days, it was significantly higher than pre-race and 100 km, recovering at 5 days. In terms of FSH, it decreased at 100 km, 1 day, and 3 days more than pre-race but recovered at 5 days. TSH was higher at 1 day and 5 days compared to pre-race. T3 was only higher at 100 km than pre-race. T4 was higher till 5 days at 100 km than pre-race. Free T4 increased more significantly at 100 km than pre-race. CONCLUSION: In terms of severe long distance running, LH and FSH which belong to hormone from anterior lobe as well as T3, T4, and Free T4 which belong to thyroid hormone showed their variation within the standard range. However, TSH showed abnormal increase from enhanced concentration of blood after marathon becoming hyper-activation even during the recovery period.

Effects of Long-Distance Running on Cardiac Markers and Biomarkers in Exercise-Induced Hypertension Runners: An Observational Study

OBJECTIVE: To investigate changes of cardiac and muscle damage markers in exercise-induced hypertension (EIH) runners before running (pre-race), immediately after completing a 100-km ultramarathon race, and during the recovery period (24, 72, and 120 hours post-race). METHODS: In this observational study, volunteers were divided into EIH group (n=11) whose maximum systolic blood pressure was ≥210 mmHg in graded exercise testing and normal exercise blood pressure response (NEBPR) group (n=11). Their blood samples were collected at pre-race, immediately after race, and at 24, 72, and 120 hours post-race. RESULTS: Creatine kinase (CK) and cardiac troponin I (cTnI) levels were significantly higher in EIH group than those in the NEBPR group immediately after race and at 24 hours post-race (all p < 0.05). However, lactate dehydrogenase (LDH), creatine kinase-myocardial band (CKMB), or CKMB/CK levels did not show any significant differences between the two groups in each period. N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were significantly higher in EIH group than those in NEBPR group immediately after race and at 24 and 72 hours post-race (all p < 0.05). A high sensitivity C-reactive protein (hs-CRP) level was significantly higher in EIH group than that in NEBPR group at 24 hours post-race (p < 0.05). CONCLUSION: The phenomenon of higher inflammatory and cardiac marker levels in EIH group may exaggerate cardiac volume pressure and blood flow restrictions which in turn can result in cardiac muscle damage. Further prospective studies are needed to investigate the chronic effect of such phenomenon on the cardiovascular system in EIH runners.

Differences in Hematological Characteristics, Including Cholesterol and Apolipoprotein B and E, between Hepatitis B Virus and Hepatitis C Virus Patients in Korea

Hepatitis B virus (HBV) and hepatitis C virus (HCV) chronically cause hepatitis, liver cirrhosis, and hepatocellular carcinoma, and biomarkers related to liver damage are elevated in HBV and HCV patients. However, comparisons of biomarkers between HBV and HCV patients have not previously been reported. The aim of this study was to investigate differences in hematological biomarker in the sera of HBV and HCV patients and to find a key biomarker to differentiate between HBV and HCV infections. HBV (n=115) and HCV (n=128) samples (serum and whole blood) were collected and tested using a biochemical analysis system. The obtained data were analyzed with SPSS 18.0 statistical software. The mean age of the HCV group (60.3±14.1) was much higher than that of the HBV group (51.1±12.4). Male and female rates were 71.3% and 28.7% in the HBV group and 53.9% and 46.1% in the HCV group, respectively (p = 0.005). AST, ALT, and TG values were higher in the HCV group than in the HBV group. Although γ-GTP and LDL levels were higher in the HBV group than in the HCV group, apoB and apoE levels were much higher in HCV group than in HBV group (p < 0.001). There were no significant differences in the other hematological biomarkers between the HBV and HCV groups. In conclusion, HBV rates were higher in male patients, and HCV rates were higher in older patients. In particular, apoE and apoB were more highly expressed in HCV patients, and they might be key markers to differentiate HCV infection.

Effect of Ultra-marathon (308 km) Race on Bone Metabolism and Cartilage Damage Biomarkers

OBJECTIVE: To evaluate the potential effects of a 308-km ultra-marathon on bone and cartilage biomarkers. METHOD: Venous blood samples were collected at pre-race, 100 km, 200 km, and 308 km checkpoints. The following markers of cartilage damage and bone metabolism were studied: osteocalcin (OC), osteoprotegerin (OPG), and calcium, phosphorous, and cartilage oligomeric matrix protein (COMP). RESULTS: Blood samples were taken from 20 male runners at four different checkpoints. Serum COMP was increased by 194.1% (130.7% at 100 km and 160.4% at 200 km). Serum OPG was significantly increased by 158.57% at 100 km and 114.1% at 200 km compared to the pre-race measures. OC was transiently suppressed at 200 km. Serum calcium and phosphorous concentrations decreased compared to the pre-race measures. CONCLUSION: This study showed that the 308-km ultra-marathon induced several changes, including transient uncoupling of bone metabolism, increased bone resorption, suppressed bone formation, and bone turnover and had a major impact on cartilage structure.

Analysis of Turnaround Time for Packed Red Blood Cell Delivery by Laboratory Information System: Shortening of Turnaround Time Through Quality Improvement Program / 임상검사와정도관리

BACKGROUND: As transfusion service is linked directly with patient's life and is often a race against time, efforts to shorten the turnaround time (TAT) for every step of transfusion process from blood request to blood transfusion are important. We introduce our experience for analysis and shortening of the packed red blood cell delivery time through quality improvement program for 2 years. METHODS: From January 2003 to December 2004, we evaluated the mean TAT for each step of transfusion process in Bundang Jesaeng General Hospital using the computerized laboratory information system which is capable of recording the exact times of blood request (request), specimen reception (reception), crossmatch completed (preparation), and blood issue (issue). We analyzed the turnaround time of packed red blood issued and notified the obtained data to transfusion-related workers and changes in TATs during the period were evaluated according to the type and place of request. RESULTS: Mean TAT from request to issue was significantly decreased from 174.4 minutes in 2003 to 126.7 minutes in 2004 (p<0.01). TAT from request to reception and TAT from preparation to issue were significantly decreased. No significant difference was observed according to type of request. Mean TAT was different according to place of request, with the operating and recovery room showing the shortest mean TAT from request to issue. CONCLUSIONS: Our computerized TAT data helps us to understand each steps of transfusion process. Continuous monitoring of TAT and periodic publicity to clinical staff and nurse can shorten the mean TAT.