Laboratory screening for rhabdomyolysis among beginners practicing vigorous exercises

ABSTRACT

The objectives of this study were screening for cases of exertional rhabdomyolysis among beginners in practicing vigorous exercises, and finding out reference laboratory values for the students who will exercise for the first time. The study was conducted in Assuit university hospital on 222 male students of first year of faculty of sports, who practiced vigorous exercises for one hour with maximal load, for the first time, and 20 apparently healthy subjects as a control group [GI]. Twenty four hours after vigorous exercise [24hs AVE], blood samples were collected and the students were classified according to [CK] levels into two groups, group II [GII]125 students, with total CK<183U/L[cut off value] and group III [GIII] 97 students, with total CK>183U/L. One month after vigorous exercises [I m AVE], blood samples were collected from [GIII] which represent the follow up group [GIV, baseline]. All participants were subjected to medical history, clinical examination including body mass index [BMI], and quadriceps circumferences. Laboratory investigations included peripheral haemogram, kidney and liver function tests, blood minerals, and specific tests including total CK, CK-MB and CK-MM isoenzymes, LDH, and serum myoglobin. This study revealed statistically highly significant elevation of total CK, CK-MM, CK-MB, AST and serum myoglobin when comparing [GIII] with each of [GI] and [GII] while a high significant reduction was found when comparing [GIV] with [GIII]. No significant difference could be detected when [GIV] compared with [GI] and [GII] compared with [GI]. There was a significant reduction in serum Na+ and serum Ca+ + level and highly significant elevation in serum K+ and phosphorus in GIII when compared with GI. No statistical significance in [BMI] was detected. Twenty four hours after vigorous exercises, 16 students [7.2%] showed total CK level more than 5 times the cut off value [183 U/L]. These students showed no signs and symptoms of rhabdomyolysis except muscle pain. The participant students who showed total CK values five times or more than the cut off value [183 U/L], are considered by some authors to be suspicious of having rhabdomyolysis. Laboratory values of the students who did not show rhabdomyolysis, could be taken as reference values for students and untrained persons who will practice exercise vigorously for the first time