title: Effect of marathon running on hematologic and biochemical laboratory parameters, including cardiac markers.
abstract: Participants in marathon races may require medical attention and the performance of laboratory assays. We report the changes in basic biochemical parameters, cardiac markers, CBC counts, and WBC differentials observed in participants in a marathon before, within 4 hours, and 24 hours after a race. The concentrations of glucose, total protein, albumin, uric acid, calcium, phosphorus, serum urea nitrogen, creatinine, bilirubin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, total creatine kinase, creatine kinase-MB, myoglobin, and the anion gap were increased after the race, consistent with the effects of exertional rhabdomyolysis and hemolysis. The increase in WBC counts was due mainly to neutrophilia and monocytosis, with a relative decrease in circulating lymphocytes, consistent with an inflammatory reaction to tissue injury. A significant percentage of laboratory results were outside the standard reference ranges, indicating that modified reference ranges derivedfrom marathon runners might be more appropriatefor this population. We provide a table of modified reference ranges (or expected ranges) for basic biochemical, cardiac, and hematologic laboratory parameters for marathon runners.
authors.affiliation: Department of Pathology, Massachusetts General Hospital, and Harvard Medical School, Boston 02114, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kratz
authors.forename: Kent B
authors.initials: KB
authors.lastname: Lewandrowski
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Siegel
authors.forename: Kelly Y
authors.initials: KY
authors.lastname: Chun
authors.forename: James G
authors.initials: JG
authors.lastname: Flood
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Van Cott
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lee-Lewandrowski
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001772:Blood Cell Count; D001774:Blood Chemical Analysis; D006403:Hematologic Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012420:Running / Q000502:physiology*
chemical_list: D015415:Biomarkers