title: Increasing creatine kinase concentrations at the 161-km Western States Endurance Run.
abstract: OBJECTIVE
  Very high blood creatine kinase (CK) concentrations have been observed among recent finishers of the 161-km Western States Endurance Run (WSER), and it has been suggested that there is a link between rhabdomyolysis and hyponatremia. Therefore, the purpose of this study was to compare CK concentrations of finishers in the 2010 WSER with past values, and to determine whether there was an association between blood CK and sodium concentrations.
  
  
  METHODS
  Consenting 2010 WSER finishers provided blood samples at the finish for determination of blood CK and sodium concentrations. Finish time, age, and gender were obtained from official race results, and running experience was determined from our database as number of prior 161-km ultramarathon finishes.
  
  
  RESULTS
  From 216 (66%) of the 328 finishers, median and mean CK concentrations were found to be 20 850 IU/L and 32 956 IU/L, respectively (range 1500-264 300 IU/L), and 13 (6%) had values greater than 100 000 IU/L. These values were statistically higher (P < .0001) than those reported from the 1995 WSER. The CK concentration was not significantly associated with finish time, age, gender, or running experience. Blood sodium concentrations were obtained from a subgroup of 159 runners, and the relationship between blood CK and sodium concentrations did not reach statistical significance (P = .06, r = -0.12).
  
  
  CONCLUSIONS
  Creatine kinase concentrations of 2010 WSER finishers are higher than values previously reported. More research should focus on explaining this observation and on whether there is a possible link between higher CK concentrations and hyponatremia.
authors.affiliation: Department of Physical Medicine & Rehabilitation, Northern California Health Care System, Sacramento, CA 95655-1200, USA. martin.hoffman@va.gov
authors.forename: Martin D
authors.initials: MD
authors.lastname: Hoffman
authors.forename: Julie L
authors.initials: JL
authors.lastname: Ingwerson
authors.forename: Ian R
authors.initials: IR
authors.lastname: Rogers
authors.forename: Tamara
authors.initials: T
authors.lastname: Hew-Butler
authors.forename: Kristin J
authors.initials: KJ
authors.lastname: Stuempfle
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis / Q000201:enzymology; D008297:Male; D010807:Physical Endurance / Q000502:physiology*; D012206:Rhabdomyolysis / Q000175:diagnosis / Q000201:enzymology; D012420:Running / Q000502:physiology*; D012964:Sodium / Q000097:blood*
chemical_list: D015415:Biomarkers; D012964:Sodium; D003402:Creatine Kinase