Advertisement

Sports Medicine

, Volume 4, Issue 4, pp 245–267 | Cite as

Effect of Exercise on Serum Enzyme Activities in Humans

  • Timothy D. Noakes
Review Article

Summary

Increased serum enzyme activity after exercise was first reported in 1958; subsequent studies have established that many factors determine the degree to which the serum activities of a variety of enzymes increase during and after exercise.

The serum activities of those enzymes found especially in muscle, particularly creatine kinase, increase in proportion to the intensity and duration of the preceding exercise, peaking 24 hours after exercise; the effect of duration is dominant, so that the highest postexercise serum enzyme activities are found after very prolonged competitive exercise such as ultradistance marathon running or triathlon events. Weight-bearing exercises which include eccentric muscular contractions such as bench stepping and downhill running induce the greatest increases in serum enzyme activities; serum enzyme activities increase very little even after prolonged participation in those non-weight-bearing activities such as swimming and cycling which do not include eccentric muscular contractions. Prolonged (>2 hours) daily training or competition in weight-bearing activities produces chronically elevated serum enzyme activities. Serum enzyme activities increase more with exercise in males, Blacks and the untrained than th ey do in females, Whites and the trained, respectively; age does not appear to influence the degree to which serum enzyme activities increase with exercise. There is a remarkable individual variability in the degree to which serum enzyme activities increase with exercise; a 50-fold difference in post-race serum creatine kinase activities has been found in healthy and equally trained athletes completing the same 90km ultra-marathon footrace. The biochemical explanation for this degree of individual variability is not currently understood; possibly persons who show abnormally large increases in serum enzyme activities with exercise may have as yet unrecognised subclinical myopathies. No circadian rhythms have been identified for serum enzyme activities; activities rise during the day because of increased physical activity. The rise in serum enzyme activities is greater after exercise at altitude or in the heat than after equivalent exercise at sea level or in the cold.

The most likely explanation for the increased serum enzyme activities that follow prolonged weight-bearing activities that also cause marked muscle soreness, is myofibrillar damage in particular sarcomeric Z-disk disruption. Alternate postulates such as sarcolemmal damage due to muscle glycogen depletion or lipid peroxidation seem less likely as they fail to explain the very different responses of serum enzyme activities to equivalent running or cycling exercise, both of which induce the same degree of muscle glycogen depletion and free radical production. The rise in serum enzyme activities that occurs, particularly after prolonged exercise such as marathon running, mimics exactly the changes that occur with acute myocardial infarction; thus the clinical interpretation of increased serum enzyme activities in persons who are physically active must be approached with extreme caution. The value of alternate diagnostic tests including the measurement of the serum content of the acute phase response protein s to distinguish the normal exercise response from that occurring during acute myocardial infarction, has yet to be determined. Serum creatine kinase activity measured both at rest and after exercise is useful in the diagnosis of Duchenne muscular dystrophy and, in particular, in the detection of the female carriers of this condition. There is, as yet, no proven value in the routine measurement of serum enzyme activities in athletes in training. In particular, serum enzyme activities cannot distinguish between appropriate training and overtraining. In addition, especially after very prolonged exercise such as ultra-marathon running, serum enzyme activities return to normal weeks or even months before normal running performance returns. Thus, complete recovery from prolonged exercise cannot be predicted on the basis of serum enzyme activities.

At present, the most interesting clinical application for the measurement of serum enzyme activities in the active and apparently healthy population might be the identification of subclinical myopathies, some of which may predispose to the development of acute renal failure or heatstroke during very prolonged exercise.

Keywords

Creatine Kinase Apply Physiology Duchenne Muscular Dystrophy Serum Activity Serum Creatine Kinase 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Andreotti L, Bencini A, Nuzzaci G. On some hormonal variations following athletic exercise of an antagonistic nature: modifications of glutamic-oxalacetic and glutamic-pyruvic transaminase activity. Societa Italian di Biologia Sperimentale Bollettino 35: 1348–1350, 1959Google Scholar
  2. Apple FS. Presence of creatine kinase MB isoenzyme during marathon training. New England Journal of Medicine 305: 764–765, 1981PubMedGoogle Scholar
  3. Apple FS, McGue MK. Serum enzyme changes during marathon training. American Journal of Clinical Pathology 79: 716–719, 1983PubMedGoogle Scholar
  4. Apple FS, Rogers MA. Skeletal muscle lactate dehydrogenase isoenzyme alterations in marathon runners. Journal of Applied Physiology 61: 477–481, 1986.PubMedGoogle Scholar
  5. Apple FS, Rogers MA, Sherman WM, Ivy JL. Comparison of serum creatine kinase and creatine kinase MB activities post marathon versus post myocardial infarction. Clinica Chimica Acta 138: 111–118, 1984CrossRefGoogle Scholar
  6. Apple FS, Rogers MA, Casal DC, Sherman WM, Ivy JL. Creatine kinase-MB isoenzyme adaptations in stressed human skeletal muscle of marathon runners. Journal of Applied Physiology 59: 149–153, 1985PubMedGoogle Scholar
  7. Baadsgaard O, Schmidt JF. Myoglobin concentration, creatine kinase, and creatine kinase subunit B activity in serum after myocardial ischaemia. Scandinavian Journal of Clinical and Laboratory Investigation 44: 679–682, 1984PubMedCrossRefGoogle Scholar
  8. Bais R, Edwards JB. Creatine kinase. CRC Critical Reviews of Clinical and Laboratory Sciences 16: 291–335, 1982CrossRefGoogle Scholar
  9. Bank WJ. Myoglobinuria in marathon runners: possible relationship to carbohydrate and lipid metabolism. Annals of the New York Academy of Sciences 301: 942–948, 1977PubMedCrossRefGoogle Scholar
  10. Bark S, Bergstrom K, Eriksson S, Henriksson J, Lindberg K. Serum enzyme CK-B rise following exhaustive physical exercise. American Heart Journal 102: 1079, 1981PubMedCrossRefGoogle Scholar
  11. Barron JL, Noakes TD, Levy W, Smith C, Millar RP. Hypothalamic dysfunction in overtrained athletes. Journal of Endocrinology and Metabolism 60: 803–806, 1985CrossRefGoogle Scholar
  12. Berg A, Haralambie G. Changes in serum creatine kinase and hexose phosphate isomerase activity with exercise duration. European Journal of Applied Physiology 39: 191–201, 1978CrossRefGoogle Scholar
  13. Bornheimer JF, Lau FY. Effects of treadmill exercise on total and myocardial creatine phosphokinase. Chest 80: 146–148, 1981PubMedCrossRefGoogle Scholar
  14. Bricknell OL, Daries PS, Opie LH. A relationship between adenosine triphosphate, glycolysis and ischaemic contracture in the isolated rat heart. Journal of Molecular and Cellular Cardiology 13: 941–945, 1981PubMedCrossRefGoogle Scholar
  15. Brooke MH, Carroll JE, Davis JE, Hagberg JM. The prolonged exercise test. Neurology 29: 636–643, 1979.PubMedCrossRefGoogle Scholar
  16. Byrnes WC, Clarkson PM, White JS, Hsieh SS, Frykman PN, et al. Delayed onset muscle soreness following repeated bouts of downhill running. Journal of Applied Physiology 59: 710–715, 1985PubMedGoogle Scholar
  17. Bryze G, Egberts PFC, Van Breukelen EAJ, Van Win EE. Serum enzyme activity and physical condition. Journal of Sports Medicine and Physical Fitness 16: 155–164, 1976.Google Scholar
  18. Cantone A, Cerrettelli P. The effects of muscular work on serum aldolase activity in trained and untrained men. International Zietschrift fur Angewandte Physiologie Einschliesslich Arbeit-physiologie 18: 107, 1960Google Scholar
  19. Carroll JE, Norris BJ, Brooke MH. Defective [U-14C] palmitic acid oxidation in Duchenne muscular dystrophy. Neurology 35: 96–97, 1985PubMedCrossRefGoogle Scholar
  20. Carroll JE, Villadiego A, Brooke MH. Increased long-chain acyl-CoA in Duchenne muscular dystrophy. Neurology 33: 1507–1510, 1983PubMedCrossRefGoogle Scholar
  21. Carroll JE, Brooke MH, DeVivo DC, Kaiser KK, Hagberg JM. Biochemical and physiologic consequences of carnitine palmityltransferase deficiency. Muscle and Nerve 1: 103–110, 1978PubMedCrossRefGoogle Scholar
  22. Chahine RA, Kazantzis A, Luchi RJ, Raizner AE, Gyorkey F. Effect of routine treadmill testing on the serum enzymes. Cardiology 61: 162–169, 1976PubMedCrossRefGoogle Scholar
  23. Costrini AM, Pitt HA, Gustafson AB, Uddin DE. Cardiovascular and metabolic manifestations of heat stroke and severe heat exhaustion. American Journal of Medicine 66: 296–302, 1979PubMedCrossRefGoogle Scholar
  24. Critz JB, Merrick AW. Serum glutamic-oxalacetic transaminase levels after exercise in men. Proceedings of the Society for Experimental Biology and Medicine 109: 608–610, 1962PubMedGoogle Scholar
  25. Critz JB, Cunningham DA. Plasma enzyme levels in man after different physical activities. Journal of Sports Medicine and Physical Fitness 12: 143–149, 1972aPubMedGoogle Scholar
  26. Critz JB, Cunningham DA, Rechnitzer PA, Yuhasz MS. Plasma enzyme levels in post-coronary patients after exercise and training. Archives of Physical Medicine and Rehabilitation 53: 499–502, 1972bPubMedGoogle Scholar
  27. Cunningham DA, Critz JB. Effect of hypoxia and physical activity on plasma enzyme levels in man. International Zietschrift fur Angewandte Physiologie Einschliesslich Arbeitphysiologie 30: 302–308, 1972Google Scholar
  28. Davies B, Daggett A, Watt DAL. Serum creatine kinase and isoenzyme responses of veteran class fell runners. European Journal of Applied Physiology 48: 345–354, 1982CrossRefGoogle Scholar
  29. Diamond TH, Smith R, Goldman AP, Myburgh DP, Bloch JM, et al. The dilemma of the creatine kinase cardiospecific isoenzyme (CK-MB) in marathon runners. South African Medical Journal 63: 37–41, 1983PubMedGoogle Scholar
  30. Dressendorfer RH, Wade CE. The muscular overuse syndrome in long-distance runners. Physician and Sports Medicine 11: 116–130, 1983Google Scholar
  31. Dufaux B, Order U, Geyer H, Hollmann W. Creactive protein serum concentrations in well-trained athletes. International Journal of Sports Medicine 5: 102–106, 1984PubMedCrossRefGoogle Scholar
  32. Ebashi S, Toyokura Y, Momoi H, Sugita H. High creatine phosphokinase activity of sera of progressive muscular dystrophy. Journal of Biochemistry 46: 103–107, 1959Google Scholar
  33. Florence JM, Fox PT, Planer GJ, Brooke MH. Activity, creatine kinase, and myoglobin in Duchenne muscular dystrophy: a clue to etiology? Neurology 35: 758–761, 1985PubMedCrossRefGoogle Scholar
  34. Fojt E, Ekelund LG, Hultman E. Enzyme activities in hepatic venous blood under strenuous physical exercise. Pflugers Archives 361: 287–296, 1976CrossRefGoogle Scholar
  35. Fowler WM, Chowdhury SR, Pearson CM, Gardner G, Bratton R. Changes in serum enzyme levels after exercise in trained and untrained subjects. Journal of Applied Physiology 17: 943–946, 1962PubMedGoogle Scholar
  36. Fowler WM, Gardner GW, Kazerunian HH, Lauvstad WA. The effect of exercise on serum enzymes. Archives of Physical Medicine and Rehabilitation 49: 554–565, 1968PubMedGoogle Scholar
  37. Francesconi RP, Maher JT, Bynum GD, Mason JW. Recurrent heat exposure: enzymatic responses in resting and exercising men. Journal of Applied Physiology 43: 308–311, 1977PubMedGoogle Scholar
  38. Friden J, Sjostrom M, Ekblom B. Myofibrillar damage following intense eccentric exercise in man. International Journal of Sports Medicine 4: 170–176, 1983PubMedCrossRefGoogle Scholar
  39. Gaines RF, Pueschel SM, Sassaman EA, Driscoll JL. Effect of exercise on serum creatine kinase in carriers of Duchenne muscular dystrophy. Journal of Medical Genetics 19: 4–7, 1982PubMedCrossRefGoogle Scholar
  40. Gale AN, Murphy EA. The use of serum creatine phosphokinase in genetic counselling for Duchenne muscular dystrophy. II. Review of methods of assay and factors which may be relevant in the interpretation of serum creatine phosphokinase activity. Journal of Chronic Diseases 32: 639–651, 1979PubMedCrossRefGoogle Scholar
  41. Galun E, Epstein Y. Serum creatine kinase activity following a 120-km march. Clinica Chimica Acta 143: 281–283, 1984CrossRefGoogle Scholar
  42. Gardner GW, Bratton R, Chowdhury SR, Fowler WM, Pearson CM. Effect of exercise on serum enzyme levels in trained subjects. Journal of Sports Medicine and Physical Fitness 4: 103–110, 1964Google Scholar
  43. Gardner-Medwin D, Pennington RJ, Walton JN. The detection of carriers of X-linked muscular dystrophy genes: a review of some methods studied in Newcastle upon Tyne. Journal of the Neurological Sciences 13: 459–474, 1971PubMedCrossRefGoogle Scholar
  44. Grande P, Pedersen A, Schaadt O, Corfitsen T, Andersen BT. Cardio-specific serum enzyme CK-MB following physical exercise in acute myocardial infarction. European Journal of Cardiology 11: 161–167, 1980PubMedGoogle Scholar
  45. Griffiths PD. Serum levels of ATP: creatine phosphotransferase (creatine kinase): the normal range and effect of muscular activity. Clinica Chimica Acta 13: 413–420, 1966CrossRefGoogle Scholar
  46. Halonen PI, Konttinen A. Effect of physical exercise on some enzymes in the serum. Nature 193: 942–944, 1962PubMedCrossRefGoogle Scholar
  47. Haralambie G. Neuromuscular irritability and serum creatine phosphate kinase in athletes in training. International Zeitschrift fur Angewandte Physiologie Einschliesslich Arbeitphysiologie 31: 279-288, 1973Google Scholar
  48. Haralambie G. Serum gamma-glutamyl transpeptidase and physical exercise. Clinica Chimica Acta 72: 363–369, 1976CrossRefGoogle Scholar
  49. Haralambie G. Serum aldolase isoenzymes in athletes at rest and after long-lasting exercise. International Journal of Sports Medicine 2: 31–36, 1981PubMedCrossRefGoogle Scholar
  50. Haralambie G, Senser L. Metabolic changes in man during long-distance swimming. European Journal of Applied Physiology 43: 115–125, 1980CrossRefGoogle Scholar
  51. Haralambie G, Cerny FJ, Huber G. Serum enzyme levels after bobsled racing. Journal of Sports Medicine and Physical Fitness 16: 54–56, 1976PubMedGoogle Scholar
  52. Helgheim I, Hetland O, Nilsson S, Ingjer F, Stromme SB. The effects of vitamin E on serum enzyme levels following heavy exercise. European Journal of Applied Physiology 40: 283–289, 1979CrossRefGoogle Scholar
  53. Henley KS, Schmidt E, Schmidt FW. Serum enzymes. Journal of the American Medical Association 174: 119–123, 1960CrossRefGoogle Scholar
  54. Herrmann FH, Spiegler AW. Carrier detection in X-linked Becker muscular dystrophy by muscle provocation test (MPT). Journal of Neurological Sciences 62: 141–146, 1983CrossRefGoogle Scholar
  55. Highman B, Altland PD. Serum enzyme rise after hypoxia and effect of autonomic blockade. Journal of Applied Physiology 199: 981–986, 1960Google Scholar
  56. Holly RG, Barnard RJ, Rosenthal M, Applegate E, Pritikin N. Triathlete characterization and response to prolonged strenuous competition. Medicine and Science in Sports and Exercise 18: 123–127, 1986PubMedGoogle Scholar
  57. Hughes RC, Park DC, Parsons ME, O’Brien MD. Serum creatine kinase studies in the detection of carriers of Duchenne dystrophy. Journal of Neurology, Neurosurgery and Psychiatry 34: 527–530, 1971CrossRefGoogle Scholar
  58. Hunter JB, Critz JB. Effect of training on plasma enzyme levels in man. Journal of Applied Physiology 31: 20–23, 1971PubMedGoogle Scholar
  59. Israel S, Scheibe J, Kohler E, Stumpe H. Enzymaktivitaten im serum nach einem 88-km-lauf. Medizin und Sport 16: 363–367, 1976Google Scholar
  60. Jaffe AS, Garfinkel BT, Ritter CS, Sobel BE. Plasma MB creatine kinase after vigorous exercise in professional athletes. American Journal of Cardiology 53: 856–858, 1984PubMedCrossRefGoogle Scholar
  61. Jansson E, Sylven C. Creatine kinase MB and citrate synthase in type I and type II muscle fibres in trained and untrained men. European Journal of Applied Physiology 54: 207–209, 1985CrossRefGoogle Scholar
  62. Jardon OM. Physiologic stress, heat stroke, malignant hyperthermia — a perspective. Military Medicine 147: 8–14, 1982PubMedGoogle Scholar
  63. Jonderko G, Gabryel A, Jonderko K, Ko’nca A, Marcisz C, Olak Z, et al. The influence of noise and vibration upon creatine kinase activity in blood serum. International Archives of Occupational and Environmental Health 49: 209–212, 1982PubMedCrossRefGoogle Scholar
  64. Kaman RL, Goheen B, Patton R, Raven P. The effects of near maximum exercise on serum enzymes: the exercise profile versus the cardiac profile. Clinica Chimica Acta 81: 145–152, 1977CrossRefGoogle Scholar
  65. Kanter MM, Kaminsky LA, Laham-Saeger J, Lesmes GR, Nequin ND. Serum enzyme levels and lipid peroxidation in ultramarathon runners. Annals of Sports Medicine 3: 39–41, 1986Google Scholar
  66. Karlsson J, Diamant B, Saltin B. Lactate dehydrogenase activity in muscle after prolonged severe exercise in man. Journal of Applied Physiology 25: 88–91, 1968PubMedGoogle Scholar
  67. Karmen A, Wroblewski F, La Due JS. Transaminase activity in human blood. Journal of Clinical Investigation 34: 126–134, 1955PubMedCrossRefGoogle Scholar
  68. Kettunen P, Kala R, Rehunen S. Creatine kinase and its isoenzymes in skeletal muscle of athletes. Lancet 2: 611, 1982PubMedCrossRefGoogle Scholar
  69. Kew MC, Bersohn I, Peter J, Wyndham CH, Seftel HC. Preliminary observations on the serum and cerebrospinal fluid enzymes in heatstroke. South African Medical Journal 41: 530–532, 1967PubMedGoogle Scholar
  70. Kew M, Bersohn I, Seftel H. The diagnostic and prognostic significance of the serum enzyme changes in heatstroke. Transactions of the Royal Society of Tropical Medicine and Hygiene 65: 325–330, 1971PubMedCrossRefGoogle Scholar
  71. Kielblock AJ, Manjoo M, Booyens J, Katzeff IE. Creatine phosphokinase and lactate dehydrogenase levels after ultra long-distance running. South African Medical Journal 55: 1061–1064, 1979PubMedGoogle Scholar
  72. King SW, Statland BE, Savory J. The effect of a short burst of exercise on activity values of enzymes in sera of healthy young men. Clinica Chimica Acta 72: 211–218, 1976CrossRefGoogle Scholar
  73. Konagaya M, Takayanagi T, Konagaya Y, Sobue I. The fluctuation of serum myoglobin levels in Duchenne muscular dystrophy and the carrier. Journal of Neurological Sciences 55: 259–265, 1982CrossRefGoogle Scholar
  74. Kosano H, Kinoshita T, Nagata N, Takatani O, Isobe M, et al. Change in concentrations of myogenic components of serum during 93h of strenuous physical exercise. Clinical Chemistry 32: 346–348, 1986PubMedGoogle Scholar
  75. Kuby SA, Noda L, Lardy HA. Adenosine triphosphate creatine transphosphorylase. I. Isolation of the crystalline enzyme from rabbit muscle. Journal of Biological Chemistry 209: 191–201, 1954PubMedGoogle Scholar
  76. Kuipers H, Keizer HA, Verstappen FT, Costill DL. Influence of a prostaglandin-inhibiting drug on muscle soreness after eccentric work. International Journal of Sports Medicine 6: 336–339, 1985PubMedCrossRefGoogle Scholar
  77. LaDue JS, Wroblewski F, Karmen A. Serum glutamic oxalacetic transaminase activity in human acute transmural myocardial infarction. Science 120: 497–499, 1954PubMedCrossRefGoogle Scholar
  78. La Porta MA, Linde HW, Bruce DL, Fitzsimons EJ. Elevation of creatine phosphokinase in young men after recreational exercise. Journal of the American Medical Association 239: 2685–2686, 1978CrossRefGoogle Scholar
  79. Liesen H, Dufaux B, Hollmann W. Modifications of serum glycoproteins the days following a prolonged physical exercise and the influence of physical training. European Journal of Applied Physiology 37: 243–254, 1977CrossRefGoogle Scholar
  80. Lijnen P, Hespel P, Van Oppens S, Fiocchi R, Goossens W, et al. Erythrocyte 2, 3 diphosphoglycerate and serum enzyme concentrations in trained and sedentary men. Medicine and Science in Sports and Exercise 18: 174–179, 1986PubMedGoogle Scholar
  81. Loll H, Hilscher A. Die bedeutung der serum-enzym-und substrat-bestimmungen bei lebererkankungen. Arztliche Forschung 12: 304–308, 1958Google Scholar
  82. Maclean D, Griffiths PD, Emslie-Smith D. Serum-enzymes in relation to electrocardiographic changes in accidental hypothermia. Lancet 2: 1266–1271, 1968PubMedCrossRefGoogle Scholar
  83. MacSearraigh ETM, Kallmeyer JC, Schiff HB. Acute renal failure in marathon runners. Nephron 24: 236–240, 1979PubMedCrossRefGoogle Scholar
  84. Magazanik A, Shapiro Y, Meytes D, Meytes I. Enzyme blood levels and water balance during a marathon race. Journal of Applied Physiology 36: 214–217, 1974PubMedGoogle Scholar
  85. Matin P, Lang G, Carretta R, Simon G. Scintigraphic evaluation of muscle damage following extreme exercise: concise communication. Journal of Nuclear Medicine 24: 308–311, 1983PubMedGoogle Scholar
  86. Maxwell JH, Bloor CM. Effects of conditioning on exertional rhabdomyolysis and serum creatine kinase after severe exercise. Enzyme 26: 177–181, 1981PubMedGoogle Scholar
  87. McKechnie JK, Leary WP, Joubert SM. Some electrocardiographic and biochemical changes recorded in marathon runners. South African Medical Journal 41: 722–725, 1967PubMedGoogle Scholar
  88. Meltzer HY. Factors affecting serum creatine phosphokinase levels in the general population: the role of race, activity and sex. Clinica Chimica Acta 33: 165–172, 1971CrossRefGoogle Scholar
  89. Meltzer HY, Holy PA. Black-White differences in serum creatine phosphokinase activity induced by exercise. Clinica Chimica Acta 54: 215–224, 1974CrossRefGoogle Scholar
  90. Metrier G, Poortmans J, Vanroux R, Gauthier R. Serum glutamic oxaloacetic acid transaminase changes during exercise of various intensities in trained athletes. Journal of Sports Medicine and Physical Fitness 20: 152–157, 1980.Google Scholar
  91. Millard M, Zauner C, Cade R, Reese R. Serum CPK levels in male and female world class swimmers during a season of training. Journal of Swimming Research 1: 12–16, 1985Google Scholar
  92. Misner JE, Massey BH, Williams BT. The effect of physical training on the response of serum enzymes to exercise stress. Medicine and Science in Sports 5: 86–88, 1973PubMedGoogle Scholar
  93. Munjal DD, McFadden JA, Matix PA, Coffman KD, Cattaneo SM. Changes in serum myoglobin, total creatine kinase, lactate dehydrogenase and creatine kinase MB levels in runners. Clinical Biochemistry 16: 195–199, 1983PubMedCrossRefGoogle Scholar
  94. Newham DJ, Jones DA, Edwards RHT. Large delayed plasma creatine kinase changes after stepping exercise. Muscle and Nerve 6: 380–385, 1983PubMedCrossRefGoogle Scholar
  95. Newham DJ, Jones DA, Edwards RHT. Plasma creatine kinase changes after eccentric and concentric contractions. Muscle and Nerve 9: 59–63, 1986.PubMedCrossRefGoogle Scholar
  96. Nicholson GA, McLeod JG, Morgan G, Meerkin M, Cowan J, et al. Variable distributions of serum creatine kinase reference values: relationship to exercise activity. Journal of Neurological Sciences 71: 225–231, 1985aCrossRefGoogle Scholar
  97. Nicholson GA, Morgan G, Meerkin M, Strauss E, McLeod JG. The creatine kinase reference interval: an assessment of intra-and inter-individual variation. Journal of Neurological Sciences 71: 233–245, 1985bCrossRefGoogle Scholar
  98. Noakes TD. Lore of running, Oxford University Press, Cape Town, 1986Google Scholar
  99. Noakes TD, Carter JW. Biochemical parameters in athletes before and after having run 160 kilometres. South African Medical Journal 50: 1562–1566, 1976PubMedGoogle Scholar
  100. Noakes TD, Carter JW. The responses of plasma biochemical parameters to a 56-km race in novice and experienced ultra-marathon runners. European Journal of Applied Physiology 49: 179–186, 1982CrossRefGoogle Scholar
  101. Noakes TD, Kotzenberg G, McArthur PS, Dykman J. Elevated serum creatine kinase MB and creatine kinase BB-isoenzyme fractions after ultra-marathon running. European Journal of Applied Physiology 52: 75–79, 1983CrossRefGoogle Scholar
  102. Norregaard Hansen K, Bjerre-Knudsen J, Brodthagen U, Jordal R, Paulev P-E. Muscle cell leakage due to long distance training. European Journal of Applied Physiology 48: 177–188, 1982CrossRefGoogle Scholar
  103. Nowacki PE, Kustner W, Haag H. The influence of exhaustive efforts at high altitude (2040m) on serum enzymes (CPK, CPK act., LDH, SGOT, SGPT) in well trained athletes. In Howald & Poortmans (Eds) Metabolic adaptation to prolonged physical exercise, Proceedings of the 2nd International Symposium on Biochemistry of Exercise, Magglingen, pp. 78–84, Birkhäuser Verlag, Basel, 1973.Google Scholar
  104. Nuttall FQ, Jones B. Creatine kinase and glutamic oxalacetic transaminase activity in serum: kinetics of change with exercise and effect of physical conditioning. Journal of Laboratory and Clinical Medicine 71: 847–854, 1968PubMedGoogle Scholar
  105. Nydick I, Wroblewski F, LaDue JS. Evidence for increased serum glutamic oxalacetic transaminase (SGO-T) activity following graded myocardial infarcts in dogs. Circulation 12: 161–168, 1955PubMedCrossRefGoogle Scholar
  106. Ohman EM, Teo KK, Johnson AH, Collins PB, Dowsett DG, et al. Abnormal cardiac enzyme responses after strenuous exercise: alternative diagnostic aids. British Medical Journal 285: 1523–1526, 1982PubMedCrossRefGoogle Scholar
  107. Okinaka S, Kumagai H, Ebashi S, Sugita H, Momoi H, et al. Serum creatine phosphokinase activity in progressive muscular dystrophy and neuromuscular diseases. Archives of Neurology 4: 64–69, 1961CrossRefGoogle Scholar
  108. Olerud JE, Homer LD, Carroll HW. Serum myoglobin levels predicted from serum enzyme values. New England Journal of Medicine 293: 483–485, 1975PubMedCrossRefGoogle Scholar
  109. Olerud JE, Homer LD, Carroll HW. Incidence of acute exertional rhabdomyolysis. Archives of Internal Medicine 136: 692–697, 1976PubMedCrossRefGoogle Scholar
  110. Olivier LR, De Waal A, Retief FJ, Marx JD, Kriel JR, et al. Electrocardiographic and biochemical studies on marathon runners. South African Medical Journal 53: 783–788, 1978PubMedGoogle Scholar
  111. Osterman PO, Ashmark H, Wistrand PJ. Serum carbonic anhydrase III in neuromuscular disorders and in healthy persons after a long-distance run. Journal of Neurological Sciences 70: 347–357, 1985CrossRefGoogle Scholar
  112. Phillips J, Horner B, Ohman M, Horgan J. Increased brain-type creatine phosphokinase in marathon runners. Lancet 1: 1310, 1982PubMedCrossRefGoogle Scholar
  113. Pohl AP, O’Halloran MW, Pannall PR. Biochemical and physiological changes in football players. Medical Journal of Australia 1: 467–470, 1981PubMedGoogle Scholar
  114. Rasch PJ, Schwartz PL. Effect of amateur wrestling on selected serum enzymes. Journal of Sports Medicine and Physical Fitness 12: 82–86, 1972PubMedGoogle Scholar
  115. Refsum HE, Stromme SB, Tveit B. Changes in serum enzyme levels after 90 km cross-country skiing. Acta Physiologica Scandinavica 84: 16A–17A, 1971Google Scholar
  116. Reinhardt WH, Straubli M, Kochli HP, Straub PW. Creatine kinase and MB-fraction after a long distance race. Clinica Chimica Acta 125: 307–310, 1982CrossRefGoogle Scholar
  117. Remmers AR, Kaljot V. Serum transaminase levels. Journal of the American Medical Association 185: 148–150, 1963CrossRefGoogle Scholar
  118. Richter K, Konitzer K. Veranderungen der Aldolase-Activitat im Blutserum bei Muskelarbeit. Klinic Wochschrafft 38: 998, 1960CrossRefGoogle Scholar
  119. Riley WJ, Pyke FS, Roberts AD, England JF. The effect of long-distance running on some biochemical variables. Clinica Chimica Acta 65: 83–89, 1975CrossRefGoogle Scholar
  120. Ritter WS, Stone MJ, Willerson JT. Reduction in exertional myoglobinemia after physical conditioning. Archives of Internal Medicine 139: 644–647, 1979PubMedCrossRefGoogle Scholar
  121. Robinson D, Williams PT, Worthington DJ, Carter TJN. Raised creatine kinase activity and presence of creatine kinase MB isoenzyme after exercise. British Medical Journal 285: 1619–1620, 1982PubMedCrossRefGoogle Scholar
  122. Rogers MA, Stull GA, Apple FS. Creatine kinase isoenzyme activities in men and women following a marathon race. Medicine and Science in Sports and Exercise 17: 679–682, 1985PubMedCrossRefGoogle Scholar
  123. Rose LI, Bousser JE, Cooper KH. Serum enzymes after marathon running. Journal of Applied Physiology 29: 355–357, 1970aPubMedGoogle Scholar
  124. Rose LI, Lowe SL, Carroll DR, Wolfson S, Cooper KH. Serum lactate dehydrogenase isoenzyme changes after muscular exertion. Journal of Applied Physiology 28: 279–281, 1970bPubMedGoogle Scholar
  125. Ross JH, Attwood EC, Atkin GE, Villar RN. A study on the effects of severe repetitive exercise on serum myoglobin, creatine kinase, transaminases and lactate dehydrogenase. Quarterly Journal of Medicine 206: 268–279, 1983Google Scholar
  126. Roli S, Iori E, Guiducci U, Emanuele R, Robuschi G, et al. Serum concentrations of myoglobin, creatine phosphokinase and lactic dehydrogenase after exercise in trained and untrained athletes. Journal of Sports Medicine and Physical Fitness 21: 113–118, 1981.Google Scholar
  127. Roxin LE, Venge P, Friman G. Variations in serum myoglobin after a 2-min isokinetic exercise test and the effects of training. European Journal of Applied Physiology 53: 43–47, 1984CrossRefGoogle Scholar
  128. Rutledge J, Clayson KJ, Strandjord PE. Effect of physical conditioning on serum creatine kinase after exercise. Journal of the American Medical Association 240: 2633, 1978PubMedCrossRefGoogle Scholar
  129. Sabria M, Ruibal A, Rey C, Foz M, Domenech FM. Influence of exercise on serum levels of myoglobin measured by radioimmunoassay. European Journal of Nuclear Medicine 8: 159–161, 1983PubMedCrossRefGoogle Scholar
  130. Sanders TM, Bloor CM. Effects of endurance on serum enzyme activities in the dog, pig and man. Proceedings of the Society for Experimental Biology and Medicine 148: 823–828, 1975aPubMedGoogle Scholar
  131. Sanders TM, Bloor CM. Effects of repeated endurance exercise on serum enzyme activities in well-conditioned males. Medicine and Science in Sports 7: 44–47, 1975bPubMedGoogle Scholar
  132. Savignano T, Hanok A, Kuo J. Creatine phosphokinase activity: a study of normal and abnormal levels. American Journal of Clinical Pathology 51: 76–85, 1969PubMedGoogle Scholar
  133. Schiff HB, MacSearraigh ETM, Kallmeyer JC. Myoglobinuria, rhabdomyolysis and marathon running. Quarterly Journal of Medicine 188: 463–472, 1978Google Scholar
  134. Schlang HA, Kirkpatrick CA. The effect of physical exercise on serum transaminase. American Journal of Medical Sciences 242: 338–341, 1961CrossRefGoogle Scholar
  135. Schmidt E, Schmidt FW. Enzyme modifications during activity. In Biochemistry of exercise, Medicine and sport, Vol. 13, pp. 216–238. J.K. Poortmans (Ed.), Baltimore, 1969Google Scholar
  136. Schnohr P. Enzyme concentrations in serum after prolonged physical exercise. Danish Medical Bulletin 21: 68–71, 1974PubMedGoogle Scholar
  137. Schnohr P, Grande P, Christiansen C. Enzyme activities in serum after extensive exercise, with special reference to creatine kinase MB. Acta Medica Scandinavica 208: 229–231, 1980PubMedCrossRefGoogle Scholar
  138. Schwane JA, Johnson SR, Vandenakker CB, Armstrong RB. Delayed-onset muscular soreness and plasma CPK and LDH activities after downhill running. Medicine and Science in Sports and Exercise 15: 51–56, 1983PubMedGoogle Scholar
  139. Schwartz PL, Carroll HW, Douglas JS. Exercise-induced changes in serum enzyme activities and their relationship to max V02. International Zietschrift fur Angewandte Physiologie Einschliesslich Arbeitphysiologie 30: 20–33, 1971Google Scholar
  140. Scrimgeour AG, Noakes TD, Adams B, Myburgh K. The influence of weekly training distance on fractional ultilization of maximum aerobic capacity in marathon and ultra-marathon runners. European Journal of Applied Physiology 55: 202–209, 1986CrossRefGoogle Scholar
  141. Shapiro Y, Magazanik A, Sohar E, Reich CB. Serum enzyme changes in untrained subjects following a prolonged march. Canadian Journal of Physiology and Pharmacology 51: 271–276, 1973PubMedCrossRefGoogle Scholar
  142. Sherman WM, Costill DL, Fink WJ, Miller JM. Effect of exercise-diet manipulation on muscle glycogen and its subsequent utilization during performance. International Journal of Sports Medicine 2: 114–118, 1981PubMedCrossRefGoogle Scholar
  143. Shumate JB, Brooke MH, Carroll JE, Davis JE. Increased serum creatine kinase after exercise: a sex-linked phenomenon. Neurology 29: 902–904, 1979PubMedCrossRefGoogle Scholar
  144. Sibley JA, Lehninger AL. Determination of aldolase in animal tissues. Journal of Biological Chemistry 177: 859–872, 1949PubMedGoogle Scholar
  145. Siegel AJ, Silverman LM, Lopez RE. Creatine kinase elevations in marathon runners: relationship to training and competition. Yale Journal of Biology and Medicine 53: 275–279, 1980PubMedGoogle Scholar
  146. Siegel AJ, Silverman LM, Holman LB. Elevated creatine kinase MB isoenzyme levels in marathon runners. Journal of the American Medical Association 246: 2049–2051, 1981PubMedCrossRefGoogle Scholar
  147. Siegel AJ, Silverman LM, Evans WJ. Elevated skeletal muscle creatine kinase MB isoenzyme levels in marathon runners. Journal of the American Medical Association 250: 2835–2837, 1983PubMedCrossRefGoogle Scholar
  148. Siegel AJ, Silverman LM, Holman BL. Normal results of post-race Thallium-201 myocardial perfusion imaging in marathon runners with elevated serum MB creatine kinase levels. American Journal of Medicine 79: 431–434, 1985.PubMedCrossRefGoogle Scholar
  149. Sjodin B, Thorstensson A, Frith K, Karlsson J. Effect of physical training on LDH activity and LDH isozyme pattern in human skeletal muscle. Acta Physiologica Scandinavica 97: 150–157, 1976PubMedCrossRefGoogle Scholar
  150. Smith I, Thomson WH. Carrier detection in X-linked recessive (Duchenne) muscular dystrophy: pyruvate kinase isoenzymes and creatine phosphokinase in serum and blood cells. Clinica Chimica Acta 78: 439–451, 1977CrossRefGoogle Scholar
  151. Stansbie D, Aston JP, Dallimore NS, Williams HM, Willis N. Effect of exercise on plasma pyruvate kinase and creatine kinase activity. Clinica Chimica Acta 132: 127–132, 1983CrossRefGoogle Scholar
  152. Stansbie D, Aston JP, Powell NH, Willis N. Creatine kinase MB in marathon runners. Lancet 1: 1413–1414, 1982PubMedCrossRefGoogle Scholar
  153. Stone MJ, Waterman MR, Harimoto D, Murray G, Willson N, et al. Serum myoglobin level as diagnostic test in patients with acute myocardial infarction. British Heart Journal 39: 375–380, 1977PubMedCrossRefGoogle Scholar
  154. Strachan AF, Noakes TD, Kotzenberg G, Nel AE, De Beer FC. Creactive protein concentrations during long distance running. British Medical Journal 289: 1249–1251, 1984PubMedCrossRefGoogle Scholar
  155. Straubli M, Roessler B, Kochli HP, Peheim E, Straub PW. Creatine kinase and creatine MB in endurance runners and in patients with myocardial infarction. European Journal of Applied Physiology 54: 40–45, 1985CrossRefGoogle Scholar
  156. Sylven JCH, Jansson E, Brandt S, Kallner A. Specificity of cardiac enzymes in diagnosis of chest pain in marathon runners. Lancet 2: 1505, 1983PubMedGoogle Scholar
  157. Symanski JD, McMurray RG, Silverman LM, Smith BW, Siegel AJ. Serum creatine kinase and CK-MB isoenzyme responses to acute and prolonged swimming in trained athletes. Clinica Chimica Acta 129: 181–187, 1983CrossRefGoogle Scholar
  158. Thomson WH. Serum enzyme studies in inherited disease of skeletal muscle. Clinica Chimica Acta 35: 183–191, 1971CrossRefGoogle Scholar
  159. Thomson WHS, Smith I. Effects of oestrogen on erythrocyte enzyme efflux in normal men and women. Clinica Chimica Acta 103: 203–208, 1980.CrossRefGoogle Scholar
  160. Tiidus PM, Ianuzzo CD. Effects of intensity and duration of muscular exercise on delayed soreness and serum enzyme activities. Medicine and Science in Sports and Exercise 15: 461–465, 1983PubMedGoogle Scholar
  161. van Rensburg JP, Kielblock AJ, van der Linde A. Physiologic and biochemical changes during a triathlon competition. International Journal of Sports Medicine 7: 30–35, 1986PubMedCrossRefGoogle Scholar
  162. Vejjaajiva A, Teasdale GM. Serum creatine kinase and physical exercise. British Medical Journal 1: 1653–1654, 1965CrossRefGoogle Scholar
  163. Wegmann HM, Bruneer H, Klein KE, Voigt ED. Enzymatic and hormonal responses to exercise, lowered pressure, and acceleration in human plasma and their correlation to individual tolerances. Federation Proceedings 25: 1405–1408, 1966PubMedGoogle Scholar
  164. Wolfson S, Rose LI, Bousser JE, Parisi AF, Acosta AE, et al. Serum enzyme levels during exercise in patients with coronary heart disease: effects of training. American Heart Journal 84: 478–483, 1972PubMedCrossRefGoogle Scholar
  165. Wroblewski F, Jervis G, LaDue JS. The diagnostic, prognostic and epidemiologic significance of serum glutamic oxaloacetic transaminase (SGO-T) alterations in acute hepatitis. Annals of Internal Medicine 45: 782–800, 1956PubMedGoogle Scholar
  166. Wroblewski F, LaDue JS. Lactic dehydrogenase activity in blood. Proceedings of the Society for Experimental Biology and Medicine 90: 210–213, 1955PubMedGoogle Scholar
  167. Wyndham CH, Kew MC, Kok R, Bersohn I, Strydom NB. Serum enzyme changes in unacclimatized and acclimatized men under severe heat stress. Journal of Applied Physiology 37: 695–698, 1974PubMedGoogle Scholar
  168. Wyse RKH. Marathon running and creatine kinase levels. Lancet 2: 155, 1982Google Scholar

Copyright information

© ADIS Press Limited 1987

Authors and Affiliations

  • Timothy D. Noakes
    • 1
  1. 1.Sports Science Centre, Department of PhysiologyUniversity of Cape Town Medical SchoolCape TownSouth Africa

Personalised recommendations