Exercise Biomarkers

SPS455 Introduction to Sport Biochemistry

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Learning outcomes
At the end of the lesson, students should be able to
1. Explain the different types of samples for
biochemical assessment
2. Describe the different classes of biomarkers
3. Explain the purposes of determining iron status,
lactate, creatine kinase, aminotransferases,
cortisol and testosterone
Samples for Biochemical Assessment

Wealth of Information

muscle muscle

blood blood

urine urine

Ease of sampling
 Samples for Biochemical Assessment
• Muscle tissue can provide more information than blood and
urine
• Muscle is the primary site of energy metabolism
• Several substances that do not appear in blood (e.g. ATP, CP
and glycogen) can be measured in muscle
• However, muscle biopsy is painful and requires highly
specialised personnel to collect
• Only small amount of muscle samples are collected so advanced
analytical techniques are needed to measure the substances
• Urine can be collected in a larger amount and painlessly but
contained few substances that are useful in evaluating an
exercising individual
• Therefore, the most suitable sample for biomarker assessment
is blood as it combines a moderate ease of sampling with a
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satisfactory amount of information
 Blood
• Blood is not a homogenous fluid
• If the tube is left to stand upright, it separates into roughly two
parts: a dark-red sediment and a yellowish supernatant
• The supernatant (55%) is usually
clear and is called
• serum (without clotting factors)
• plasma (with clotting factors)
• Plasma is obtained from blood
collected with anticoagulants such
as EDTA and heparin
• The sediment contains mainly red
blood cells (45%)
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 Aims and Scope of Biochemical Assessment
• The aim of biochemical assessment of an exercising person is to
protect or improve health and to increase their performance
• Good health is the foundation on which sport performance is built
and it should be the primary concern when monitoring an athlete
• Samples can be collected at different time points relative to
exercise
1. Samples collected at rest
• The baseline state of the body
2. Samples collected during exercise
• The acute biochemical changes caused by the physical
activity
3. Samples collected after exercise
• Acute effects of exercise, duration of the changes elicited
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by exercise or changes of delayed onset
 Exercise Biomarkers
A biochemical parameter that can be measured and
quantified to indicate levels of biological state, physiological
condition and physical performance of an individual
Classes of Biomarkers
Iron status Metabolites Enzymes Hormones
• Hemoglobin • Lactate • Creatine kinase • Cortisol
• Iron • Glucose • Aminotransferases • Testosterone
• Total iron-binding • Triglycerides (ALT, AST)
capacity (TIBC) • Total
• Transferrin cholesterol
saturation • HDL
• Soluble transferrin • LDL
receptor • Glycerol
• Ferritin • Urea
• Ammonia
• Creatinine
 Metabolites used as biomarker
assessment for exercising individuals
Parameter Relevant to the metabolism of
Lactate
Carbohydrates
Glucose
Triglycerides
Total cholesterol
HDL Lipids
LDL
Glycerol
Urea
Amino acids
Ammonia
Ammonia
Compounds of high phosphoryl transfer potential
Creatinine
 Iron Status
• Iron is very important in oxygen transport, storage and usage
for aerobic energy production
• Iron is part of heme that binds oxygen and is found in
myoglobin and haemoglobin
Heme

Iron

• Haemoglobin is responsible for transporting oxygen in blood

• Myoglobin carries and stores oxygen in the muscle cells
• Iron is also part of several proteins in the electron transport
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chain
 Iron Status
• Iron is transported in the plasma by binding to transferrin
(transport protein)
• Ferritin is iron-storing protein that can is mainly found in the
spleen, marrow and liver

• Iron content of the tissues is one of the factors determining

the aerobic capacity of an individual
• Therefore, adequacy of iron is closely link to health, fitness
and sport performance 14
 Iron Status
• Iron status can be examined by measuring
1. Haemoglobin (Hb) concentration
• Shows the capacity of the blood to absorb oxygen in
the lungs and carry it to the tissues
• If Hb concentration below the lower reference limits →
anaemia
• Besides genetic, the main cause of anaemia is
nutritional i.e. inadequate intake of iron, protein or
certain vitamins (folate and B6)
2. Iron concentration
• Shows the amount of iron that is available for tissues
to uptake
• The higher the iron concentration, the higher the
amount of iron the tissues can absorb and incorporate
in proteins 15
 Iron Status
3. Total iron-binding capacity (TIBC)
• Represents the amount of iron that the plasma can
carry
• TIBC is the value when iron-binding proteins in plasma
are fully saturated
4. Transferrin saturation
• Shows how saturated the iron transport system is
• = [Fe3+]
x 100
TIBC
5. Soluble transferrin receptor and ferritin concentration
• Transferrin receptor is a protein of the plasma
membrane that is involved in iron uptake
• Ferritin is the iron-storing protein
• Shows the amount of iron stored in the body 16
WHAT ARE THE PARAMETERS
THAT CAN BE MEASURED TO
DETERMINE A PERSON’S IRON
STATUS?

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 Iron Deficiency
• It is important to detect iron deficiency because it may
lead to reduced synthesis of haemoglobin, myoglobin
and proteins of the ETC
• Prolonged iron deficiency can deplete iron stores in the
body and leads to iron deficiency anaemia
• This condition is characterised by paleness, fatigue and
reduced ability to keep body warm in cold environment
• Iron deficieny anemia is indicated by
• Low transferrin saturation
• Low ferritin concentration
• Low haemoglobin concentration
• Eating iron-rich foods and taking iron supplements
usually rectifies iron deficiency 18
 Lactate
• Lactate is the end product of anaerobic glycolysis

• Lactate level can be measured by taking blood sample

• Blood lactate concentration at rest is ~1 mmol/L and after
maximal exercise for 1.5 min, it can go >20 mmol/L
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 Lactate
• When measuring lactate in
blood after maximal
exercise, it takes some
minutes for lactate to peak
• Therefore, repeated
samplings need to be
taken 2 minutes apart for
~10 min

• Lactate measurement can be used to

1. Estimate anaerobic capacity
2. Programme training
3. Estimate aerobic endurance
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 Estimating Anaerobic Lactic Capacity
• High anaerobic lactic capacity is of interest to athletes in
events that rely on the lactate system
• e.g. sprint or middle distance running & swimming
• When activity of enzymes in the lactate system increases,
the power of lactate system increases and the maximal rate
of lactate production increases

Which line in
A the graph shows
B the highest
C
anaerobic lactic
capacity?

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 Estimating Anaerobic Lactic Capacity
• If a maximal effort leads to a higher blood lactate
concentration than before, it is due one or more of the
following factors:
1. Increased lactate production
2. Increased buffering capacity of the muscle, blood or
both
3. Faster exit of lactate (along with H+) from muscle fibers
• Any of these adaptations may increase performance that
depends greatly on the lactate system
• Positive relationship between peak blood lactate
concentration and performance in events such as 400 and
800m running have been found
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 Programming Training
• Measuring blood lactate can also help to define the desired
training intensity
• It is superior than heart rates because lactate relates directly
to muscle metabolism and adaptations
• Exercise intensities that hold the blood lactate concentration
below 4 mmol/L are the most effective in improving aerobic
endurance, cardiac function and lipidemic profile

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 Estimating Aerobic Endurance
• A high endurance performance goes with being fast while
keeping the lactate concentration low
• Endurance training increases fat oxidation during prolonged
moderate-intensity exercise
• This adaptation enable an athlete to exercise at a higher
intensity while spending the same amount of carbohydrate
• The higher the aerobic endurance, the lower the lactate
concentration due to decreased carbohydrate breakdown
• Monitoring the adaptations to aerobic training allow us to:-
1. Determine whether the training program works
2. Upgrade the training intensities to push the adaptations
forward 24
 Estimating Aerobic Endurance

• Endurance training shifts the lactate-intensity plot to the right

• After endurance training, a given blood lactate concentration
is achieved at a higher exercise intensity 25
 HOW LACTATE MEASUREMENTs CAN
BE USED TO IMPROVE EXERCISE
PERFORMANCE?
A : swimming 2 m/s
A : higher anaerobic capacity B : swimming 1.3 m/s (ideal) A : sprinter
B : lower anaerobic capacity C : swimming 1 m/s B : marathoner
Blood lactate concentration
Blood lactate concentration

Blood lactate concentration

(mmol/L)
(mmol/L)

(mmol/L)
Time (min) Time (min) Work intensity
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 Creatine kinase
• Creatine kinase (CK) catalyses the interconversion of CP and ATP

creatine kinase

• The enzyme is present in almost all tissues but is highest in the

heart, skeletal & smooth muscles and also in the brain (B)
• CK-MM dominates in skeletal muscle
• CK-MB dominates in the heart
• CK-BB in the brain and smooth muscle
• The serum CK concentration increases when an organ that
contains the enzyme is damaged 27
 Creatine kinase
• Serum CK increases in healthy persons
after exercise due to increased muscle
fibre damage
• Athletes have higher serum CK
concentrations than non-athletes because
of regular strain caused by training on
their muscles
• However, the increase in serum CK
concentration after a set of exercise is
lower in athletes than non-athletes due
to repeated-bout effect
• Repetition of an exercise (particularly eccentric exercise), causes less
muscle fibre damage than the previous exercise 28
 Aminotransferases
• Aminotransferases catalyse the transfer of amino group from
amino acid which is important for amino acid metabolism
• Two commonly known aminotransferases are
1. Alanine aminotransferase (ALT)
– mostly in liver and kidney, smaller amount in skeletal muscle

2. Aspartate aminotransferase (AST)

- mostly in liver, heart, skeletal muscles and red blood cells

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 Aminotransferases
• The serum ALT and AST are low unless the organs that contain
them are damaged (e.g. liver diseases such as hepatitis &
cirrhosis)

• It is also increased when athletes use anabolic androgenic

steroids that damage the liver
• Hard exercise also causes both aminotransferases (particularly
AST as its muscle concentration is higher) to increase due to
muscle fibre damage but the increase is still lower than the
rise in CK 30
 Cortisol
• Cortisol is a steroid hormone that exhibit diurnal variation
• It is high in the morning and low in the evening
• Cortisol enhance gluconeogenesis, glycogen synthesis and protein
synthesis in the liver and increase plasma glucose level
• Cortisol secretion is increased in hypoglycaemia, obesity, physical
and mental stress
• It is also increased in exercise > 60% of VO2max and hard resistance
exercise
• However, cortisol causes protein breakdown (proteolysis) in muscle
and hence, high concentrations of cortisol is undesirable
• At high concentrations, it can suppress the immune system and
athletes may use these drugs to counter the inflammation caused
by injury to compete although this practice is banned by WADA31
 Testosterone
• Testosterone is a steroid hormone and its concentration is heavily
influenced by gender and biological age
• Testosterone is responsible for the development and maintenance
of the male reproductive system
• Testosterone also have anabolic effects on skeleton, skeletal
muscles and skin as they promote protein synthesis and red blood
cell production
• The higher the intensity of exercise (> 1 min), the larger the
increase in testosterone but the concentration will begin to
decrease after 1 h of exercise
• Natural and synthetic steroids are apparently the most widely used
doping substance due to their positive effects on muscle mass and
strength 32
 Testosterone
• The serum testosterone concentration of a man using anabolic
steroids decreases because these drugs trick the hypothalamus
into detecting an excessive testosterone concentration in the body
• The hypothalamus supresses the gonadotropin-releasing hormone
secretion and gonadotropin secretion by the pituitary gland
decreases which leads to the decreased testosterone synthesis by
the testes
• Gonadotropin is needed for testis development and sperm
production and the shortage of this hormone causes testicular
atrophy and suppression/disruption of sperm production
• Steroids and gonadotropin are also banned as doping substances

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CAN YOU GIVE SOME EXAMPLES OF
BIOMARKERS IN EACH CLASS?

Classes of Biomarkers
Iron status Metabolites Enzymes Hormones

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