BIOCHEMICAL ANALYSIS IN

SPORTS
Nutrition and Physical activity

Dra. Marissa Islas

IMPORTANCE

 The analytical for athletes consists of carrying out a blood and urine analysis in
which certain parameters are studied. The result of the analyzes, together with
the sensations of the patient during exercise, analyze the effects of sport on the
body.

 Biochemistry and hematology are more and more important and sometimes
crucial in sport medicine for diagnosing, controlling and preventing purposes.
 WHEN TO PERFORM BIOCHEMICAL
ANALYSIS IN SPORTS
 A minimum of 3 timers a year are recommended:
 Season start: to assess general health status.
 The mesocycle with the highest aerobic volume to monitor possible anemias.
 To the beginning of the competition season to assess the state of health

We can also perform them when:

After the realization of a good mark, to have some reference levels.

Before any manifestation of any symptom that has no logical explanation, such as fatigue,
muscle weakness, dizziness, weight loss and / or performance, tests should be done
 WHEN TO PERFORM THE ANALYSIS

 When the athlete starts with the training the

plasma volume can increase between 20 and 25%,
depending on the type of training and sport that
the athlete is performing.
 Example: If his volume at that time is 5 liters of blood,
due to the effect of resistance training, the volume will
increase to 6 liters.
 This increase is due to the release of certain hormones
that causes a net retention of Na and H2O, and thus the
volume of expansion of blood and a dilutional
pseudoanemia can be caused.
 HEMATOLOGY

 The evaluation of hemoglobin blood cells and

particles is usual in athlete to study iron
metabolism, or optimal oxygen transportation,
possible infections and other diseases.
 Hematocrit and (or) hemoglobin have been chosen
by some sports federations to indirectly discover
blood doping and erythropoietin administration.
 To have a good cardiovascular performance, the
blood count must be at adequate levels. When the
presence of red blood cells is low, anemia occurs.
BIOCHEMISTRY

 We can assess liver and kidney function, the state of the muscles and the levels of
some important ions.

 Hepatic function:
 Physical exercise can result in transient elevations of liver function tests.
 The liver function parameters, aspartate aminotransferase AST/GOT and alanine
aminotransferase ALT/GPT and gamma-glutamyl transferase GGT.
 GOT also originates in the muscle, kidney and even the brain. Its maximum elevation peak
occurs 24-48 hours after competition, but returns to normal levels in 3-4 days. It is the most
important of the three.
 BIOCHEMISTRY

 Renal function:
 It is measured by urea and creatinine.
 After intense exercise and if the fluid intake is insufficient, we become dehydrated
and these two parameters increase in the blood, especially urea.
 Once rehydrated, the values normalize. If we do a urinalysis, it is common to find
the presence of blood, but at such small levels that it does not discolor the urine,
keeping it its normal color.
 The same goes for proteins in the urine (creatinine), especially myoglobin, which
is the protein that carries oxygen within the muscle. When muscle fibers break
during exercise (rhabdomyolysis), it is released, passes into the blood, and from
there to the kidneys and urine. All of this should be clarified two or three days
after the effort.
BIOCHEMISTRY

 Muscle function:
 It is measured thanks to two enzymes such as Serum lactate dehydrogenase (LDH) and creatine
phosphokinase (CPK).
 CPK originates in the muscle and the heart. It increases significantly with exercise, especially
within the first two days. It normalizes in two or three days, but if the effort has been very
important, it can take up to a week to reach normal values.
 LDH also increases with exercise within a few hours and recovers much more quickly than CPK.
 CKP is an enzyme of phosphocreatine metabolism released into plasma by breaking the Z band of
the sarcomere, being the most sensitive to muscle damage.
 Their values are related to the intensity of the load.
BIOCHEMISTRY

 Ammonia
 Initial step to urea production; it is a faster marker than urea for the same parameters.
Reports the intensity of the anaerobic pathway.
 The accumulation of ammonia is responsible for fatigue from exercise due to central
nervous system dysfunction.
 In intense lactic exercises, ammonia is secreted by the accumulation of lactate;
However, in these cases the exercise has to decrease or end, not because of the massive
presence of lactic acid, but because of excessive tension in the muscle fiber that the
nervous system cannot relax; however research should further clarify the role of
ammonia.
MAGNESIUM

 Magnesium is key for the metabolism of proteins and carbohydrates and we find
it mainly in fruits, green vegetables and in fish.

 Average values and variations

 Its average values are between 1.90 and 2.50 mg / dl or 0.8 - 1.0 mmol / l.
 Elite Athletes should aim for a value greater than 0.9 mmol / l.

Low values can cause irritability, muscle cramps, poor

appetite, sleep disturbances, poor concentration, etc.
LACTATE

 Lactate is maybe the most used chemical parameter in sport to identify the
anaerobic metabolism. It is usually measured directly in fresh capillary whole
blood collected from ear lobe or fingers.
 While an elevated Lactate may be indicative of ischemia or hypoxemia, it may
also be a “normal” physiological response to exertion.
 Lactate concentration in the blood of healthy humans usually follows workload
(WL) demands.
 The rapid lactate accumulation can be explained by a reduced aerobic energy
supply as a consequence of insufficient O2 delivery.
VITAMIN E

 Vitamin E is a natural antioxydant: the evaluation of antioxydant status is an

important new part of sport biochemistry.
 Recent studies suggest that endurance exercise may promote free radical
generation in the body, and vitamin E may play an important role in preventing
the free radical damage associated with endurance exercise.
 IONS AND MINERALS:
 Metal ions (zinc, copper, aluminum, lead) are oligoelements variably assayed in sport for
evaluating nutritional status or for toxicological reasons.
 Zinc: protects against the effects of increased free reactive oxygen species.
 Selenium: in glutathione peroxidase protects the cardiovascular system, and the
muscles, and helps combat allergic and inflammatory diseases.
 Copper: and iron are involved in many aspects of energy metabolism and are important
components in the synthesis of hemoglobin, myoglobin and cytochromes.

Fluorine and Cu protect the ligaments and tendons.

IONS AND MINERALS:
Calcium
• Is important for the quality of bone, teeth, blood clotting, and muscle function. It competes with other ions to be absorbed in the
intestine, as in the case of iron. If we take calcium supplements unnecessarily, iron is not absorbed and we will have anemia.

Phosphorus
• Plays an important role in bone quality and energy metabolism within muscle, since there are two compounds that mostly contain
phosphorus and are very important as energy creators: ATP and phosphocreatine.
• If your blood level drops, fatigue and muscle weakness occur.
Sodium
• Is an essential mineral involved in the body's water balance. The average intake should be 1.5 grams per day.
• Due to sweat losses, it is necessary to increase your intake, especially on hot days. It is a key ingredient in sports drinks as it encourages
the desire to drink to maintain the volume of plasma lost.
• When it is not replaced properly, the dreaded cramps and contractures appear.
Potassium
• Is the main mineral found within cells. It is involved in muscle contractions.
• Its deficit is rare and only occurs in situations such as abundant diarrhea or persistent vomiting or abusive use of diuretics or laxatives.
• Little potassium is usually lost through sweat, then it does not seriously affect athletes who are well nourished.
Iron
• Is essential to form oxygen transporting compounds such as hemoglobin in the blood and myoglobin in the muscle.
• The amount of iron that is absorbed will depend on the amount of iron stored. Rarely more than 20% of the iron contained in the food
consumed is absorbed. Beware of the obsession with carbohydrates that runners can have especially, thus neglecting the consumption
of meat, and therefore, decreasing the intake of iron.
 AVERAGE VALUES
RED SERIES FUNCTION FUNCTION OBSERVATIONS
Man Woman
Red blood cells or It is the red blood cell 4.5 – 6.5 3.8 – 5.8 Red blood cells are responsible for
Erythrocytes count. million / mm3 million / mm3 transferring oxygen to cells.
Hemoglobin It is the protein that 13 – 18 g/dl 12 – 16 g/dl In endurance sports, high values are
fixes the oxygen for its recommended. Less than 12g / dl may
transport indicate anemia.
Hematocrit Percentage of red blood 40-50% 38-47%
cells in total blood
volume.
Medium corpuscular Indicates the size of the 83 – 97 fl 83 – 97 fl
volume Mean red blood cells.
Corpuscular Indicates how much 31 – 36 g/dl 31 – 36 g/dl Values out of the ordinary usually
Hemoglobin hemoglobin there is per indicate some types of non-iron
Concentration red blood cell. deficiency anemia
Mean Corpuscular Indicates the 26 – 34 pg 26 – 34 pg
Hemoglobin hemoglobin
concentration and the
total number of red
blood cells.
WHITE SERIES AVERAGE VALUES HIGH COUNT LOW COUNT
Leukocytes 4,000,500 – 10000 Inflammation (may be caused by Low defenses In athletes it may be
per mm3 microtraumas from training) due to overtraining.
Infective process
Segmented 45 – 75% Pericious anemia Bacterial infection burns or
Folic acid deficiency abrasions (falls on a bicycle for
example)
Neutrophils 55 – 70% Bacterial infection Burns Stress Vitamin B12 deficiency
Lymphocytes 16 – 45% Virus infections Immune diseases Weakness from prolonged illness
High level of steroids
Monocytes 3 – 12 % Virus infections Infrequent
Chronic diseases Tuberculosis
Leukemia
Eosinophils 1 – 4% Allergic reactions Stress
Parasitic infection Overtraining
Basophils 0.5 – 2% Allergic reactions Pregnancy
Ovulation
Stress
 OTHER
FUNCTION
PARAMETERS
Platelet series Serum Platelets are responsible
for blood clotting
Erythrosedimentation It indicates the speed with
which the red blood cells
sediment
Serum Iron Indicates the amount of
iron circulating in the
blood
Ferritin Iron storage molecule
Transferrin Iron transport molecule
Total proteins Indicates circulating
proteins in plasma
Glucose Indicator of carbohydrate
metabolism
AVERAGE VALUES
OBSERVATIONS
M W
150 – 450 x 1000 mm3 An elevated count should be monitored for possible
thrombosis A decreased memory can indicate bleeding
1 – 13 mm/h in the first It is a very unspecific value that depends on many
hour 2 – 30 mm in the factors. It generally increases when there are bacterial
second hour infections, in rheumatic diseases, muscle-type injuries
and certain hematological diseases
45 – 170 50 – 140 It is not an indicator of iron reserves in the body In
ug/dl ug/dl endurance athletes, values greater than 80ug / dl are
recommended.
30 – 300 10 – 200 It indicates iron stores in the body and is used to
ng/ml ng/ml diagnose anemia in its early stages. For endurance
athletes, minimum values of 130ng / ml are
recommended.
202 – 400 mg % Indicates iron that is out of hemoglobin or not in the
reserve bound to ferritin
6.6 – 8.7 % For endurance athletes, values of 7.8 to 8.2% are
recommended
90 – 100 mg/dl High values should be studied for possible diabetes
 OTHER
FUNCTION AVERAGE VALUES OBSERVATIONS
PARAMETERS

Urea It is an indicator of protein
metabolism
Creatinine Indicates the use of phosphogens
as energy
CPK / CK They are enzymes that indicate
muscle damage and therefore
their values are related to load
intensity.
Trasaminase Indicator enzyme of amino acid
metabolism
Cholesterol They are LDL lipoproteins:
responsible for the transport of
cholesterol to the tissues. HDL:
removes cholesterol from tissues
and takes it to the liver, reducing
cardiovascular risk
Triglycerides Responsible for the transport of
fatty acids
20 – 50 mg/dl High Urea values are indicators of muscle
catabolism. Training intensity should be reduced
0.70 – 1.50 mg/dl High creatinine values concurrent with high uric
acid values indicate excessive training loads
80 U/l Their values are a good indicator of the intensity
of the loads supported
Lower tan 40 U/L Its increase reflects an excessive work of the liver
or the destruction of tissues.
It is increased with intense exercises
Total Cholesterol Resistance training is usually favored in balance
135 – 200 mg/dl between HDL and LDL cholesterol
HDL: + 35 mg/dl
LDL: -150 mg/dl
40 – 170 mg/dl High values are harmful since they indicate a
higher viscosity of the blood
OTHER ANALYSIS

OTHER PARAMETERS FUNCTION AVERAGE VALUES OBSERVATIONS

Cortisol Cataolic hormone 50 – 250 ng/ml High levels indicate

Short term marker muscle destruction

Testosterone Anabolic hormone 0.4 – 5 nmol/L Low levels can lead

Long-term marker to overtraining
OTHER ANALYSIS

 There are numerous peptides and proteins of endocrinological interest used for
research and routine purposes in sport medicine.
 Osteocalcin is a bone protein produced by osteoblasts and its measurement is
recommended in diagnosis and therapy of bone metabolism diseases. Some interest on
this protein has been expressed in sport medicine for the study of longtime
administration of steroids, which induces bone matrix depauperation.
 Cardiac markers can be used to monitor the myocardial involvement, particularly
in endurance or extreme performances.
 Myoglobin and creatinkinase isoenzyme MB (CKMB) should be measured in serum.
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