Abstract

Background: The health benefits of endurance sports are undeniable. Nevertheless, sometimes during these sports, individuals can be exposed to acute physiological imbalances, sometimes pathological and serious. Unlike gastrointestinal complications that are frequent and often benign, liver damage is very rare and poorly understood during these sports. Our objective was to study the hepatic disturbances in athletes during endurance activity, as well as the various individual and environmental factors that may influence their occurrence and prognosis.

Methods: A prospective observational study in 50 military athletes participating in a semi-marathon in southeastern Tunisia.

Results: Hepatic and/or muscular cytolysis was observed in 53% of the runners for ALAT, 53% for ASAT, 38% for both ASAT and ALAT, 61% for creatinine phosphokinase, and 85% for lactate dehydrogenase. Total bilirubin was elevated (minimal cholestasis) in 36% of subjects and associated with hepatic cytolysis in 78% of cases. Only two serious cases of hepatitis were noted (ischemic liver injury). Further evolution was favorable in all cases. These clinico-biological disorders were significantly more frequent in younger, less trained, and less acclimatized athletes.

Conclusion: These complications deserve to be known and considered in endurance sports. Their best treatment remains preventive based on regular training, acclimatization, appropriate diet, and hydration.

Keywords

liver, endurance sport, cytolysis, exercise hepatitis, ischemic liver, athlete’s hepatitis