Muscular exercise can cause highly pathological liver function tests in healthy men

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British Journal of Clinical Pharmacology 65 (2), 253–259.

doi:10.1111/j.1365-2125.2007.03001.x

Abstract

Muscular exercise can cause highly pathological liver function tests in healthy

men

Jonas Pettersson, Ulf Hindorf, a Persson, Bengtsson, Ulf

Malmqvist,11Department of Clinical Pharmacology, Lund University Hospital, Lund,

and Viktoria Werkström11Department of Clinical Pharmacology, Lund University

Hospital, Lund, and & Mats Ekelund22AstraZeneca R & D Mölndal, Mölndal,

SwedenAstraZeneca R & D Lund and 1Department of Clinical Pharmacology, Lund

University Hospital, Lund, and 2AstraZeneca R & D Mölndal, Mölndal, Sweden

Ulf Hindorf, Medical Science, AstraZeneca R & D Lund, SE-221 87 Lund, Sweden.

Tel: + 46 4633 7143

Fax: + 46 4633 7576

E-mail: ulf.hindorf@...

Abstract

What is already known about this subject

• The occurrence of idiosyncratic drug hepatotoxicity is a major problem in

all phases of clinical drug development and the leading cause of postmarketing

warnings and withdrawals.

• Physical exercise can result in transient elevations of liver function

tests.

• There is no consensus in the literature on which forms of exercise may cause

changes in liver function tests and to what extent.

What this study adds

• Weightlifting results in profound increases in liver function tests in

healthy men used to moderate physical activity, not including weightlifting.

• Liver function tests are significantly increased for at least 7 days after

weightlifting.

• It is important to impose relevant restrictions on heavy muscular exercise

prior to and during clinical studies.

Aim

To investigate the effect of intensive muscular exercise (weightlifting) on

clinical chemistry parameters reflecting liver function in healthy men.

Methods

Fifteen healthy men, used to moderate physical activity not including

weightlifting, performed an 1 h long weightlifting programme. Blood was sampled

for clinical chemistry parameters [aspartate aminotransferase (AST), alanine

aminotransferase (ALT), lactate dehydrogenase (LD), gamma-glutamyl transferase

(γGT), alkaline phosphatase (ALP), bilirubin, creatine kinase (CK) and

myoglobin] at repeated intervals during 7 days postexercise and at a follow-up

examination 10–12 days postexercise.

Results

Five out of eight studied clinical chemistry parameters (AST, ALT, LD, CK and

myoglobin) increased significantly after exercise (P < 0.01) and remained

increased for at least 7 days postexercise. Bilirubin, γGT and ALP remained

within the normal range.

Conclusion

The liver function parameters, AST and ALT, were significantly increased for at

least 7 days after the exercise. In addition, LD and, in particular, CK and

myoglobin showed highly elevated levels. These findings highlight the importance

of imposing restrictions on weightlifting prior to and during clinical studies.

Intensive muscular exercise, e.g. weightlifting, should also be considered as a

cause of asymptomatic elevations of liver function tests in daily clinical

practice.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2125.2007.03001.x

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