军事训练中的肌肉、肝脏和肾脏生物标志物:一项为期37周的辍学者和入围者的比较研究。

IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Thalita Ponce, A Carneiro, C V Lucena, F R Aquino Neto, J B Pesquero, D Viana-Gomes
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引用次数: 0

摘要

简介:军事作战训练的士兵受到极端的身体和环境压力,增加了劳累性横纹肌溶解(ER)和急性肾损伤(AKI)的风险。这项研究分析了巴西海军陆战队员的肌肉、肝脏和肾脏生物标志物,他们在不同的生物群落中进行了259天的高强度训练,比较了完成课程(决赛选手)和退出课程(辍学者)的生物标志物行为。方法:本观察性研究对35名男性海军陆战队员(5名最终入选者,30名中途退出者)进行了6次作战任务,每次任务持续7-12天,包括高强度体力消耗、控制进食、剥夺睡眠和自由补水。在基线和任务后采集血样,测定肌酸激酶(CK)、乳酸脱氢酶(LDH)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、γ -谷氨酰转移酶(GGT)、白蛋白、肌酐、尿素、肾小球滤过率(eGFR)和电解质。统计分析包括方差分析、弗里德曼检验和曲线下面积比较。结果:CK、LDH和AST水平在整个训练过程中保持升高,CK值在“热带任务”中达到峰值(3,156 (2,397;4,804) U/L)和100公里行军后的“高空任务”(9,720 (7,956;8,3969) U/L),表明亚临床ER。ALT在“高海拔任务”中显著增加(1,431 (902;7099) U/L),而GGT和白蛋白保持稳定。肌酐变化显著,在“高空任务”生存期后下降(0.7 (0.7;0.8毫克/分升),在“半干旱任务”中eGFR降低(92 (82;118毫升/分钟/1.73平方米)。在最终入围者和辍学者之间,CK、肌酐和eGFR没有显著差异,这表明非生理因素影响了辍学率。结论:“热带任务”和“高海拔任务”由于CK升高和肌酐波动导致ER和AKI的风险最高。加强补水方案和CK参考值调整可能是必要的,以减轻军事训练中的健康风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Muscle, liver and kidney biomarkers in military training: a 37-week comparative study of dropouts and finalists.

Introduction: Military operational training soldiers are subjected to extreme physical and environmental stress, increasing the risk of exertional rhabdomyolysis (ER) and acute kidney injury (AKI). This study analysed muscle, liver and kidney biomarkers in Brazilian Navy marines undergoing 259 days of high-intensity training across diverse biomes, comparing biomarker behaviour between those who completed the course (finalists) and those who withdrew (dropouts).

Methods: This observational study followed 35 male marines (five finalists, 30 dropouts) during six operational missions, each lasting 7-12 days, involving intense physical exertion, controlled feeding, sleep deprivation and free hydration. Blood samples were collected at baseline and post-mission to measure creatine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), albumin, creatinine, urea, estimated glomerular filtration rate (eGFR) and electrolytes. Statistical analyses included analysis of variance, Friedman tests and area-under-the-curve comparisons.

Results: CK, LDH and AST levels remained elevated throughout training, with peak CK values in the 'tropical mission' (3,156 (2,397; 4,804) U/L) and the 'high-altitude mission' post-100km march (9,720 (7,956; 8,3969) U/L), indicating subclinical ER. ALT increased significantly in the 'high-altitude mission' (1,431 (902; 7,099) U/L), while GGT and albumin remained stable. Creatinine showed significant variation, decreasing after the survival phase of the 'high-altitude mission' (0.7 (0.7; 0.8) mg/dL), with eGFR reductions in the 'semi-arid mission' (92 (82; 118) mL/min/1.73 m²). No significant differences in CK, creatinine or eGFR were found between finalists and dropouts, suggesting non-physiological factors influenced dropout rates.

Conclusion: The 'tropical mission' and 'high-altitude mission' posed the highest risk for ER and AKI due to extreme CK elevations and creatinine fluctuations. Enhanced hydration protocols and CK reference value adjustments may be necessary to mitigate health risks in military training.

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来源期刊
Bmj Military Health
Bmj Military Health MEDICINE, GENERAL & INTERNAL-
CiteScore
3.10
自引率
20.00%
发文量
116
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