Changes And Nonrecovery In Hypersensitive C-reactive Protein And Prealbumin Level During Prolonged Physical Strain In Male Cadets

Introduction
Sustained high physical load is connected with severe metabolic and hormonal changes in the organism. Recently great
attention has been paid to protein malnutrition in relation to several diseases (Beck, Rosenthal, 2002) but there are no
data on intensive physical load and objective estimation of adequate protein nutrition. The purpose of the present study
was to assess the prealbumin level and inflammatory background (hsCRP) during severe long-lasting physical load in
male well-trained cadets.

Methods
Eight army male cadets (25.5±3.0 yrs, 75.4±9.7 kg, 180.1±5.6 cm, VO2max/kg: 64.5±8.1 ml/min/kg) were examined
during a military international combat course (ERNA, Estonia) of 3.5 days’ duration (84 hours). The course involved
walking, jogging and special military combat activities (in total 150 km). Biochemical analyses were performed at
baseline, during the race (after 2nd day), immediately after the course (finish) and during recovery period (24 hrs after
the race). Blood samples were analyzed for hemoglobin (Hgb), hematocrit (Hct), serum testosterone (TESTO), cortisol
(CORT), growth hormone (GH), hypersensitive C-reactive protein (hsCRP) and prealbumin (PA). All biochemical
markers were corrected according to the changes in plasma volume (Dill, Costill, 1974). Statistical analysis was
performed using SPSS 11.0 version. T-test for dependent variables and Pearson correlation analysis was used.

Results
Study results showed significant changes in all measured mean hormonal, hsCRP and PA values (Table 1), although
there existed great interindividual differences. Mean HsCRP increased significantly during the race and stayed
relatively high during the recovery period. The lowest recovery period’ hsCRP values were shown by three cadets with
the highest VO2max/kg. Prealbumin level decreased significantly during the race and was continously very low during
the recovery period. Physical fitness level (VO2max/kg) was inversely related to the hsCRP value during the race (r=-
0.685, p=0.052) and prealbumin level of the recovery period (r=-0.769, p=0.026).

Discussion / Conclusions
Our study results showed that the military combat ERNA-course of 3.5 days’ duration was characterized by severe
hormonal changes, which is in a good agreement with other studies (Aakvang et al., 1978). The serum level of hsCRP
was markedly elevated during the physical strain. Prealbumine as marker of protein pool decreased considerably during
the prolonged physical strain and did not recover to the baseline values during the 24 hr recovery period. Our data
provide evidence that high physical fitness (VO2max/kg) is related to the better protein nutrition and inflammatory
background during the long-lasting physical strain and recovery period.

References
[1]. Beck FK, RosenthalTC (2002). Am Fam Physician, 15, 1575-1578.
[2]. Dill DB, Costill DL (1974). J Appl Physiol, 37, 247-248.
[3]. Aakvang A, Sand T, Opstad PK, Fonnum F. (1978). Eur J Appl Physiol Occup Physiol, 20, 283-291.

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