Polimorfismos genéticos e marcadores bioquímicos associados à rabdomiólise em militares do Exército Brasileiro submetidos à intensa atividade física

Abstract

Training and proper nutrition are important things to achieving high levels of military physical performance, but when physical activity is practiced in excess, leads to disruption of muscle fibers, releasing intracellular components to the bloodstream. Those components are used as surrogate markers of smooth skeletal muscle injury. There are several factors that may influence muscle damage and physical performance of any athlete and it is understood that some polymorphisms may also be involved in the improvement or less physical wear. The aim of this study was to evaluate the biochemical and molecular profile of military of Brazilian Army, participants of Operations Course in the Jungle - OCJ. 233 military men and OCJ students were assessed in 2013. Each course lasted three months, during this time 12 blood samples were taken from each military. Were measured levels CK-MM, CK-MB and correlated with polymorphisms of ACTN3 (C1747T), GDF8 (C2T), MLC (C49T), AMPD1 (C34T), FKRP (A19G) MYH9 (A22G), GSTP1 (A341G), GSTP1-1 (C16T). The SNP MLCK was not found in the studied population. SNPs in ACTN3, GDF8, GSTP1 were frequent and when correlated with creatine kinase, fractions and MM-MB, statistically significant (p <0.001). All military carriers of R577X SNP had elevated CK levels, suggesting that carriers of this polymorphism have better physical performance and CK degradation faster, unlike the holders of the SNPs FKRP-A19G and MYH9-A22G, who developed lower physical performance. In this study was demonstrated that the genotypes for ACTN3, GSTM1 and GSTP1/1 corroborate literature data, with high frequencies. Holders of the SNP GDF8-C2T showed levels of CK-MM and CK-MB within baseline limits after high intensity exercise, while carrying the SNP ACTN3-R577X demonstrated high levels. During this study a single case of rhabdomyolysis occurred in a military, but due to cocaine use, with serum levels of creatine kinase MM fraction 99,500 U/L and MB fraction 6,500 U/L. Sodium levels were observed at 1.730 mmol/L, potassium 42.1 mmol/L, phosphorus 48.3 mg/dl, chloro 1.243 mmol/L, magnesium and 36.1 mg/dl; renal disorders, such as urea 302.6 mg/dl and creatinine 11.1 mg/dl. Quality tests, troponin and myoglobin, showed positive results. It is concluded that genetic polymorphisms may influence the increase or decrease in muscle damage and physical performance of military personnel exposed to strenuous physical training.