Beumer Prieto Blanca, Moreno-Parro Isabel, Sufrate-Vergara Berta, Fabre-Estremera Blanca, Buño Soto Antonio, Fernández-Calle Pilar, Díaz-Garzón Marco Jorge
Deparment of Laboratory Medicine, 16268 La Paz University Hospital , Madrid, Spain.
IdiPaz - Hospital La Paz Institute for Health Research, Madrid, Spain.
Clin Chem Lab Med. 2025 Jan 28;63(5):987-994. doi: 10.1515/cclm-2024-1203. Print 2025 Apr 28.
Cardiac biomarkers are useful for the diagnostic and prognostic assessment of myocardial injury (MI) and heart failure. By measuring specific proteins released into the bloodstream during heart stress or damage, these biomarkers help clinicians detect the presence and extent of heart injury and tailor appropriate treatment plans. This study aims to provide robust biological variation (BV) data for cardiac biomarkers in athletes, specifically focusing on those applied to detect or exclude MI, such as myoglobin, creatine kinase-myocardial band (CK-MB) and cardiac troponins (cTn), and those related to heart failure and cardiac dysfunction, brain natriuretic peptide (BNP) and N-terminal brain natriuretic pro-peptide (NT-proBNP).
Thirty athletes participated, providing monthly fasting blood samples over 11 months. Samples were analyzed using chemiluminescent immunoassays and statistical analyses were conducted using the classical ANOVA method, a linear mixed model and a Bayesian approach.
The study observed significant gender differences in biomarker concentrations, with higher BNP and NT-proBNP in females and higher myoglobin and CK-MB in males. Physical activity within 24 h before sampling notably affected CK-MB, myoglobin, and hs-cTnI variability. The BV estimates demonstrated high individuality for most biomarkers, suggesting their potential for personalized monitoring. The study also revealed substantial heterogeneity for NT-proBNP and BNP within the population.
These findings underscore the importance of considering gender-specific reference intervals and the impact of recent physical activity when interpreting cardiac biomarkers in athletes. The study delivers new BV estimates for CK-MB and myoglobin while emphasizing the need for tailored clinical assessments in athlete populations.
心脏生物标志物有助于心肌损伤（MI）和心力衰竭的诊断及预后评估。通过测量心脏应激或损伤时释放到血液中的特定蛋白质，这些生物标志物可帮助临床医生检测心脏损伤的存在及程度，并制定合适的治疗方案。本研究旨在提供运动员心脏生物标志物的可靠生物学变异（BV）数据，特别关注那些用于检测或排除MI的标志物，如肌红蛋白、肌酸激酶同工酶（CK-MB）和心肌肌钙蛋白（cTn），以及那些与心力衰竭和心脏功能障碍相关的标志物，脑钠肽（BNP）和N末端脑钠肽前体（NT-proBNP）。
30名运动员参与研究，在11个月内每月提供空腹血样。使用化学发光免疫分析法对样本进行分析，并采用经典方差分析方法、线性混合模型和贝叶斯方法进行统计分析。
研究观察到生物标志物浓度存在显著性别差异，女性的BNP和NT-proBNP较高，男性的肌红蛋白和CK-MB较高。采样前24小时内的体力活动对CK-MB、肌红蛋白和高敏肌钙蛋白I（hs-cTnI）的变异性有显著影响。大多数生物标志物的BV估计显示出高度个体差异，表明它们具有个性化监测的潜力。研究还揭示了人群中NT-proBNP和BNP存在大量异质性。
这些发现强调了在解释运动员心脏生物标志物时考虑性别特异性参考区间和近期体力活动影响的重要性。该研究提供了CK-MB和肌红蛋白新的BV估计值，同时强调了对运动员群体进行个性化临床评估的必要性。
