Effects of Underwater Rugby on the Plasma Concentrations of Urea, Uric acid, Creatinine, Albumin, Globulin and Bilirubin,
(This study was presented 12nd International Physical Education and Sports Conference- Komotini,Greece)
(This study was also published in Exercise and Society Journal of Sports Science, 2004, (36), p.246)
Levent CAVAS1 – Bulent CAVAS2 – Kadir YURDAKOC 1, *
University of Dokuz Eylül, 1 Faculty of Arts and Sciences, Department of Chemistry (Biochemistry Division), 35160, Kaynaklar Campus, IZMIR, TURKEY, 2Faculty of Education, Department of Science Education, 35150, IZMIR, TURKEY
* Corresponding Author
Correspondence Address: University of Dokuz Eylül, Faculty of Arts and Sciences, Department of Chemistry (Biochemistry Division), 35160, Kaynaklar Campus, IZMIR, TURKEY, E-mail: k.yurdakoc@deu.edu.tr , Tel: +90 232 4535072-2135 Fax: +90 232 4534188
In the present study, we aimed to observe effects of Underwater Rugby (UWR) on the serum urea, uric acid, creatinine, albumin, globulin and total, direct and indirect bilirubin levels in the periods of 24 hrs and of 5 min, respectively, before the game starts and periods of 5 min, of 24 hrs and of 48 hrs, respectively, as soon as the UWR game finishes in 8 female and 9 male well-trained UWR players. Serum uric acid, urea, and creatinine levels increased significantly (p<0.05) after the UWR game in both female and male UWR players. No significant (p>0.05) changes were found in total protein, albumin globulin and indirect bilirubin levels. While total bilirubin levels decreased significantly (p<0.05) in female UWR players, it increased significantly (p<0.05) in male UWR players. There was a significant (p<0.05) decrease in the direct bilirubin levels in female players 5-min after the UWR, no statistical change was observed in male UWR players. In conclusion, since the biochemical parameters investigated in this study remained within the normal limits, negative effects of UWR on liver and kidney functions in the UWR players could not be considered. Since some increased parameters such as uric acid, urea and creatinine in both female and male UWR players have been observed, this game may be recommended to people who are willing to lose their overweight by increased catabolic state of metabolism.
Key Words:
Underwater Rugby, Urea, uric acid, creatinine, albumin, globulin and total, direct and indirect bilirubin, physical exercise
Inhibitor effects of regular physical activities on especially cardiovascular diseases have been shown in many reports so far (1-3). Accordingly, the expenses for health will be lower in the people that would chose physical exercise as a life-style. The number of different and interesting physical activities has been increasing. Among them, Underwater Rugby (UWR) is the only 3 dimensional team sports in the world. It is played below the surface of the water in a swimming pool by two teams of 11 players, 6 in the water and 5 substitutes. Each player is wearing basic underwater equipment, i.e. fins, mask, cap with ear protection and snorkel. The object of the game is to put a negatively buoyant ball into the opposing team's goal having the design of a larger sized waste paper basket. One goal is located at each end of the playing area on the bottom of the pool. The depth of the water can be 3.5 - 5 meters. The duration of the game is divided into two periods of 15 minutes with a recreation time of 5 minutes (16). UWR tournaments officially in Turkey started about nineties years and has been continuing with increasing participation. According to Turkish Underwater Federation, about 79 teams has applied to national tournament will be held in Turkey in the year 2004 (14). Besides the development of this sports all around the world, effect of this sport on human metabolism is not clear yet. Positive effects of regular physical activities are clear. Urea and uric acid are the end products of protein and nucleoprotein metabolism, respectively and are excreted by the kidney. Elevations in the both urea and uric acid concentrations can be evidence increased catabolic state in physical exercise. Creatine is present in muscle, brain, and blood both as phosphocreatine and in the free state. Creatinine is anhydride form of creatine and is produced in muscle by irreversible non-enzymatic dehydration of creatine phosphate. This product of metabolism is increased in acute or chronic renal insufficiency, urinary tract obstruction. It was showed the increased creatinine levels in elevated catabolic states. Observation of urea, uric acids and creatinine during physical activities may give extra information about the functional state of some organs such as liver and kidney. The some blood proteins such as albumin and globulin play vital roles in blood. The concentration of their levels during physical activities shows general effects of physical activities on blood metabolism. Bilirubin is the product of the reaction of hemoglobin degradation in the reticuloendothelial system. Lower values of bilirubin has no clinical importance however higher elevations with other liver marker enzymes (GOT, LDH, GGT) may show liver failure (8).
Overall, we aimed to observe effects of UWR on the plasma parameters such as urea, uric acid, creatinine, albumin, globulin and total, direct and indirect bilirubin levels in female and male UWR players.
8 female and 9 male well-trained UWR players participated the study. The subjects gave written informed consent after having been explained the purpose, possible risk and stress associated with the study. Physical characteristics of players are presented in Table 1.
Venous blood samples (anticoagulated with 14300 U/l heparin or 1g/l EDTA) of the subjects were collected from anticubital vein 24 hour and 5 minute before and 5 min, 24 hours and 48 hours after the UWR. All UWR players had been advised to obey standard a 3500 – 4500 kcal daily diet and they also had been advised not to consume any other supplements one week before and after two days of the game. The official CMAS game time and rules were applied during the study. Briefly, the game is two 15 minute halves with a four minutes half time. The parameters were measured in OPERA-Chemistry System (Bayer) Analyzer by using Biacon, Roche Diagnostic kits. Normal limits related to determined parameters were presented Table 2.
The values are presented as Mean ± SD. Significant differences between both pre-post and values of female and male players were computed using Student’s t-test. The significance was set at p<0.05.
Serum uric acid, urea, creatinine, total protein, albumin, globulin, total bilirubin, direct bilirubin and indirect bilirubin levels were measured before and after an UWR game. The results are presented in Table 3. As can be seen from Table 3, serum urea levels increased significantly (p<0.05) in both female and male UWR players at post-5min compared to pre-5min values. After post-5min, urea levels declined the initial values in both gender. Accordingly, serum uric acid levels showed the similar trend as well as serum urea levels in female and male UWR players. Serum creatinine levels also increased significantly (p<0.05) after UWR game in female and male UWR players. Post-24h and -48h levels were also significantly (p<0.05) than those of pre-5min values in female and male UWR players. We did not observe any statistical changes in the concentrations of total protein, albumin, and globulin in female and male UWR players. Total bilirubin levels decreased and increased significantly (p<0.05) in female and male UWR players, respectively, 5 min after the UWR game compared to pre-5 min values. While direct bilirubin levels in female UWR player at post-5 min and post-24-h were significantly different (p<0.05) compared to pre-5min value, no significant (p>0.05) differences were observed in male UWR players. Indirect bilirubin levels did not change in both female and male UWR players. All parameters investigated in this study remained within the normal limits.
The beneficial effects of regular physical activity in especially cardiovascular diseases have been shown in numerous reports. On the other hand, prolonged and intensive exercise may cause free-radical generation and may cause reactive oxygen species based diseases. To see both acute and chronic effects of UWR game on the metabolism, some biochemical markers investigated in the present study. Although the changes in the blood biochemical markers after various exercise events were well-studied, no record on UWR for latter parameters exist in the literature. Therefore, comparisons have been made with various exercise types in this study. Serum uric acid levels at post-5 min when compared to pre-5 min and other values increased significantly (p<0.05) in both female and male UWR players. The final value being not significantly (p>0.05) different from the pre-game values. Baseline uric acid level in male UWR players was found to be higher compared to female UWR players. This can be explained by higher muscle mass contents in males than those of females. While Noakes and Carter (10) found a statistical increase in serum uric acid levels after 160 km run, Irving et al (6) and Fallon et al (4) found no significant increases in uric acid levels after a 56 km run and a 1600 km run, respectively. Different exercise duration and intensities may underlie different uric acid responses to exercise. The increases in uric acid concentration after UWR may be caused by degradation of purine nucleotides (4-5). When female and male UWR players are compared; although slight decrease (from 2.6 ± 0.20 to 3.0 ± 0.21 mg/dL) was observed between post-5 min and post-24h in female UWR players, a sharp decrease (from 3.9 ± 0.34 to .7 ± 0.23 mg/dL) was observed in male UWR players. These results may show that the rate of degradation of purine nucleotides in female players was lower than those of male UWR players. As well as uric acid levels, we also observed significant increases in serum urea levels in both female and male UWR players 5 min after a UWR game. Fallon et al reported urea levels at 4, 11 and at the end of the 1600 km run (4). The increases in serum urea levels were also reported in several investigation after runs of 56 km(6), 100 km (12) and 160 km (10) and 24 hours (9). Our study also supports the increases in serum urea levels after a physical exercise. The increase in serum urea level may show muscle damage with increased enzyme activities. However, in our previous study, although we observed increased muscle enzyme activities, they remained within the normal limits. Therefore, muscle damage could not be considered in our players after a UWR game. The increases in urea levels after a UWR game in both female and male UWR players may show that the increased catabolic state in metabolism. As well as uric acid and urea levels, we also observe significantly increased creatinine levels after a UWR game in both female and male UWR players. Although the decreases were observed 5 min after a UWR game, the values still significantly higher when compared to pre-5min value in both gender. The mean creatinine levels remained within the normal limits. Significant increased creatinine levels were reported after a 100 km (12) and 160 km runs (10) in the literature. As Fallon reported (4), reduced renal blood flow, reduced glomerular filtration rate and hypovolemia in shorter physical activities underlie the increased creatinine level in both female and male UWR players after a UWR game. When we compared the creatinine levels between female and male UWR players, similar responses to UWR may be considered. Since the values remained within the normal limits, no hepatic stress in our UWR players were concerned. No significant differences were observed in total protein levels in both female and male UWR players after a UWR game. Unchanged albumin levels were reported in many studies (4,6). However, increased albumin levels in serum also reported in some studies (7, 10, 11). When albumin is concerned as a negative acute phase reactant, a decrease may have been expected in serum levels. On the contrary this, we did not observe any statistical difference between the total protein levels. Unchanged total protein levels in our study may have been caused by mission of the total proteins of the protection of total plasma volume in both gender. No statistical changes were observed in albumin levels in female and male UWR players. All mean values remained within the normal limits. Similar unchanged albumin levels in some exercise types (4, 6). On the other hand, the increases in serum albumin levels were reported in some exercise events such as marathon running (7) and 100 km (11) and 160 km (10) runs. Turgut et al also did not find any significantly difference in serum albumin levels between Turkish sedanters and sportsmen (13). Since albumin is a marker of general health and nutrition, no negative effect of UWR on the metabolism may be concerned in both female and male UWR players. Globulin is the antibody protein and plays a vital role for fighting against pathogenics and also shows general information about health and nutrition as well as albumin. Globulin levels in the present study did not change in both female and male UWR players. Bilirubin is the product of the degradation reaction of hemoglobin. While unconjugated form of bilirubin can be transported by blood, conjugated form of bilirubin is lipoid-soluble and toxic. In our study, although a statistical (p<0.05) decrease and increase in the total bilirubin levels of female and male UWR players, respectively, the all mean values remained within the normal limits. No significant differences were found between pre-5 min and post-24 h and –48h levels of both sexes. While direct bilirubin levels decreased significantly (p<0.05) after a UWR game in female UWR players, no significant (p>0.05) change was observed in direct bilirubin levels of male UWR players. Indirect bilirubin levels in both female and male UWR players did not change before and after UWR game. Therefore, bilirubin originated disorders could not be considered in UWR players, if they would obey to official CMAS game duration. Significant (4) and insignificant (15) changes in bilirubin levels were reported in the literature after various exercise events.
In conclusion, the biochemical parameters investigated in this study remained within the normal limits, negative effects of UWR on liver and kidney function could not be considered. Since observation of some increased parameters such as uric acid, urea and creatinine in both female and male UWR players, this game may be recommended to people who are willing to loss their overweight by increased catabolic state of metabolism.
Acknowledgements
The authors are gratefully acknowledged the financial support of İzmir Metropolitan Municipality and wish to thank the players who took place in the present study.
Variable |
Mean (±SD) |
| |
|
|
Female n=8 |
Male n=9 | |
|
Age |
18.1 ± 2.2 |
19.6 ± 1.4* | |
|
Weight (kg) |
51 ± 4.3 |
64.4 ± 3.7** | |
|
Height (cm) |
162.4 ± 5.5 |
180.4 ± 6.1* | |
|
BMI (kg/m2) |
18.6 ± 1.5 |
22.8 ± 3.2* | |
|
Years of training |
6.4 ± 1.2 |
7.1 ± 4.1 | |
Skin folds (mm) |
| ||
|
Biceps |
10.5 ± 2.3 |
8.9± 0.9 | |
|
Triceps |
15.1 ± 4.4 |
14.0 ± 2.8** | |
|
Front thigh |
25 ± 7.6 |
15.6 ± 2.4** | |
Table 1 Some physical characteristics of the subjects of this study. Indicates present statistical differences between male and female players (* p<0.05, **p<0.01).
Unit 10 – 50 mg/dL Creatinine 0.5 – 1.5 mg/dL Total Protein 6.7 – 8.7 g/dL Albumin 3.5 – 5.0 g/dL Globulin 1.5 – 3.5 g/dL Uric acid 2.5 – 7.0 mg/dL Total Bilirubin 0.0 – 1.0 mg/dL Direct Bilirubin 0.0 – 0.30 mg/dL Indirect Bilirubin 0.0 – 0.75 mg/dL
Variables
Normal Limits
Urea
Table 2 The normal limits of the parameters determined in this study.
|
|
Female Players |
Male Players | ||||||||
|
|
Pre |
Post |
Pre |
Post | ||||||
Variables |
24-h |
5-min |
5-min |
24-h |
48-h |
24-h |
5-min |
5-min |
24-h |
48-h |
|
Uric acid (mg/dL) |
2.5 ± 0.20 |
2.6 ± 0.20 |
3.0 ± 0.21* |
2.7 ± 0.23 |
2.6 ± 0.22 |
3.7 ± 0.31 |
3.9 ± 0.34 |
4.8 ± 0.42* |
4.0 ± 0.39 |
4.1 ± 0.29 |
|
Urea (mg/dL) |
20 ± 1.8 |
20 ± 1.4 |
26 ± 2.0* |
24 ± 1.3 |
23 ± 1.7 |
22 ± 1.2 |
23 ± 1.3 |
30 ± 1.9* |
24 ± 1.5 |
24 ± 1.6 |
|
Creatinine (mg/dL) |
0.83 ± 0.02 |
0.85 ± 0.02 |
1.10 ± 0.03** |
1.05 ± 0.03* |
0.99 ± 0.03* |
0.89 ± 0.02 |
0.90 ± 0.03 |
1.35 ± 0.04** |
1.05 ± 0.03* |
0.99 ± 0.03* |
|
Total Protein (g/dL) |
7.6 ± 0.1 |
7.5 ± 0.1 |
7.7 ± 0.2 |
7.5 ± 0.1 |
7.6 ± 0.2 |
7.5 ± 0.1 |
7.4 ± 0.1 |
7.6 ± 0.2 |
7.7 ± 0.1 |
7.5 ± 0.2 |
|
Albumin (g/dL) |
4.7 ± 0.13 |
4.7 ± 0.18 |
4.8 ± 0.19 |
4.6 ± 0.25 |
4.7 ± 0.19 |
4.7 ± 0.19 |
4.6 ± 0.13 |
4.8 ± 0.19 |
4.7 ± 0.16 |
4.7 ± 0.18 |
|
Globulin (g/dL) |
2.9 ± 0.22 |
3.1 ± 0.14 |
2.8 ± 0.12 |
2.9 ± 0.21 |
3.0 ± 0.18 |
2.8 ± 0.15 |
2.8 ± 0.14 |
2.8 ± 0.19 |
2.8 ± 0.16 |
2.8 ± 0.17 |
|
Total Bilirubin (mg/dL) |
0.42 ± 0.012 |
0.45 ± 0.014 |
0.39 ± 0.015* |
0.41 ± 0.016 |
0.45 ± 0.011 |
0.44 ± 0.013 |
0.43 ± 0.015 |
0.48 ± 0.016* |
0.47 ± 0.012 |
0.46 ± 0.013 |
|
Direct Bilirubin (mg/dL) |
0.21 ± 0.004 |
0.23 ± 0.007 |
0.18 ± 0.003* |
0.19 ± 0.006* |
0.22 ± 0.005 |
0.19 ± 0.005 |
0.22 ± 0.005 |
0.24 ± 0.004 |
0.22 ± 0.009 |
0.24 ± 0.003 |
|
Indirect Bilirubin (mg/dL) |
0.23 ± 0.005 |
0.22 ± 0.005 |
0.21 ± 0.003 |
0.22 ± 0.007 |
0.23 ± 0.008 |
0.25 ± 0.005 |
0.21 ± 0.003 |
0.24 ± 0.005 |
0.25 ± 0.002 |
0.22 ± 0.005 |
Table 3 The changes in blood chemistry of female and male UWR players before and after UWR game. The pre-5 min values were compared with the post race values and also with pre-24 h values. Significant differences from the pre-5 min value as indicated by the paired t-tests: *p < 0.05, **p<0.01.