Effect of antioxidant supplementation on exercise-induced cardiac troponin release in cyclists: a randomized trial

Lieke J J Klinkenberg, Peter T Res, Guido R Haenen, Aalt Bast, Luc J C van Loon, Marja P van Dieijen-Visser, Steven J R Meex, Lieke J J Klinkenberg, Peter T Res, Guido R Haenen, Aalt Bast, Luc J C van Loon, Marja P van Dieijen-Visser, Steven J R Meex

Abstract

Background: Cardiac troponin is the biochemical gold standard to diagnose acute myocardial infarction. Interestingly however, elevated cardiac troponin concentrations are also frequently observed during and after endurance-type exercise. Oxidative stress associated with prolonged exercise has been proposed to contribute to cardiac troponin release. Therefore, the aim of this study was to assess the effect of 4 week astaxanthin supplementation (a potent cartenoid antioxidant) on antioxidant capacity and exercise-induced cardiac troponin release in cyclists.

Methods: Thirty-two well-trained male cyclists (age 25±5, weight 73±7 kg, maximum O2 uptake 60±5 mL·kg(-1)·min(-1), Wmax 5.4±0.5 W·kg(-1); mean ± SD) were repeatedly subjected to a laboratory based standardized exercise protocol before and after 4 weeks of astaxanthin (20 mg/day), or placebo supplementation in a double-blind randomized manner. Blood samples were obtained at baseline, at 60 min of cycling and immediately post-exercise (≈ 120 min).

Results: The pre-supplementation cycling trial induced a significant rise of median cardiac troponin T concentrations from 3.2 (IQR 3.0-4.2) to 4.7 ng/L (IQR 3.7-6.7), immediately post-exercise (p<0.001). Four weeks of astaxanthin supplementation significantly increased mean basal plasma astaxanthin concentrations from non-detectable values to 175±86 µg·kg(-1). However, daily astaxanthin supplementation had no effect on exercise-induced cardiac troponin T release (p = 0.24), as measured by the incremental area under the curve. Furthermore, the elevation in basal plasma astaxanthin concentrations was not reflected in changes in antioxidant capacity markers (trolox equivalent antioxidant capacity, uric acid, and malondialdehyde). Markers of inflammation (high-sensitivity C-reactive protein) and exercise-induced skeletal muscle damage (creatine kinase) were equally unaffected by astaxanthin supplementation.

Conclusion: Despite substantial increases in plasma astaxanthin concentrations, astaxanthin supplementation did not improve antioxidant capacity in well-trained cyclists. Accordingly, exercise-induced cardiac troponin T concentrations were not affected by astaxanthin supplementation.

Trial registration: ClinicalTrials.gov NCT01241877.

Conflict of interest statement

Competing Interests: The astaxanthin and placebo pills for this study were a kind gift of BioReal Sweden. BioReal is the producer of astaxanthin. There are no further patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

Figures

Figure 1. Flow chart of the trial.
Figure 1. Flow chart of the trial.
Figure 2. cTnT, CK and hsCRP concentrations…
Figure 2. cTnT, CK and hsCRP concentrations during the pre- and post-supplementation exercise trials.
A, D, G. Whole group cTnT, CK and hsCRP concentrations during the pre-supplementation exercise trials. B, E, H. cTnT, CK and hsCRP concentrations in the placebo group measured during the pre- and post-supplementation cycling trials. C, F, I. cTnT, CK and hsCRP concentrations in the astaxanthin group during the pre- and post-supplementation trials. ***denotes a significant increase from baseline (P

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