Medicina Sportiva (2018), vol. XI V no 1, 3017- 3020 [621103]

Medicina Sportiva (2018), vol. XI V no 1, 3017- 3020
Journal of the Romanian Sports Medicine Society

Case study of effect induced by physical effort on urinary protein level on the
unschooled young male (smoker and non-smoker)

Radu MD1,2, Chirică R3 , Munteanu Anca4, Bala ܈oiu Maria5, Băcănoiu Manuela5, ܇apte Elena6
1Faculty of Natural and Agricultural Sciences, Ovidius University of Constanta, Romania, 2Faculty
of Pharmacy, Ovidius University of Constanta, Romania, 3Faculty of Medicine, Ovidius University
of Constanta, Romania, 4National Public Hygiene, Bucharest, Romania, University of Medicine and
Pharmacy Craiova, Romania 5Faculty of Dental Medicine, Ovidius University of Constanta,
Romania

Abstract . The excretory system is responsible for eliminating post-effort metabol ism products. Otherwise, the
components of renal parenchyma are subject to additional stress, both, d uring exercise as a result of the post-ischemic
reperfusion process and post-exercise as a result of the elimination of excess metabolic products.The mechanism of
inducing proteinuria during exercise is not fully known. nstead, a series o f events that occur as a result of physical effort
is a cause of the proteinuria phenomenon. The experimental data obtained revealed that in our experimental model the
physical effort, induces the increase of urinary protein level in two exper imental groups that was studied. This
information indicates that from a functional point of view, the excretory sy stem of smokers or non-smokers can suffer
functional deterioration as a result of the new physiological requirements im posed by physical effor t. Repetitive
physical effort has led to the downgrading of the proteinuria phenomeno n, a parameter that indicates the state of renal
integrity and functional adaptation to physical effort, a physiological aspect th at indicates the body's inability to adap t
within 7 days to the new demands imposed by physical effort. T he physiological response of the excretory system to the
physical exertion of the two categories studied is the same. Key words: exercise, proteinuria, urinary protein.

Introduction
The beneficial effects of physical effort were first reported in the wri tings of Hipocrates, which refers to the
fact that active people are much healthier than sedentary (1 ). Clinical and non-clinical experimental studies
of the benefits of physical exercise on modern human health have been summarized over the last 10 years in
molecular studies of physical effort and their implications in cardiovascular pat hology, metabolic diseases
(diabetes and obesity), various cancers and the phenomenon of aging.
In cardiovascular disease the most common trigger factor is chronic hypertension (2). Blood hypertension is
not a fundamental feature of the aging process but the sum of factors such as; hypercaloric diet, weight gain
and sedentarism (3 ). Clinical experimental studies have shown that moderate exercise over 16-32 w eeks has
led to lowering blood pressure in hypertensive individuals, even after a 33% reduction of antihypertensive
drugs (1,4,5 ).
Obesity and overweight are risk factors for a range of chronic pathologies such as; high blood pressure,
coronary artery disease and premature mortality (1 ). In the case of overweight people, regular exercise of
moderate intensity leads to a relatively modest reduction in body weight. It i s certain that regular exercise is
associated with a lower risk of mortality in normal, overweight and obese men (6,7 ). Recent studies on mice
have shown that during physical exercise the skeletal edge releases into the vascul ar torrent a series of
peptide-inducing factors involved in the body's resistance to the onset of metabolic dise ases (diabetes,
obesity) (8 ). More epidemiological data show that physical effort reduces the risk of cancer ( 9). During and
after physical exercise, a series of changes occur in nature; biological , epigenetic, metabolic and
inflammatory. However, it is not known exactly whether the unitary changes o r their combination, influence
the pathways of genesis or maintenance of cancerous processes (9- 11). An intense problem studied in the last
decade in medical context is early aging, strongly covered by the scientific communit y. Aging is in a
multifactorial process that includes variables such as; individual's genetics , social status and lifestyle (12).
An aspect dependent on the individual's lifestyle is the loss of functional ca pacity that is associated with
sedentaryism and contributes to the onset of cardiovascular disease, type II diabetes and colon cancer ( 12- 3017

Case study of effect induced by physical effort on urin ary protein level on the unschooled young male (smok er and non-smoker)
Radu MD & all

Medicina Sportiva 3018

14). There is clear evidence that regular exercise reduces the development and progress ion of chronic
diseases in the elderly (12-14 ).
In the above-mentioned information, we refer to the beneficial aspects of physica l effort and new bio-
medical research trends. Over the last 5 years, physical physiology studies have crosse d the cellular border
and have reached the molecular domain. Appearance showing the evolution and degree of interest in t he
physical effort of the scientific community. However, physical effort is also an im portant source of transient
pathophysiological events whose role is not fully known. Thus, physical effort not only causes changes in the
molecular dynamics of the skeletal muscle (15), but also changes the functional act ivity of the organs
involved in post-exercise metabolic recovery or the elimination of the resulting metabolic products. The
excretory system is responsible for eliminating post-effort metabolism products. O therwise, the components
of renal parenchyma are subject to additional stress, both, during exercise as a r esult of the post-ischemic
reperfusion process and post-exercise as a result of the elimination of excess metabolic pr oducts.
During physical exercise, as a reversible process, urinary protein excreti on can be increased, a process called
proteinuria (16). Proteinuria is a predictive marker of renal pathology ( 17). The mechanism of inducing
proteinuria during exercise is not fully known. Instead, a series of events that o ccur as a result of physical
effort is a cause of the proteinuria phenomenon. Thus, during physical exercise, the blood f low decreases in
the kidney, as a result of targeting the vascular flow to the muscles in activity and increases the filtration
fraction, an event that could facilitate the passage of proteins in the ultraf iltrate (18-19). Post effort the
mechanism of induction of the proteinuria phenomenon is the increase in glomer ular permeability that
exceeds the tubular resorption capacity (18,21 ). The presented physiological mechanisms explain
theoretically the mechanism of induction of proteinuria as a result of phy sical exercise, but are unable t o
explain how the proteinuria phenomenon can persist and 72 hours post-exercise. The experimental study
quantifies the functional response of the male, unschooled, smoker and non-smoker adult, exc retory system
subjected to moderate physical effort for seven days.

Material and Method
Urine samples were collected as follows: In the first step (Step 1), urine samples were collected for 7 days
before following the training cycle, and total protein content was determi ned from the urine; In the second
phase (Step 2), urine specimens were collected 24 hours post-exercise after each of t he 7 exercises conducted
according to the physical exercise pattern, and the urine samples were determined for total pr otein content.
Biochemical parameters determined: Urinary protein level – Total urine protein levels were assayed by the
spectrophotometric technique described by Lowry et al. (1951) and values expressed as mg/mL urine.
The experimental model was composed of two lots, a smoker's batch and a non-smoking bat ch. Urine
samples were collected before following the training cycle and during the first 7 days of training. During the
seven days of training the urine samples were collected after the effort, to get a clear picture of the exertion
response to physical effort. The experiment aimed analyzing the response of t he excretory device to the
physical effort and not comparing the biochemical status of smokers with non-smokers.
Physical effort model. The study comply with all the ethical rules. Before completing the training cycle,
subjects were subjected to specific clinical investigations that targeted both, the cardiovascular and the
respiratory system. The subjects underwent physical exercise according to the proto col – easy running on
tape for 30 minutes and progressively pedaling at medium intensity for 20 minutes/day/seven day s.
Statistical Analysis. Data were processed in the program OriginPro7.5 . The significance threshold was set at
p≤0.05.

Results
Table 1. Protein concentration in urine expressed in mg /ml urine
Statistical
Analysis Smoker`s Group/ urinary protein
level expressed as mg/mL urine Non-smoker`s Group/ urinary protein
level expressed as mg/mL urine
Step 1. Urinary protein
level – pre – workout X±ES 0.76 ± 0.04 0.43 ± 0.05
n 6 6
Step 2. Urinary protein
level – post – workout X±ES 1.25 ± 0.08 0.89 ± 0.06
n 6 6
t 5.31 3.76
p≤ 0.01 ↑ 0.01 ↑
X± ES = mean ± standard error; n = the number of individual samples tha t represented the arithmetic mean in the end;
t = the value of the “t” test taken by the Student; p ≤ the threshold of significance established on the basis of the “t” value.

Case study of effect induced by physical effort on urin ary protein level on the unschooled young male (smok er and non-smoker)
Radu MD & all

Medicina Sportiva
3019
Discussions
Non-invasive or minimally invasive monitoring of organs during physical exer cise has been particularly
prominent in the last decade. Until 1990, most physiological studies focused on physiological behavior of the
skeletal muscle and heart muscle, today studies target organs directly involved in supporting physical effort
and organs involved in the post-exercise metabolic recovery or product elimination of metabolism. Aspects
that concern the body's ability to perform a workout of the same intensity and t ime, at a time interval, set by
the amateur or performance sportsman. Recent studies have shown that there is a direct relationship between
the intensity of physical effort and post-exercise recovery time. The excretor y system is involved in the
recovery of the post-effort body. The normal functioning of the excretory system i s involved in the
compatibility between the type of exercise and the individual's ability to physiolo gically adapt to the type of
exercise. The degree of adaptation means the physiological ability of the indi vidual to move from amateur to
performance. Post-exercise proteinuria is a parameter of renal function integrity and degree of adaptation to
new demands imposed by physical effort. As mentioned before, the literature shows the possibl e
physiological mechanisms by which proteins can reach ultrafiltered during and afte r the training. From the
analysis of the data presented in the literature it appears that the post-effort proteinuria phenomenon occurs
both in experimental models on laboratory animals and at performance athletes who per form mainly
intensive workouts (23). Post-exercise proteinuria is a transient and reversible phy siological event but with a
direct implication on the adaptation of the organ to physical effort, knowing t he role of the kidneys in
maintaining the balance of the internal environment. An aspect of triggering the proteinuria phenomenon can
be the oxidative stress (24). It is known that high concentrations of fr ee oxygen radicals that can inactivate
the antioxidant defense system and, implicitly, the oxidative stress phenomenon are gener ated during
physical exercise (16,25). Recent studies show that the excretory system of perform ance athletes can adjust
their functional activity through umoral mechanisms, and also the activity of the antioxidant defense system.
However, functional and antioxidant adjustment may occur as a result of a longer workout cycle compared to
the reporting time for our study. In our experimental model we studied a biochemic al parameter that
indicates the state of functioning of the excretory system and which may have cli nical valency. We studied
both smokers and non-smokers for practical reasons, without making a comparison betwe en the
physiological response of the excretory system of the two categories studied. The experiment al data obtained
revealed that in our experimental model the physical effort induces the increase of urinary protein level, in
the two experimental groups that was studied. This information indicates that fr om a functional point of
view, the excretory system of smokers or non-smokers can suffer functional det erioration as a result of the
new physiological requirements imposed by physical effort. Our experimental data opens up a topical area
for researchers but especially for clinicians who face a number of challenges f rom practitioners of different
sports. Summarizing our study, the phenomenon of proteinuria appears as a result of the physica l effort and it
can have the source of the oxidative stress phenomenon. Administration of antioxidant compounds under the
same study conditions, could provide valuable practical information on the hypothesi s launched. At the same
time, the proteinuria correlation with the oxidative stress parameters could supplement the information and
explain to a better extent, that the proteinuria source is oxidative stress.

Conclusion
The conclusion of the experimental study was that after a unitary effort, the phenomenon of proteinuria is
correlated with the installation of the oxidative stress phenomenon.The physiological r esponse of the
excretory system to the physical exertion of the two categories studied is the same. Repetitive physical effort
has led to the downgrading of the proteinuria phenomenon, a parameter that indicat es the state of renal
integrity and functional adaptation to physical effort, a physiological aspect th at indicates the body's inability
to adapt within 7 days to the new demands imposed by physical effort.

References
1. Kokkinos P (2012). Review Article – Phy sical activity, health benefits, and mortality risk. International Scholarly
Research Network ISRN Cardiology , Volume 2012, Article ID 718789.
2. Chobanian AV , Bakris GL , Black HR , Cushman WC , Green LA , , et all ; National Heart, Lung, and Blood Institute
Joint National Committee on Prevention , Detection , Evaluati on, and Treatment of High Blood Pressure ; National
High Blood Pressure Education Program Coordinating Committee (2003) . The seventh report of the Joint National

Case study of effect induced by physical effort on urin ary protein level on the unschooled young male (smok er and non-smoker)
Radu MD & all

Medicina Sportiva 3020
Committee on Prevention , Detection , Evaluation, and Treatment of High Blood Pressure: the JNC 7 report . JAMA .
May 21; 289 (19): 2560- 72.
3. Gurven M, Blackwell AD, Rodrıguez DE, Stieglitz J, H. Kaplan H (2012). Does blood pressure inevitably rise
with age?: longitudinal evidence among forager-horticulturalists. Hypertension , Vol. 60, no. 1, pp. 25 –33.
4. Ishikawa K, Ohta T, Zhang J, Hashimoto S , Tanaka H (1999). Influence of age and gender on exercise
traininginduced blood pressure reduction in systemic hypertension. American Journ of Cardiology ; 84(2):192 –196.
5. Kokkinos PF, Narayan P, Colleran JA, Pittaras A, Notargiacomo A, Reda D, Papademetriou V (1995). E ffects of
regular exercise on blood pressure and left ventricular hypertrophy in African -American men with severe
hypertension. The New England Journal of Medicine , Vol. 333, no. 22, pp. 1462 –1467.
6. King GA, Fitzhugh EC, Bassett DR Jr, McLaughlin JE, Strath SJ, Swartz A M, Thompson DL (2001).
Relationship of leisure-time physical activity and occupational activity to the pr evalence of obesity. International
Journal of Obesity , Vol. 25, no. 5, pp. 606 –612.
7. Wei M , Kampert JB , Barlow CE , Nichaman MZ , Gibbons LW , Paffenbarger RS Jr , Blair SN (1999). Relationship
between low cardiorespiratory fitness and mortality in normal-weight, o verweight, and obese men. JAMA ;
282(16 ):1547 –1553.
8. Boström P , Wu J , Jedrychowski MP , Korde A , Ye L , Lo JC , Rasbach KA , et all (2012). A PGC1- αdependent
myokine that drives brown-fat-like development of white fat and thermogene sis. Nature ; vol481, no.7382: 463 –8.
9. Thomas RJ, Kenfield SA, Jimenez A (2017). Exercise -induced biochemical changes and their potential influence
on cancer: a scientific review. Br. J. Sports Med . 51: 640 –644.
10. Thomas R, Holm M (2014). The benefits of exercise after cancer— an international review of the clinical and
microbiological benefits. Br . J. Med. Pract . 1:2–9.
11. Haydon AM, Macinnis RJ, English DR, Giles GG (2006). The effect of physical activity and body size on survival
after diagnosis with colorectal cancer. Gut. Jan; 55(1): 62 –67.
12. Sbardelotto ML, Pedroso GS, Pereira FT, Soratto HR, Brescianini SMS , Effting PS, Thirupathi A , Nesi RT,
Silveira PCL , Pinho RA (2017). The effects of physical training are varied and occ ur in an exercise type-dependent
manner in elderly men. Aging Dis. Dec; 8(6): 887 –898.
13. Deslandes A (2013). The biological clock keeps ticking, but exercise may tur n it back. Arq.Neuro.Psiquiatr ; 71:
113-8.
14. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT (2012). Effect of physical inactivity on major
non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet.380: 219-229.
15. A Apostol, A Ionescu, M Vasilescu (2013). Aerobic versus Anaerobic-comp arative studies concerning the
dynamics of the aerobic and anaerobic effort parameters in top athletes. Medicina Sportiva ; 9(2): 2130 -2140.
16. Radu MD, ܇chiopu S, Tuță Liliana Ana , Chirică R (2015 ). Proteinuria and acute physical effort. Sp. Soc. Int. J.
Ph. Ed. Sp .; 15(1): 25-33.
17. Wakasugi M, Kazama J, Ichiei Narita, Iseki K, Fujimoto S, Moriyama T, Yamagata K, Konta T, Tsuruya K, Asahi
K, Kondo M, Kurahashi I, Ohashi Y, Kimura K, Watanabe T (2017). Asso ciation between overall lifestyle
changes and the Incidence of proteinuria: A Population-based, Cohort Study. Intern. Med. 56: 1475-1484.
18. Natasha CM, Sindler AL, Muller-Delp JM, Baylis C (2011). Twelve weeks of tr eadmill exercise does not alter age-
dependent chronic kidney disease in the Fisher 344 male rat. J. Physiol. 589. 24: 6129 – 6138 .
19. Poortmans JR (1988). Evidence of increased glomerular permeability to proteins during exercise in healthy men.
Contrib. Nephrol. 68:136 –140.
20. Poortmans JR (1985). Postexercise proteinuria in humans. J. Am. Med. Assoc . 253: 236 –240.
21. Bellinghieri G, Savica V, Santoro D (2008). Renal alterations during exercise. J. Ren . Nutr. Jan. 18(1):158- 64.
22. Lowry OH, Rosebrough NJ, Farr AL, Randall RJ (1951). Protein meas urement with the folin phenol reagent. J.
Biol. Chem. 193: 265-275.
23. Kohler M, Schanzer W, Thevis M (2015). Effects of exercise on the urin ary proteome. Adv. Exp. Med. Biol .
845:121- 31.
24. Kocer G, Senturk UK, Kuru O, Gunduz F (2008). Potential sources of oxidati ve stress that induce postexercise
proteinuria in rats. J. Appl. Physiol . 104 (4), 1063- 1068.
25. Powers SK, Malcolm J (2008). Exercise induced oxidative stress: cellular mech anisms and impact on muscle force
production. Physiol. Rev . 88: 1243-1265.

Corresponding author
Radu Marius-Daniel
Faculty of Natural and Agricultural Science/Faculty of Pharmacy, Ovidius Uni versity
Constanta, Romania
Phone: +40731682470
E -mail: drd_maryus @yahoo.com

Received: January, 2018
Accepted: April, 2018