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Research Article Volume 9 Issue 1
Liver involvement in endurance sport: a prospective observational study in athletes participating in a semi-marathon
Salem Bouomrani, Aïda Hmidi, Maher Beji
Department of Internal medicine, Military Hospital of Gabès, Tunisia
Sfax Faculty of Medicine, University of Sfax. Sfax 3029, Tunisia
Received: February 17, 2026 | Published: February 26, 2026
Citation: Bouomrani S, Hmidi A, Beji M. Liver involvement in endurance sport: a prospective observational study in athletes participating in a semi-marathon. MOJ Sports Med. 2026;9(1):18‒22. DOI: 10.15406/mojsm.2026.09.00196
Abstract
Background: The health
benefits of endurance sports are undeniable. Nevertheless, sometimes during
these sports, individuals can be exposed to acute physiological imbalances,
sometimes pathological and serious. Unlike gastrointestinal complications that
are frequent and often benign, liver damage is very rare and poorly understood
during these sports. Our objective was to study the hepatic disturbances in
athletes during endurance activity, as well as the various individual and
environmental factors that may influence their occurrence and prognosis.
Methods: A prospective
observational study in 50 military athletes participating in a semi-marathon in
southeastern Tunisia.
Results: Hepatic and/or
muscular cytolysis was observed in 53% of the runners for ALAT, 53% for ASAT,
38% for both ASAT and ALAT, 61% for creatinine phosphokinase, and 85% for
lactate dehydrogenase. Total bilirubin was elevated (minimal cholestasis) in
36% of subjects and associated with hepatic cytolysis in 78% of cases. Only two
serious cases of hepatitis were noted (ischemic liver injury). Further
evolution was favorable in all cases. These clinico-biological disorders were
significantly more frequent in younger, less trained, and less acclimatized
athletes.
Conclusion: These
complications deserve to be known and considered in endurance sports. Their
best treatment remains preventive based on regular training, acclimatization,
appropriate diet, and hydration.
Keywords: liver, endurance sport, cytolysis, exercise hepatitis, ischemic liver, athlete’s hepatitis
©2026 Bouomrani, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.