Myoglobin turnover--influence of renal and extrarenal factors

The serum level of myoglobin, an LMW constituent of striated and myocardial muscle, has been studied in various clinical situations in order to obtain information about factors influencing myoglobin turnover. The myoglobin level was significantly correlated to different variables of GFR such as serum beta2-microglobulin, serum creatinine, and 51Cr-EDTA clearance. Following a successful renal transplantation rapid decrease in serum myoglobin was found parallel to increase in GFR's. In patients with advanced long-standing uremia, comparatively small elevations of serum myoglobin were seen when correlated to the degree of GFR reduction, demonstrating an influence of extrarenal factors on the myoglobin levels. The importance of extrarenal factors on the actual serum level of LMW proteins was also illustrated by serial studies on SLE patients receiving corticosteroid therapy. In these patients, elevations of serum myoglobin levels were found, but serum beta2-microglobulin levels gradually decreased during therapy. Finally, calculations based on curves of serum disappearance of myoglobin in patients with acute myocardial infarction indicate that only about 0.3 mg of myoglobin per day is released from the muscle pool during normal conditions, which suggests that myoglobin catabolism mainly occurs within the muscle tissue.