GPT and injury: Alanine transaminase (ALT) and aspartate aminotransferase (AST) serve as markers of liver disease, and increases in AST, ALT, and LDH after long-distance exercise such as an ultramarathon induces chronic liver injury.18–20 In particular, ALT and γ-GTP serve as specific markers for liver injury, and their levels are increased after long-distance running.3,21–23 Meanwhile, long-distance running is reported to induce not only liver injury but also temporary acute kidney injury.9