Objectives A unique opportunity was used to examine the fitness parameters, bone mineral density and skeletal muscle characteristics of a 79-year-old Caucasian elite male master athlete (body height 168.2 cm, body mass 59.5 kg, BMI 21 kg/m2) who won all major marathon events in his category (below 3 h 40) and in 2019 won the world championship title. Equipment and methods All of that despite the long-term diagnosis of inherited ß-thalassemia minor. Muscle sampling was performed at rest and obtained from vastus lateralis. Results The individual's mean myofiber diameter results (58.60 ± 13.92 µm vs. 49.60 ± 15.60 µm) are very similar to the young counterparts and type II fibers were smaller and less represented (38 compared to 72%), as well as ultrastructure of skeletal fibers is well preserved. The two type-groupings refer to reinnervation events and circulating levels of C-terminal agrin fragment as a biomarker of neuromuscular junction destabilization was lower than in aged matched sedentary elderlies (5623 pg/mL vs. 6350,7 pg/mL). The relative lower body strength parameters showed similar values as aged-matched individuals (2.32 NM/kg) and despite the volume of physical activity, the densitometry results showed osteopenia. The blood parameters showed decreaed hemoglobin (106 g/L), and other erythrocytes related values. In conclusion, the diagnosis of heterozygote form of ß-thalassemia is not precluding the positive and rejuvenating effect of a long-term endurance activity on functional, morphological and ultrastractural changes on neuromuscular system and fitness of an elite master endurance runner.
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