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Vauthier J, Touze C, Mauvieux B, Hingrand C, Delaunay P, Besnard S, Jouffroy R, Noirez P, Maboudou P, Parent C, Heyman E, Poussel M. Increased risk of acute kidney injury in the first part of an ultra-trail-Implications for abandonment. Physiol Rep 2024; 12:e15935. [PMID: 38684379 PMCID: PMC11058001 DOI: 10.14814/phy2.15935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 05/02/2024] Open
Abstract
Acute kidneys injuries (AKIs) have been described in marathon and trail running. The currently available data allows assessment of before/after comparisons but does not allow an analysis of what happens during the race. A multidisciplinary assessment protocol was performed during the first trail of Clécy (Normandy France) in November 2021. This allowed an initial assay to be carried out, then at the end of each of the 6 loops of 26 km, and finally after 24 h of recovery. The race extends over 156 km in hilly terrain and 6000 m of elevation gain (D+). The level of impairment according to the RIFLE classification was defined for each runner at each assay. Fifty-five runners were at the start, and the per protocol analysis involved 36 runners (27 men and 9 women, 26 finishers). Fifteen (41.7%) of the riders presented at least one result corresponding to a "RIFLE risk" level. After 24 h of rest, only one runner still had a "RIFLE Risk". The distance around the marathon seems to be the moment of greatest risk. For the first time, we find an association between this renal risk and the probability of abandonment. Many runners are vulnerable to kidney damage during long-duration exercise, which is why it's important to limit risk situations, such as the use of potentially toxic drugs or hydration disorders. The consumption of NSAIDs (nonsteroidal anti-inflammatory drugs) before or during an ultra-distance race should therefore be prohibited. Attention should be paid to hydration disorders.
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Affiliation(s)
- Jean‐Charles Vauthier
- Département de Médecine GénéraleFaculté de MédecineNancyFrance
- Département of General PracticeMaison de Santé des Trois MontsDommartin‐lès‐RemiremontFrance
- INTERPSY 5UR4432Université de LorraineNnacyFrance
| | - Charlie Touze
- Département of General PracticeMaison de Santé des Trois MontsDommartin‐lès‐RemiremontFrance
| | | | | | | | - Stéphane Besnard
- UR 7480 VERTEXUniversité de CaenCaenFrance
- Service d'ORLCentre Hospitalier Universitaire de CaenCaenFrance
| | - Romain Jouffroy
- Intensive Care UnitAmbroise Paré University Hospital, Assistance Publique – Hôpitaux de Paris, and Paris Saclay UniversityBoulogneFrance
- IRMES – Institute for Research in Medicine and Epidemiology of SportInstitut National du Sport, de l'Expertise et de la PerformanceParisFrance
- INSERM U‐1018, Centre de recherche en Epidémiologie et Santé des PopulationsCentre de recherche en Epidémiologie et Santé des Populations, Paris Saclay UniversityParisFrance
| | - Philippe Noirez
- Performance Santé Métrologie Société (EA7507)Université Reims Champagne ArdenneReimsFrance
| | - Patrice Maboudou
- Univ. Lille, CHU Lille, Biologic et Pathologic CenterLilleFrance
| | - Cassandra Parent
- ULR 7369 – URePSSS – Unité de Recherche pluridisciplinaire Sport Santé SociétéUniv. Lille, Univ. LittoralLilleFrance
- Institut de Recherches Cliniques de MontréalMontréalQuébecCanada
| | - Elsa Heyman
- ULR 7369 – URePSSS – Unité de Recherche pluridisciplinaire Sport Santé SociétéUniv. Lille, Univ. LittoralLilleFrance
- Institut Universitaire de FranceParisFrance
| | - Mathias Poussel
- Department of Pulmonary Function Testing and Exercise PhysiologyUniversity Hospital of Nancy, University Centre of Sports Medicine and Adapted Physical Activity, University of LorraineNancyFrance
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Jaworska M, Siatkowski S, Żebrowska A. The Effects of Omega-3 Fatty Acid Supplementation on the Lipid Profile and Cardiovascular Markers Following Downhill Running in Long-Distance Runners. J Hum Kinet 2023; 89:123-138. [PMID: 38053947 PMCID: PMC10694724 DOI: 10.5114/jhk/174107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 10/10/2023] [Indexed: 12/07/2023] Open
Abstract
Exercise-induced injury may intensify inflammatory response and reduce the cardiovascular protection mechanisms of omega 3 polyunsaturated fatty acids (ω 3 PUFA). Therefore, this study aimed to determine the erythrocyte content of fatty acids (ω 3 and ω 6), the levels of cardiac damage markers (CKMB, hsTnT, H - FABP), the concentration of inflammation mediators (IL-6, TNF α) in long distance runners supplemented with ω 3 PUFA. Twenty-four male long distance runners, who were randomly assigned to a placebo group (GrP) or a group supplemented (GrSuppl) with a daily dose of 3,000 mg of ω 3 PUFA for three weeks, participated in the study. Participants performed a downhill running exercise test. Blood samples were collected at rest and after the exercise protocol to analyse the levels of cardiac markers and inflammatory cytokines. The erythrocyte membrane content of EPA and DHA in the GrSuppl at the 3rd week of supplementation was significantly higher than at the baseline (p < 0.001). The erythrocyte membrane content of ω 3 PUFA in the GrSuppl was significantly higher at the completion of supplementation (p < 0.001). Supplementation with ω 3 PUFA improved blood lipid profiles and reduced the concentration of inflammation mediators measured after the eccentric exercise tests. The increased ω 3 PUFA content in the erythrocyte membrane and lower blood concentrations of cardiac damage markers and inflammation mediators in distance runners supplemented for three weeks with ω 3 PUFA suggest that the cardiovascular function has been improved.
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Affiliation(s)
- Marzena Jaworska
- Department of Physiological and Medical Sciences, Institute of Sport Science, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Szymon Siatkowski
- Institute of Healthy Living, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Aleksandra Żebrowska
- Department of Physiological and Medical Sciences, Institute of Sport Science, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
- Institute of Healthy Living, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
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Ušaj A, Lihteneger Vidmajer J, Lojen S. Recovery after Running an "Everesting" Mountain Ultramarathon. Life (Basel) 2023; 13:1946. [PMID: 37895328 PMCID: PMC10607996 DOI: 10.3390/life13101946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023] Open
Abstract
Blood markers of muscle microdamage and systemic inflammation do not adequately explain the reduced performance observed over a prolonged recovery after running a mountain ultramarathon. This case study aimed to determine whether the reduced performance after the Everesting mountain ultramarathon can be further assessed by considering cardiorespiratory and metabolic alterations determined via repeated incremental and continuous running tests. A single runner (age: 24 years, BM: 70 kg, BMI: 22, Vo2peak: 74 mL∙min-1∙kg-1) was observed over a preparatory period of two months with a one-month recovery period. The Everesting consisted of nine ascents and descents of 9349 vertical metres completed in 18:22 (h:min). During the first phase of the recovery, enhanced peak creatine kinase (800%) and C-reactive protein (44%) levels explained the decreased performance. In contrast, decreased performance during the second, longer phase was associated with a decreased lactate threshold and Vo2 (21% and 17%, respectively), as well as an increased energetic cost of running (15%) and higher endogenous carbohydrate oxidation rates (87%), lactate concentrations (170%) and respiratory muscle fatigue sensations that remained elevated for up to one month. These alterations may represent characteristics that can explain the second phase of the recovery process after Everesting.
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Affiliation(s)
- Anton Ušaj
- Laboratory of Biodynamics, Faculty of Sport, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Jon Lihteneger Vidmajer
- Laboratory of Biodynamics, Faculty of Sport, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Sonja Lojen
- Department of Environmental Sciences, Institute Jožef Stefan, Jamova 39, 1000 Ljubljana, Slovenia;
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Haller N, Behringer M, Reichel T, Wahl P, Simon P, Krüger K, Zimmer P, Stöggl T. Blood-Based Biomarkers for Managing Workload in Athletes: Considerations and Recommendations for Evidence-Based Use of Established Biomarkers. Sports Med 2023; 53:1315-1333. [PMID: 37204619 PMCID: PMC10197055 DOI: 10.1007/s40279-023-01836-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2023] [Indexed: 05/20/2023]
Abstract
Blood-based biomarkers can provide an objective individualized measure of training load, recovery, and health status in order to reduce injury risk and maximize performance. Despite enormous potentials, especially owing to currently evolving technology, such as point-of-care testing, and advantages, in terms of objectivity and non-interference with the training process, there are several pitfalls in the use and interpretation of biomarkers. Confounding variables such as preanalytical conditions, inter-individual differences, or an individual chronic workload can lead to variance in resting levels. In addition, statistical considerations such as the detection of meaningful minimal changes are often neglected. The lack of generally applicable and individual reference levels further complicates the interpretation of level changes and thus load management via biomarkers. Here, the potentials and pitfalls of blood-based biomarkers are described, followed by an overview of established biomarkers currently used to support workload management. Creatine kinase is discussed in terms of its evidence for workload management to illustrate the limited applicability of established markers for workload management to date. We conclude with recommendations for best practices in the use and interpretation of biomarkers in a sport-specific context.
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Affiliation(s)
- Nils Haller
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Johannes Gutenberg University of Mainz, Mainz, Germany
- Department of Sport and Exercise Science, University of Salzburg, Schlossallee 49, Salzburg, 5400 Hallein-Rif, Austria
| | - Michael Behringer
- Department of Sports Sciences, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Thomas Reichel
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig-University Gießen, Gießen, Germany
| | - Patrick Wahl
- Department of Exercise Physiology, German Sport University Cologne, Cologne, Germany
| | - Perikles Simon
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Karsten Krüger
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig-University Gießen, Gießen, Germany
| | - Philipp Zimmer
- Division of Performance and Health (Sports Medicine), Institute for Sport and Sport Science, TU Dortmund University, Dortmund, Germany
| | - Thomas Stöggl
- Department of Sport and Exercise Science, University of Salzburg, Schlossallee 49, Salzburg, 5400 Hallein-Rif, Austria.
- Red Bull Athlete Performance Center, Salzburg, Austria.
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Le Goff C, Viallon M, Kaux JF, Andonian P, Moulin K, Seidel L, Giardini G, Gergelé L, Croisille P, Cavalier E, Millet GP. Kinetics of Cardiac Remodeling and Fibrosis Biomarkers During an Extreme Mountain Ultramarathon. Front Cardiovasc Med 2022; 9:790551. [PMID: 35321109 PMCID: PMC8934929 DOI: 10.3389/fcvm.2022.790551] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/24/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives The effects of ultra-distance on cardiac remodeling and fibrosis are unclear. Moreover, there are no data reporting the kinetics of cardiac alterations throughout the event and during recovery. Our aim was to investigate the kinetics of biological markers including new cardiac fibrosis biomarkers suppression of tumorigenicity 2 (ST2) and galectin-3 (Gal-3) during and after an extreme mountain ultramarathon. Methods Fifty experienced runners participating in one of the most challenging mountain ultramarathons (330 km, D+ 25,000 m) were enrolled in our study. Blood samples were collected at four time points: before (Pre-), at 148 km (Mid-), at the finish line (Post-), and 3 days after the recovery period (Recov-). Results The cardiac fibrosis biomarkers (ST2 and Gal-3) increased from Pre- to Mid-. During the second half, ST2 remained higher than pre-values as opposed to Gal-3. Necrosis, ischemia, and myocyte injury biomarkers increased until Mid- then decreased but remained higher at Recov- than Pre-values. Oxidative stress appeared at Mid-. Lipid peroxides remained higher at Recov- compared to Pre-. The maximal value in most of these biomarkers was observed at Mid- and not at Post-. Conclusions The present study supports biphasic kinetics of cardiac fibrosis biomarkers, with a relative recovery during the second half of the event that seems specific to this extreme event. Overall, performing at such an extreme ultramarathon seems less deleterious for the heart than shorter events.
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Affiliation(s)
- Caroline Le Goff
- Department of Clinical Chemistry, CHU de Liège, University of Liège, Liège, Belgium
- *Correspondence: Caroline Le Goff
| | - Magalie Viallon
- Department of Radiology, University Hospital of Saint Etienne, Saint-Étienne, France
- CREATIS, CNRS (UMR 5220), INSERM (U1044), INSA Lyon, University of Lyon, Lyon, France
| | - Jean-François Kaux
- Physical Medicine and Sport Traumatology Department, SportS, IOC Research Centre for Prevention of Injury and Protection of Athlete Health, FIFA Medical Centre of Excellence, FIMS Collaborative Centre of Sports Medicine, University Hospital of Liège, University of Liège, Liège, Belgium
| | - Pierre Andonian
- Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Kevin Moulin
- Department of Radiology, University Hospital of Saint Etienne, Saint-Étienne, France
- CREATIS, CNRS (UMR 5220), INSERM (U1044), INSA Lyon, University of Lyon, Lyon, France
| | - Laurence Seidel
- Biostatistics Department, University Hospital of Liège, Liège, Belgium
| | - Guido Giardini
- Neurology Department, Valle d'Aosta Regional Hospital, Aosta, Italy
| | - Laurent Gergelé
- Department of Anesthesiology, University Hospital of Saint Etienne, Saint-Étienne, France
| | - Pierre Croisille
- Department of Radiology, University Hospital of Saint Etienne, Saint-Étienne, France
- CREATIS, CNRS (UMR 5220), INSERM (U1044), INSA Lyon, University of Lyon, Lyon, France
| | - Etienne Cavalier
- Department of Clinical Chemistry, CHU de Liège, University of Liège, Liège, Belgium
| | - Gregoire P. Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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Hernando C, Hernando C, Panizo N, Collado-Boira E, Folch-Ayora A, Martínez-Navarro I, Hernando B. Renal Function Recovery Strategies Following Marathon in Amateur Runners. Front Physiol 2022; 13:812237. [PMID: 35295572 PMCID: PMC8918951 DOI: 10.3389/fphys.2022.812237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Long distance races have a physiological impact on runners. Up to now, studies analyzing these physiological repercussions have been mainly focused on muscle and cardiac damage, as well as on its recovery. Therefore, a limited number of studies have been done to explore acute kidney failure and recovery after performing extreme exercises. Here, we monitored renal function in 76 marathon finishers (14 females) from the day before participating in a marathon until 192 h after crossing the finish line (FL). Renal function was evaluated by measuring serum creatinine (sCr) and the glomerular filtration rate (GFR). We randomly grouped our cohort into three intervention groups to compare three different strategies for marathon recovery: total rest (REST), continuous running at their ventilatory threshold 1 (VT1) intensity (RUN), and elliptical workout at their VT1 intensity (ELLIPTICAL). Interventions in the RUN and ELLIPTICAL groups were performed at 48, 96, and 144 h after marathon running. Seven blood samples (at the day before the marathon, at the FL, and at 24, 48, 96, 144, and 192 h post-marathon) and three urine samples (at the day before the marathon, at the finish line, and at 48 h post-marathon) were collected per participant. Both heart rate monitors and triaxial accelerometers were used to control the intensity effort during both the marathon race and the recovery period. Contrary to our expectations, the use of elliptical machines for marathon recovery delays renal function recovery. Specifically, the ELLIPTICAL group showed a significantly lower ∆GFR compared to both the RUN group (p = 4.5 × 10−4) and the REST group (p = 0.003). Hence, we encourage runners to carry out an active recovery based on light-intensity continuous running from 48 h after finishing the marathon. In addition, full resting seems to be a better strategy than performing elliptical workouts.
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Affiliation(s)
- Carlos Hernando
- Sport Service, Jaume I University, Castellon, Spain
- Department of Education and Specific Didactics, Jaume I University, Castellon, Spain
- *Correspondence: Carlos Hernando,
| | - Carla Hernando
- Department of Mathematics, Carlos III University of Madrid, Madrid, Spain
| | - Nayara Panizo
- Nephrology Service, University Clinical Hospital of Valencia, Valencia, Spain
| | | | - Ana Folch-Ayora
- Faculty of Health Sciences, Jaume I University, Castellon, Spain
| | - Ignacio Martínez-Navarro
- Department of Physical Education and Sport, University of Valencia, Valencia, Spain
- Sports Health Unit, Vithas-Nisa 9 de Octubre Hospital, Valencia, Spain
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Partyka A, Waśkiewicz Z. The Consequences of Training and Competition to the Musculoskeletal System in Ultramarathon Runners: A Narrative Review. Front Physiol 2021; 12:738665. [PMID: 34630159 PMCID: PMC8497806 DOI: 10.3389/fphys.2021.738665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/26/2021] [Indexed: 12/15/2022] Open
Abstract
Ultramarathons are becoming increasingly popular every year, leading to more and more publications focusing on athletes of these endurance events. This paper summarizes the current state of knowledge on the effects of ultramarathons on the motor system. Various studies have attempted to answer questions about negative and positive effects on the musculoskeletal system, common injuries, optimal strategies, and regeneration. Considering the increasing number of ultramarathon athletes, the discoveries may have practical applications for a multitude of experts in the field of sports medicine, as well as for the athletes themselves. Acute locomotor system changes in runners as assessed by locomotor biomarkers are reversible and may be asymptomatic or painful. Injuries suffered by runners largely allow them to finish the competition and are usually overlooked. Regeneration, including regular massage and the use of supporting techniques, allows for faster convalescence. This publication is meant to be a source of knowledge for people associated with this discipline.
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Affiliation(s)
| | - Zbigniew Waśkiewicz
- Institute of Sport Science, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.,Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University, Moscow, Russia
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Le Goff C, Kaux JF, Dulgheru R, Seidel L, Pincemail J, Cavalier E, Melon P. The impact of an ultra-trail on the dynamic of cardiac, inflammatory, renal and oxidative stress biological markers correlated with electrocardiogram and echocardiogram. Acta Cardiol 2021; 76:739-747. [PMID: 32539581 DOI: 10.1080/00015385.2020.1778871] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The aim of this study was to describe the effects of a 64.2 km ultra-trail on the biomarkers of muscle damage, inflammation and oxidative stress, and compare the results observed with an ECG and an echocardiogram, both performed before and after the race.Thirty-three ultra-trail volunteers (45.8 ± 8.7 years old) were enrolled in our study. Three blood tests were drawn from each runner, one just before (TPRE), one just after (TPOST) and the last 3 h after the end of the race (TPOST3h).All the markers increased. The maximum concentrations observed were at TPOST3h and were significant (p < 0.001) for creatine kinase, creatine kinase isoform MB, high-sensitivity C-reactive protein, uric acid and for the ratio of reduced glutathione to oxidised glutathione. However, in the case of myoglobin, high-sensitive troponin T, N-terminal pro-brain natriuretic peptide, oxidised glutathione, myeloperoxidase, cystatin C and creatinine, the most significant increases were at TPOST (p < 0.001). Modifications were observed in the medical imaging using echocardiography such as reduction of left ventricule end-sytolic and diastolic volumes and left ventricular global longitudinal strain. ECG showed electrical criteria for left ventricular hypertrophy and incomplete right bundle branch block after the race.Endurance races cause significant physiological stress to the body that can be measured by the increase of different biomarkers. From a laboratory perspective, it is important to take into account the possible exercise performed previous to the testing to avoid a misinterpretation of the results. From a training perspective, due to these increases in biomarkers, it is recommended that runners wait at least 72 h after an ultra-trail before subsequent training. In addition a transient impairment of ventricular function due to dehydration were observed.
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Affiliation(s)
- C. Le Goff
- Clinical Chemistry Department, University and University Hospital of Liège, Liège, Belgium
| | - J-F. Kaux
- Physical Medicine and Sports Traumatology Department, SportS2, FIFA Medical Centre of Excellence, IOC Research Centre for Prevention of Injury and Protection of Athlete Health, FIMS Collaborating Center of Sports Medicine, University and University Hospital of Liège, Liège, Belgium
| | - R. Dulgheru
- Department of Cardiology, University and University Hospital of Liège, Liège, Belgium
| | - L. Seidel
- Biostatistic Department, University Hosptial of Liège, Liège, Belgium
| | | | - E. Cavalier
- Clinical Chemistry Department, University and University Hospital of Liège, Liège, Belgium
| | - P. Melon
- Department of Cardiology, University and University Hospital of Liège, Liège, Belgium
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Khodaee M, Irion B, Spittler J, Saeedi A, Hoffman MD. Characteristics of runners meeting acute kidney injury criteria following a 161‐km ultramarathon. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.276] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Morteza Khodaee
- Department of Family Medicine & Orthopedics University of Colorado School of Medicine Denver USA
| | - Bjørn Irion
- Western Orthopedics and Sports Medicine Grand Junction CO USA
| | - Jack Spittler
- Department of Family Medicine & Orthopedics University of Colorado School of Medicine Denver USA
| | - Anahita Saeedi
- Department of Biostatistics School of Public Health & Health Sciences University of Massachusetts Amherst MA USA
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Pradas F, Falcón D, Peñarrubia-Lozano C, Toro-Román V, Carrasco L, Castellar C. Effects of Ultratrail Running on Neuromuscular Function, Muscle Damage and Hydration Status. Differences According to Training Level. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5119. [PMID: 34065969 PMCID: PMC8150532 DOI: 10.3390/ijerph18105119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/05/2021] [Accepted: 05/09/2021] [Indexed: 12/19/2022]
Abstract
The status of trail running races has exponentially grown in recent years. The present study aimed to: (a) evaluate the acute response of ultratrail racing in terms of neuromuscular function, muscle damage and hydration status; (b) analyze if responses could differ according to training levels. Twenty runners participated in the present study. The participants were divided into amateur training level (n = 10; 43.30 ± 4.52 years) or high level competitors (n = 10; 41.40 ± 6.18). Neuromuscular response (squat jump, countermovement jump and Abalakov jump), muscle damage (alanine aminotransferase, bilirubin, creatine kinase and leukocytes) and hydration status (sodium and creatinine) were evaluated before and after the Guara Somontano Ultratrail Race (108 km distance, with an accumulated slope of 5800 m). The height and power achieved by vertical jumps were lower after the race (p < 0.001). The post-race muscle damage and creatinine parameters increased in both groups (p < 0.001). The high-level group obtained lower percentages of change in squat jump and countermovement jump than the amateur-level group (p < 0.05). However, the increase in creatinine was greater for the high-level group (p < 0.05). Ultratrail racing reduces neuromuscular function and increases muscle damage. High-level runners showed less neuromuscular fatigue compared to amateur ones.
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Affiliation(s)
- Francisco Pradas
- ENFYRED Research Group, Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain; (F.P.); (D.F.); (C.P.-L.); (C.C.)
- Department of Corporal Expression, Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain
| | - David Falcón
- ENFYRED Research Group, Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain; (F.P.); (D.F.); (C.P.-L.); (C.C.)
- Department of Corporal Expression, Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain
| | - Carlos Peñarrubia-Lozano
- ENFYRED Research Group, Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain; (F.P.); (D.F.); (C.P.-L.); (C.C.)
- Department of Corporal Expression, Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain
| | - Víctor Toro-Román
- School of Sport Sciences, University of Extremadura, Avenida de la Universidad s/n, 10003 Cáceres, Spain
| | - Luis Carrasco
- BIOFANEX Research Group, Department of Physical Education and Sport, Faculty of Education Sciences, University of Seville, 41004 Seville, Spain;
| | - Carlos Castellar
- ENFYRED Research Group, Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain; (F.P.); (D.F.); (C.P.-L.); (C.C.)
- Department of Corporal Expression, Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain
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11
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Tiller NB, Stewart GM, Illidi CR, Levine BD. Exercise Is Medicine? The Cardiorespiratory Implications of Ultra-marathon. Curr Sports Med Rep 2021; 19:290-297. [PMID: 32769665 DOI: 10.1249/jsr.0000000000000738] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Regular physical activity decreases the risk of cardiovascular disease, type II diabetes, obesity, certain cancers, and all-cause mortality. Nevertheless, there is mounting evidence that extreme exercise behaviors may be detrimental to human health. This review collates several decades of literature on the physiology and pathophysiology of ultra-marathon running, with emphasis on the cardiorespiratory implications. Herein, we discuss the prevalence and clinical significance of postrace decreases in lung function and diffusing capacity, respiratory muscle fatigue, pulmonary edema, biomarkers of cardiac injury, left/right ventricular dysfunction, and chronic myocardial remodeling. The aim of this article is to inform risk stratification for ultra-marathon and to edify best practice for personnel overseeing the events (i.e., race directors and medics).
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Affiliation(s)
- Nicholas B Tiller
- Institute of Respiratory Medicine and Exercise Physiology, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA
| | - Glenn M Stewart
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Camilla R Illidi
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, UNITED KINGDOM
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Center, Dallas, TX
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Martínez-Navarro I, Sanchez-Gómez JM, Aparicio I, Priego-Quesada JI, Pérez-Soriano P, Collado E, Hernando B, Hernando C. Effect of mountain ultramarathon distance competition on biochemical variables, respiratory and lower-limb fatigue. PLoS One 2020; 15:e0238846. [PMID: 32915883 PMCID: PMC7485829 DOI: 10.1371/journal.pone.0238846] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 08/25/2020] [Indexed: 12/26/2022] Open
Abstract
The study aimed at assessing the acute physiological effects of running a 65-km vs a 107-km mountain ultramarathon. Nineteen athletes (15 males and 4 females) from the shorter race and forty three athletes (26 males and 17 females) from the longer race were enrolled. Body weight, respiratory and lower limb strength were assessed before and after the race. Blood samples were obtained before, after and 24-h post-race. Body weight loss did not differ between races. A decrease in squat jump height (p<0.01; d = 1.4), forced vital capacity (p<0.01; d = 0.5), forced expiratory volume in 1 s (p<0.01; d = 0.6), peak inspiratory flow (p<0.01; d = 0.6) and maximal inspiratory pressure (p<0.01; d = 0.8) was observed after the longer race; while, after the shorter race only maximal inspiratory pressure declined (p<0.01; d = 0.5). Greater post-race concentrations of creatine kinase (p<0.01; d = 0.9) and C-reactive protein (p<0.01; d = 2.3) were observed following the longer race, while high-sensitivity cardiac troponin was higher after the shorter race (p<0.01; d = 0.3). Sodium decreased post-competition only after the shorter race (p = 0.02; d = 0.6), while creatinine increased only following the longer race (p<0.01; d = 1.5). In both groups, glomerular filtration rate declined at post-race (longer race: p<0.01, d = 2.1; shorter race: p = 0.01, d = 1.4) and returned to baseline values at 24 h post-race. In summary, expiratory and lower-limb fatigue, and muscle damage and inflammatory response were greater following the longer race; while a higher release of cardiac troponins was observed after the shorter race. The alteration and restoration of renal function was similar after either race.
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Affiliation(s)
- Ignacio Martínez-Navarro
- Physical Education and Sports Department, University of Valencia, Valencia, Spain
- Sports Health Unit, Vithas 9 de Octubre Hospital, Valencia, Spain
| | - Juan Miguel Sanchez-Gómez
- Sports Health Unit, Vithas 9 de Octubre Hospital, Valencia, Spain
- University Clinical Hospital of Valencia, Valencia, Spain
| | - Inma Aparicio
- Research Group in Sports Biomechanics (GIBD), Physical Education and Sports Department, University of Valencia, Valencia, Spain
- AITEX (Textil Research Institute), Alcoy, Spain
| | - Jose Ignacio Priego-Quesada
- Research Group in Sports Biomechanics (GIBD), Physical Education and Sports Department, University of Valencia, Valencia, Spain
| | - Pedro Pérez-Soriano
- Research Group in Sports Biomechanics (GIBD), Physical Education and Sports Department, University of Valencia, Valencia, Spain
| | - Eladio Collado
- Faculty of Health Sciences, Jaume I University, Castellon, Spain
| | | | - Carlos Hernando
- Sport Service, Jaume I University, Castellon, Spain
- Department of Education and Specific Didactics, Jaume I University, Castellon, Spain
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Abstract
Exercise is universally recognized for its health benefits and distance running has long been a popular form of exercise and sport. Ultramarathons, defined as races longer than a marathon, have become increasingly popular in recent years. The diverse ultramarathon distances and courses provide additional challenges in race performance and medical coverage for these events. As the sport grows in popularity, more literature has become available regarding ultramarathon-specific illnesses and injuries, nutrition guidelines, psychology, physiologic changes, and equipment. This review focuses on recent findings and trends in ultramarathon running.
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Affiliation(s)
- Jack Spittler
- UCH-A.F. Williams Family Medicine Center at Stapleton, Denver, CO
| | - Lauren Oberle
- University of Colorado-Denver, Anschutz Medical Campus, Denver, CO
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Acute Responses of Novel Cardiac Biomarkers to a 24-h Ultra-Marathon. J Clin Med 2019; 8:jcm8010057. [PMID: 30625976 PMCID: PMC6351937 DOI: 10.3390/jcm8010057] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 12/31/2018] [Accepted: 01/01/2019] [Indexed: 12/24/2022] Open
Abstract
The aim of the present study was to examine the acute effect of an ultra-endurance performance on N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac specific troponin T (cTnT), creatinine kinase-myocardial band (CK-MB), high sensitive C-reactive protein (hsCRP), ischemia modified albumin (IMA), heart-type fatty acid binding protein (H-FABP) and cardiovascular function. Cardiac biomarkers were evaluated in 14 male ultra-marathoners (age 40 ± 12 years) during a 24 h ultra-marathon at five points (i.e., Pre-race; Marathon, 12-h run, 24-h run, and 48-h post-race). All subjects underwent baseline echocardiography assessment at least 10 days prior to the ultra-marathon and 48 h post-race. The average distance covered during the race was 149.4 ± 33.0 km. Running the ultra-marathon led to a progressive increase in hsCRP and H-FABP concentrations (p < 0.001). CK-MB and cTnT levels were higher after a 24-h run compared to pre-race (p < 0.05). Diastolic function was altered post-race characterized by a reduction in peak early to late diastolic filling (p < 0.01). Running an ultra-marathon significantly stimulates specific cardiac biomarkers; however, the dynamic of secretion of biomarkers linked to myocardium ischemia were differentially regulated during the ultra-marathon race. It is suggested that both exercise duration and intensity play a crucial role in cardiovascular adaptive mechanisms and cause risk of cardiac stress in ultra-marathoners.
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15
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Wołyniec W, Ratkowski W, Kasprowicz K, Jastrzębski Z, Małgorzewicz S, Witek K, Grzywacz T, Żmijewski P, Renke M. Glomerular Filtration Rate Is Unchanged by Ultramarathon. J Strength Cond Res 2018; 32:3207-3215. [DOI: 10.1519/jsc.0000000000002348] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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16
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Knechtle B, Nikolaidis PT. Physiology and Pathophysiology in Ultra-Marathon Running. Front Physiol 2018; 9:634. [PMID: 29910741 PMCID: PMC5992463 DOI: 10.3389/fphys.2018.00634] [Citation(s) in RCA: 152] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/11/2018] [Indexed: 12/31/2022] Open
Abstract
In this overview, we summarize the findings of the literature with regards to physiology and pathophysiology of ultra-marathon running. The number of ultra-marathon races and the number of official finishers considerably increased in the last decades especially due to the increased number of female and age-group runners. A typical ultra-marathoner is male, married, well-educated, and ~45 years old. Female ultra-marathoners account for ~20% of the total number of finishers. Ultra-marathoners are older and have a larger weekly training volume, but run more slowly during training compared to marathoners. Previous experience (e.g., number of finishes in ultra-marathon races and personal best marathon time) is the most important predictor variable for a successful ultra-marathon performance followed by specific anthropometric (e.g., low body mass index, BMI, and low body fat) and training (e.g., high volume and running speed during training) characteristics. Women are slower than men, but the sex difference in performance decreased in recent years to ~10–20% depending upon the length of the ultra-marathon. The fastest ultra-marathon race times are generally achieved at the age of 35–45 years or older for both women and men, and the age of peak performance increases with increasing race distance or duration. An ultra-marathon leads to an energy deficit resulting in a reduction of both body fat and skeletal muscle mass. An ultra-marathon in combination with other risk factors, such as extreme weather conditions (either heat or cold) or the country where the race is held, can lead to exercise-associated hyponatremia. An ultra-marathon can also lead to changes in biomarkers indicating a pathological process in specific organs or organ systems such as skeletal muscles, heart, liver, kidney, immune and endocrine system. These changes are usually temporary, depending on intensity and duration of the performance, and usually normalize after the race. In longer ultra-marathons, ~50–60% of the participants experience musculoskeletal problems. The most common injuries in ultra-marathoners involve the lower limb, such as the ankle and the knee. An ultra-marathon can lead to an increase in creatine-kinase to values of 100,000–200,000 U/l depending upon the fitness level of the athlete and the length of the race. Furthermore, an ultra-marathon can lead to changes in the heart as shown by changes in cardiac biomarkers, electro- and echocardiography. Ultra-marathoners often suffer from digestive problems and gastrointestinal bleeding after an ultra-marathon is not uncommon. Liver enzymes can also considerably increase during an ultra-marathon. An ultra-marathon often leads to a temporary reduction in renal function. Ultra-marathoners often suffer from upper respiratory infections after an ultra-marathon. Considering the increased number of participants in ultra-marathons, the findings of the present review would have practical applications for a large number of sports scientists and sports medicine practitioners working in this field.
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Affiliation(s)
- Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
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17
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Abstract
Among factors impacting performance during an ultramarathon, sleep is an underappreciated factor that has received little attention. The aims of this study were to characterize habitual sleep behaviors in ultramarathon runners and to examine strategies they use to manage sleep before and during ultramarathons. Responses from 636 participants to a questionnaire were considered. This population was found to sleep more on weekends and holidays (7–8 h to 8–9 h) than during weekdays (6–7 h to 7–8 h; p < 0.001). Work was a mediator of napping habits since 19–25% reported napping on work days and 37–56% on non-work days. There were 24.5% of the participants reporting sleep disorders, with more women (38.9%) reporting sleep problems than men (22.0%; p < 0.005). Mean (±SD) sleepiness score on the Epworth Sleepiness Scale was 8.9 ± 4.3 with 37.6% of respondents scoring higher than 10, reflecting excessive daytime sleepiness. Most of the study participants (73.9%) had a strategy to manage sleep preceding an ultramarathon, with 54.7% trying to increase their opportunities for sleep. Only 21% of participants reported that they had a strategy to manage sleep during ultramarathons, with micronaps being the most common strategy specified. Sub-analyses from 221 responses indicated that sleep duration during an ultramarathon was correlated with finish time for races lasting 36–60 h (r = 0.48; p < 0.01) or > 60 h (r = 0.44; p < 0.001). We conclude that sleep duration among ultramarathon runners was comparable to the general population and other athletic populations, yet they reported a lower prevalence of sleep disorders. Daytime sleepiness was among the lowest rates encountered in athletic populations, which may be related to the high percentage of nappers in our population. Sleep extension, by increasing sleep time at night and daytime napping, was the main sleep strategy to prepare for ultramarathons.
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Abstract
Zusammenfassung. Wir stellen die wichtigsten Erkenntnisse zu Organschädigungen durch einen Ultramarathon zusammen. Nach einem Ultramarathon können kardiale Biomarker wie CK, CK-MB, kardiales Troponin I (cTnI) und N-terminales pro-Brain Natriuretic Peptide (NT-pro BNP) erhöht sein. Bis 80 % und mehr der Finisher klagen über Verdauungsprobleme, die einer der Hauptgründe sind, einen Ultramarathon nicht zu finishen. Bis zu 90 % der Läufer, die einen Ultramarathon aufgeben, klagen über Übelkeit. Nach einem Ultramarathon steigen die Leberwerte oft an, schwerwiegende Konsequenzen bleiben meist aus. Risikofaktoren für eine Einschränkung der Nierenfunktion sind eine ausgeprägte Muskelschädigung mit Rhabdomyolyse, Dehydratation, Hypotonie, Hyperurikämie, Hyponatriämie, geringe Wettkampferfahrung sowie die Einnahme von NSARs. Ultraläufer leiden nach einem Ultramarathon oft an Infekten der oberen Atemwege.
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Affiliation(s)
- Beat Knechtle
- 1 Medbase St. Gallen
- 2 Institut für Hausarztmedizin, Universität Zürich
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Tirabassi JN, Olewinski L, Khodaee M. Variation of Traditional Biomarkers of Liver Injury After an Ultramarathon at Altitude. Sports Health 2018; 10:361-365. [PMID: 29558239 PMCID: PMC6044117 DOI: 10.1177/1941738118764870] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Significant elevations of traditional biomarkers of liver injury can occur as
a result of running an ultramarathon. Hypothesis: Traditional serum biomarker levels of liver injury will significantly
increase as the result of participating in this 161-km race at altitude. Study Design: Prospective cross-sectional study. Level of Evidence: Level 3. Methods: A total of 64 (before) and 83 (after) volunteer runners participated in a
prospective observational field-based study at the Leadville 100
ultramarathon race. Changes in serum aspartate aminotransferase (AST),
alanine aminotransferase (ALT), alkaline phosphatase (ALP), creatine kinase
(CK), and bilirubin levels were measured. Results: Of 669 athletes who started the race, 352 successfully completed the race
within the 30-hour cutoff (53%). Of 36 runners who had pre- and postrace
blood samples taken, the mean ALT, AST, and bilirubin levels were increased
from 23 ± 10 U/L, 23 ± 5 U/L, and 0.60 ± 0.29 mg/dL to 117 ± 106 U/L, 485 ±
500 U/L, and 1.60 ± 0.61 mg/dL, respectively (all P <
0.001). There was no change in the mean ALP level (P =
0.11). There were no significant correlations between postrace ALT, AST,
ALP, lactate dehydrogenase (LDH), and bilirubin levels and athletes’ age,
sex, body mass index, or finishing time. Significant positive linear
correlations between AST, ALT, and LDH with CK were seen. Athletes in this
study did not seek medical attention after the race based on an electronic
survey (92% response rate). Conclusion: Significant elevations of traditional biomarkers of liver injury occurred as
a result of running an ultramarathon at altitude. These correlated with CK,
a marker of muscle injury. Clinical Relevance: When reviewing laboratory studies of traditional biomarkers of liver injury
in athletes after an ultramarathon, significant elevations may be seen from
baseline but are likely to be of no clinical consequence.
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Affiliation(s)
- Jill N Tirabassi
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Fitchburg, Massachusetts
| | - Lucianne Olewinski
- Department of Family Medicine, University of Colorado School of Medicine, Denver, Colorado
| | - Morteza Khodaee
- Department of Family Medicine, University of Colorado School of Medicine, Denver, Colorado
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Untargeted Metabolomics Profiling of an 80.5 km Simulated Treadmill Ultramarathon. Metabolites 2018; 8:metabo8010014. [PMID: 29438325 PMCID: PMC5876003 DOI: 10.3390/metabo8010014] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 02/08/2018] [Accepted: 02/08/2018] [Indexed: 01/23/2023] Open
Abstract
Metabolomic profiling of nine trained ultramarathon runners completing an 80.5 km self-paced treadmill-based time trial was carried out. Plasma samples were obtained from venous whole blood, collected at rest and on completion of the distance (post-80.5 km). The samples were analyzed by using high-resolution mass spectrometry in combination with both hydrophilic interaction (HILIC) and reversed phase (RP) chromatography. The extracted putatively identified features were modeled using Simca P 14.1 software (Umetrics, Umea, Sweden). A large number of amino acids decreased post-80.5 km and fatty acid metabolism was affected with an increase in the formation of medium-chain unsaturated and partially oxidized fatty acids and conjugates of fatty acids with carnitines. A possible explanation for the complex pattern of medium-chain and oxidized fatty acids formed is that the prolonged exercise provoked the proliferation of peroxisomes. The peroxisomes may provide a readily utilizable form of energy through formation of acetyl carnitine and other acyl carnitines for export to mitochondria in the muscles; and secondly may serve to regulate the levels of oxidized metabolites of long-chain fatty acids. This is the first study to provide evidence of the metabolic profile in response to prolonged ultramarathon running using an untargeted approach. The findings provide an insight to the effects of ultramarathon running on the metabolic specificities and alterations that may demonstrate cardio-protective effects.
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21
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Impact of the 24-h ultramarathon race on homocysteine, oxidized low-density lipoprotein, and paraoxonase 1 levels in professional runners. PLoS One 2018; 13:e0192392. [PMID: 29394290 PMCID: PMC5796729 DOI: 10.1371/journal.pone.0192392] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 01/23/2018] [Indexed: 12/28/2022] Open
Abstract
The impact of the 24-h ultramarathon race on homocysteine (Hcy) and oxidized low-density lipoprotein (oxLDL) levels, two well-recognized cardiovascular risk factors, has not been deeply investigated. Similarly, no information exists on paraoxonase 1 (PON1), an antioxidant enzyme associated with high-density lipoproteins, which may detoxify oxLDL and Hcy-thiolactone, hence preventing their proatherogenic action. Taking this into account, a competitive 24-h ultramarathon race was organized in Reggio-Emilia (Italy) recruiting professional runners (n = 14) from the Italian Ultramarathon and Trail Association. Blood samples were collected from each participant before, during (14 h), and immediately after (24 h) the competition, thus to monitor the serum changes in Hcy, oxLDL, and PON1 levels, as well as other oxidative stress-related parameters, namely reactive oxygen metabolites (ROM) and total antioxidant capacity (PAT). As a result, a significant PON1 increase was recorded after 14 h of racing that persisted until the end of the performance. The same trend was observed for PAT values, which positively correlated to PON1 levels (R = 0.643, P<0.001). Hcy, oxLDL, and ROM remained almost unchanged throughout the competition. In conclusion, the present study suggested a protective role of PON1 in sustaining the antioxidant defense system and contrasting lipoprotein oxidative modifications over the 24-h race, and did not specifically evidence either Hcy or oxLDL accumulation in such challenging sporting events.
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Abstract
Zusammenfassung. In den vergangenen Jahrzehnten hat sich die Zahl der Ultraläufer vervielfacht, und viele Studien haben den Einfluss auf den Bewegungsapparat untersucht. Wir stellen die Erkenntnisse zu Schäden zusammen, die ein Ultramarathon an Gelenken und Muskeln verursachen kann. Die häufigsten Verletzungen bzw. Überlastungsschäden betreffen die untere Extremität, wobei Sprunggelenk und Knie am häufigsten betroffen sind. Bei sehr langen Läufen kommt es zu einer Anpassung mit Verdickung von Sehnen und Knorpel. Ein Ultramarathon kann zu einem ausgeprägten Muskelschaden führen, mit einem Anstieg von myozellulären Metaboliten wie Myoglobin, Laktat-Dehydrogenase und Creatinkinase.
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Affiliation(s)
- Beat Knechtle
- 1 Medbase St. Gallen am Vadianplatz, St. Gallen
- 2 Institut für Hausarztmedizin, Universität Zürich, Zürich
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Magrini D, Khodaee M, San-Millán I, Hew-Butler T, Provance AJ. Serum creatine kinase elevations in ultramarathon runners at high altitude. PHYSICIAN SPORTSMED 2017; 45:129-133. [PMID: 28075653 DOI: 10.1080/00913847.2017.1280371] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Creatine kinase (CK) is a sensitive enzyme marker for muscle damage in athletes. Elevated CK levels have been reported in many endurance physical activities. The consequence and possible long-term sequela of the CK elevation in athletes is unknown. There is a paucity of literature stating actual numerical values of CK associated with competing in an ultramarathon with extreme environmental conditions. Our hypothesis was that the serum CK levels increase significantly as a result of running a 161 km ultramarathon at high altitude. METHODS This was a prospective observational study of participants of the Leadville 100 ultramarathon race in Leadville, Colorado at high altitude (2800-3840 m) in August 2014. We collected blood samples from sixty-four volunteer runners before and eighty-three runners immediately after the race. RESULTS Out of 669 athletes who started the race, 352 successfully completed the race in less than the 30-hour cut-off time (52%). The majority of runners were male (84%). We were able to collect both pre- and post-race blood samples from 36 runners. Out of these 36 runners, the mean pre-race CK was increased from 126 ± 64 U/L to 14,569 ± 14,729 U/L (p < 0.001). There was a weak linear correlation between lower sodium levels and higher CK levels post-race (p = 0.003; R2 = 0.10). Using a multiple regression model, other than a negative correlation between sodium and CK levels (p = 0.001), there were no statistically significant correlations between post-race CK levels and athletes' age, BMI, or finishing time. CONCLUSIONS Significant elevation of CK level occurs as a result of running ultramarathons. The majority of athletes with significantly elevated CK levels were asymptomatic and required no major medical attention.
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Affiliation(s)
- Danielle Magrini
- a Division of Orthopedics , Children's Hospital of Philadelphia , Philadelphia , PA , USA
| | - Morteza Khodaee
- b Department of Family Medicine, Division of Sports Medicine , University of Colorado School of Medicine , Denver , CO , USA
| | - Iñigo San-Millán
- c Department of Physical Medicine and Rehabilitation, Division of Sports Medicine , University of Colorado School of Medicine , Aurora , CO , USA
| | - Tamara Hew-Butler
- d Exercise Science Program, Oakland University School of Health Sciences , Rochester , MI , USA
| | - Aaron J Provance
- e Department of Orthopedics, Division of Sports Medicine , University of Colorado School of Medicine , Aurora , CO , USA
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