Impact of the 24-h ultramarathon race on homocysteine, oxidized low-density lipoprotein, and paraoxonase 1 levels in professional runners

The Effects of Acute and Chronic Exercise on Paraoxonase-1 (PON1): A Systematic Review With Meta-Analysis

Purpose: To determine the acute and chronic effects of exercise on Paraoxonase-1 (PON1) concentration and activity. Methods: A literature search was performed using 16 electronic databases. Effect sizes (ES) were computed and two-tailed α values < .05 and non-overlapping 95% confidence intervals (95%CI) were considered statistically significant. Heterogeneity, inconsistency (I²), and small-study effects using the LFK index were examined. Results: Eighteen studies (n = 377 participants) met the criteria for inclusion. The acute effects of exercise on PON1 concentration were trivial and non-significant (ES = -.03, 95%CI = -.39 to .34, p > .05), heterogeneous (p = .05), moderately inconsistent (I² = 48%), with minor asymmetry (LFK index = 1.34). The chronic effects of exercise on PON1 concentration were also trivial and non-significant (ES = -.04, 95%CI = -.53 to.45, p > .05), homogenous (p = .65), displayed low inconsistency (I² = 0%), and minor asymmetry (LFK index = -1.14). The acute effects of exercise on PON1 activity were trivial and non-significant (ES = .11, 95%CI = -.02 to.24, p > .05), homogenous (p = .85), showed low inconsistency (I² = 0%), and no asymmetry (LFK index = .82). The chronic effects of exercise on PON1 activity were trivial and non-significant (ES = .31, 95%CI = -.03 to.65, p > .05), homogenous (p = .17), moderately inconsistent (I² = 36%), with no asymmetry (LFK index = .60). Conclusion: Acute and chronic exercise training, overall, exerted a trivial effect on PON1 concentration and activity.

The Placebo-Controlled Effect of Percutaneous Coronary Intervention on Exercise Induced Changes in Anti-Malondialdehyde-LDL Antibody Levels in Stable Coronary Artery Disease: A Substudy of the ORBITA Trial

Aim: Malondialdehyde-modified low-density lipoprotein (MDA-LDL) forms a significant component of oxidised LDL. The effects of exercise on levels of MDA-LDL and anti-MDA-LDL antibodies are not well-understood. Furthermore, it is not known whether these can be modified in patients with coronary artery disease by percutaneous coronary intervention (PCI). Methods: The Objective Randomised Blinded Investigation with optimal medical Therapy of Angioplasty in stable angina (ORBITA) trial was the first blinded, multi-centre randomised trial of PCI vs. placebo procedure for angina relief. Serum samples were available at four time-points: pre-randomisation pre- (P1) and post- (P2) exercise and post-randomisation (6-weeks following the PCI or placebo procedure), pre- (P3) and post- (P4) exercise. ELISAs were performed using laboratory-developed assays for MDA-LDL (adjusted for Apolipoprotein B) and anti-MDA-LDL antibodies. Results: One hundred ninety-six of the 200 patients (age 66.1 [SD 8.99] years, 28% female) with severe single vessel coronary artery disease suitable for PCI enrolled in the ORBITA trial had blood available for analysis. With exercise at pre-randomisation (P2-P1) there was no significant change in adjusted MDA-LDL (-0.001, 95% CI -0.004 to 0.001; p = 0.287); however, IgG and IgM anti-MDA-LDL significantly declined (-0.022, 95% CI -0.029 to -0.014, p < 0.0001; -0.016, 95% CI -0.024 to -0.008, p = 0.0002, respectively). PCI did not have a significant impact on either the pre-exercise values (P3 controlling for P1) of MDA-LDL (p = 0.102), IgG (p = 0.444) or IgM anti-MDA-LDL (p = 0.909). Nor did PCI impact the exercise induced changes in these markers (P4 controlling for P1, P2, and P3) for MDA-LDL (p = 0.605), IgG (p = 0.725) or IgM anti-MDA-LDL (p = 0.171). Pre-randomisation ischaemia on stress echo did not impact these interactions. Conclusions: Exercise results in an acute reduction in anti-oxLDL antibodies in patients with severe single vessel coronary disease, possibly indicating an induction in homoeostatic clearance via the innate immune system. However, PCI did not ameliorate this effect.

Exercise-Induced Hyperhomocysteinemia Is Not Related to Oxidative Damage or Impaired Vascular Function in Amateur Middle-Aged Runners under Controlled Nutritional Intake

To determine the influence of different doses of maximal acute exercise on the kinetics of plasma homocysteine (tHcy) and its relationship with oxidative status and vascular function, nine recreational runners completed a 10 km race (10K) and a marathon (M). Blood samples were collected before (Basal), immediately post-exercise (Post0), and after 24 h (Post24). Nutritional intake was controlled at each sample point. A significant increase in tHcy was observed after both races, higher after M. Basal levels were recovered at Post24 after 10K, but remained elevated at Post 24 for M. A significant decrease in GSH/GSSG ratio was observed in Post0, especially marked after M. Furthermore, this increase in pro-oxidant status remained at Post24 only after M. Other oxidative status markers failed to confirm this exercise-induced pro-oxidant status except glutathione peroxidase activity that was lower in Post24 compared to Basal in 10K and in Post0 and Post24 in M. No statistical correlation was found between oxidative markers and tHcy. No significant changes were observed in the concentration of endothelial cell adhesion molecules (VCAM-1 and E-Selectin) and VEGF. In conclusion, tHcy increases in an exercise–dose–response fashion but is not related to endothelial dysfunction mediated by oxidative stress mechanisms.

Impact of Plasma Oxidative Stress Markers on Post-race Recovery in Ultramarathon Runners: A Sex and Age Perspective Overview

Oxidative stress has been widely studied in association to ultra-endurance sports. Although it is clearly demonstrated the increase in reactive oxygen species and free radicals after these extreme endurance exercises, the effects on the antioxidant defenses and the oxidative damage to macromolecules, remain to be fully clarified. Therefore, the aim of this study was to elucidate the impact of an ultramarathon race on the plasma markers of oxidative stress of 32 runners and their post-race recovery, with especial focused on sex and age effect. For this purpose, the antioxidant enzymes glutathione peroxidase (GPx) and glutathione reductase (GR) activity, as well as the lipid peroxidation product malondialdehyde (MDA) and the carbonyl groups (CG) content were measured before the race, in the finish line and 24 and 48 h after the race. We have reported an increase of the oxidative damage to lipids and proteins (MDA and CG) after the race and 48 h later. Moreover, there was an increase of the GR activity after the race. No changes were observed in runners' plasma GPx activity throughout the study. Finally, we have observed sex and age differences regarding damage to macromolecules, but no differences were found regarding the antioxidant enzymes measured. Our results suggest that several basal plasma markers of oxidative stress might be related to the extent of muscle damage after an ultraendurance race and also might affect the muscle strength evolution.

Changes in immunological parameters in ultramarathon runners depending on the duration of the load

BACKGROUND

In recent decades, there has been an increasing interest in long-distance running, not only to the classic marathon distances but also to an ultramarathon -100 km, 250 km, and multi-day races. One of the most reactive body systems in conditions of prolonged muscular loads is the immune system. The work aimed to investigate the changes in immunological parameters in runners for extra-long distances of various durations.

METHODS

We examined 73 male athletes specializing in long-distance and ultra-long-distance running. The design of the survey included the study of immunological status during the marathon race, 100 km run, and six-day run. We studied the dynamics of leukocyte formula; subpopulations of lymphocytes; fractions of immunoglobulins: IgA, IgM, IgG; phagocytic activity.

RESULTS

During the marathon run, athletes' immunological changes are manifested by the development of neutrophilic leukocytosis with a decrease in the phagocytic activity of neutrophils. There was a sharp increase in the NLR and decrease in the LMR. A 100-km race caused a decrease in the absolute and relative number of T-lymphocytes. NLR increased almost ten times, and LMR, on the contrary, decreased nearly five times. On the first day of the 6-days run, there is a sharp increase in NLR and a decrease in LMR, after which there is a relative stabilization of both indicators.

CONCLUSIONS

Changes in immunological parameters during jogging are closely related to the duration of the load. The most pronounced changes are observed on the part of neutrophils and lymphocytes.

Serum changes in sTWEAK and its scavenger receptor sCD163 in ultramarathon athletes running the 24-h race

In the present investigation, the serum changes of sTWEAK levels, a multifunctional cytokine involved in tissue response to acute injury and inflammation, and of its scavenger receptor sCD163, were monitored for the first time in ultramarathon athletes running the 24-h competition, an extremely demanding race in terms of muscular and physiological exertion. To this aim, venous blood samples were collected from each participant (n = 22, M = 12, F = 10) both before and immediately after the 24-h running. Other than sTWEAK and sCD163, the common serum biomarkers of inflammation (namely CRP and IL-6) and tissue injury (such as CPK, LDH, CPK-MB, troponin-I, and NT-proBNP) were evaluated. All parameters were within the reference ranges at baseline, indicating no alterations of the normal physiological processes before the competition; on the contrary, most biomarkers of tissue damage and inflammation strongly increased after the ultramarathon race. Interestingly, a significant decrement of sTWEAK levels associated with an increment of its scavenger receptor sCD163 was observed at post-race. Positive relationships were evidenced between IL-6 and sCD163 levels and the markers of cardiac damage troponin-I and NT-proBNP. On the contrary, sTWEAK showed an inverse correlation with IL-6 and NT-proBNP. This study opens the way to further investigations aimed at clarifying the role of TWEAK pathway during the prolonged ultraendurance activity, paying particular attention to the link of IL-6, CD163 and TWEAK with the cardiac function.

Importance of paraoxonase 1 (PON1) as an antioxidant and antiatherogenic enzyme in the cardiovascular complications of type 2 diabetes: Genotypic and phenotypic evaluation

Oxidant-antioxidant imbalance is involved in the etiology of different diseases, including cardiovascular diseases (CVDs), liver disorders, kidney diseases, cancers and diabetes mellitus. Antioxidant enzymes play a key role in striking an oxidant-antioxidant balance. Moreover, paraoxonase 1 (PON1) is an antioxidant enzyme that binds with high-density lipoprotein (HDL) in the circulation, and antioxidant and antiaterogenic properties of this lipoprotein are significantly associated with PON1. Research suggests PON1 contributes to the pathogenesis of certain human diseases such as type 2 diabetes (T2D). The association between PON1 and T2D appear to be reciprocal so that the disease significantly decreases PON1 levels and in turn, the genetics of PON1 may have a role the risk of susceptibility to T2D. Several factors that reduce the activity and concentration of PON1 in patients with T2D include increased glycation and loss-of-function polymorphisms. The genotypic and phenotypic evaluations of PON1 are therefore crucial for assessing the risk of cardiovascular complications in these patients, and strategies for increasing or restoring PON1 levels are useful for reducing or preventing their cardiovascular complications as their main cause of mortality. The present review aimed at discussing and emphasizing the key role of PON1 in T2D as a silent and dangerous disease.

Evaluation of Paraoxonase, Arylesterase, and Homocysteine Thiolactonase Activities in Patients with Diabetes and Incipient Diabetes Nephropathy

Background

The aim of this study is to examine the relationship among the changes in activities of paraoxonase (PON), arylesterase (ARE) and homocysteine thiolactonase (HTLase) enzyme having antioxidant properties and the development of diabetic nephropathy (DN), one of the most common complications of diabetes.

Methods

Normoalbuminuric type-2 diabetic patients (Group II, n=100), microalbuminuric type 2 diabetic patients (Group III, n=100) and the control group (Group I, n=100) were included in the study. The age and gender of the patient groups matched with the age and gender of the control group. HTLase, PON and ARE enzyme activities were measured by the spectrophotometric method using a g-thiobutyrinolactone, paraoxon, and phenylacetate substrates respectively. In this study, an autoanalyzer application was developed in order to measure HTLase enzyme activity for the first time.

Results

Serum HTLase, ARE and PON activities of Group III and Group II were significantly low compared to HTLase, ARE and PON results of Group I (p<0.05).

Conclusions

Based on our results, PON, ARE and HTLase enzyme activities were found to be decreased due to the increase in the degree of DN.

Nutritional Knowledge and Dietary Practice in Elite 24-Hour Ultramarathon Runners: A Brief Report

Several factors contribute to athletes’ sporting performance and diet is a key component. Higher levels of nutritional knowledge seem to correlate with a higher quality of diet, but this remains poorly explored and findings are still not conclusive. The aim of our study was to assess nutritional knowledge and dietary adequacy, detecting any potential association between these two factors in elite 24-hour ultramarathon runners, a sport which seems to have been increasing in popularity over the last decade. Nutritional knowledge and Mediterranean dietary adequacy scores were assessed by means of validated questionnaires given to 10 elite ultramarathon runners (six males and four females) from the Italian Ultramarathon and Trail Association (IUTA). The overall nutritional knowledge in the entire sample of athletes seemed to be good, especially in terms of “dietary recommendations” and “nutrient sources” knowledge. However, females had higher total nutritional knowledge scores when compared to males. Finally, linear regression analysis showed that greater nutritional knowledge was positively associated with an increase in Mediterranean dietary adequacy scores (β = 1.27; 95% CI = 0.039–2.494; p = 0.045) after adjusting for level of education. Our findings provide evidence that higher nutritional knowledge is associated with better dietary practice in elite 24-hour ultramarathon runners. Future studies are needed to assess the usefulness of educational programs as a strategy to improve the adequacy of dietary intake in this specific population.

The Usefulness of Performing Biochemical Tests in the Saliva of Kickboxing Athletes in the Dynamic of Training

The study aimed to determine the suitability of testing the saliva of kickboxing athletes to show changes in biochemical parameters in dynamic of training. 8 elite male athletes (mean age 17.29± 0.31 years, body mass 66.82± 3.46kg, with 5.62±0.96 years of training experience) participated in the study. Indicators of lipid peroxidation and glycolysis (the concentration of lactic acid and pyruvic acid) were defined before and after a training session. Significant increases in indicators of lipid peroxidation activity indicators and the concentration of lactic acid (4-fold) were observed; analysis of correlation matrices confirms the absence of expressed changes. At the same time, significant decreases in catalase (10-fold from 3.69 μkat/L to 0.39 μkat/L) and pyruvic acid (from 3.92 μl/l to 0.55 μl/l) were observed. Our results confirm the value of using saliva to determine training load in an individual. Moreover, the study provided information on the importance of indexes reflecting a correlation of various biochemical indicators to estimate the sufficiency of training loads. The ease of sampling and informational content of saliva are reasons to use such tests in monitoring athletes' functional state to prevent fatigue.

Motivation in ultra-marathon runners

Background

In ultra-marathon running the proper motivation of the athlete is one of the milestones, not only during the races, but also during the practice sessions, which are long and very exhausting.

Purpose

The aim of this study was to examine the relationship of sport experience (expressed as number of finishes in ultra-marathons) with motivation characteristics of ultra-marathon runners.

Subjects and methods

The Motivation of Marathoners Scale examined the motivation of ultra-marathon runners compared to endurance runners of shorter distances (control group). Participants were 1,539 Polish runners, 382 women (24.7%) and 1,157 men (75.3%). Ultra-marathoners (N=425; 26.7%) finished at least one ultra-marathon, whereas the control group consisted of runners of shorter distances (N=1,114, 72.3%).

Results

Ultra-marathoners had higher scores in affiliation (3.55±1.60 vs 3.34±1.62, P<0.05), life meaning (4.20±1.40 vs 4.03±1.44, P<0.05) and lower in the areas of weight concern (4.33±1.68 vs 4.64±1.65, P<0.01), personal goal achievement (5.09±1.25 vs 4.64±1.65, P<0.001) and self-esteem (4.44±1.36 vs 4.68±1.38, P<0.01), than runners in the control group. The number of completed ultra-marathons was negatively related to the personal goal achievement, competition and recognition scale. The level of training experience was negatively correlated with the personal goal achievement scale in all participants, and with the self-esteem scale in the control group. In summary, ultra-marathoners had different motivations compared to runners of shorter race distance.

Conclusions

These findings should be considered by sport psychologists and other professionals to develop performance-tailored interventions for ultra-marathoners.