Biochemical changes in the context of a 160 km Ultramarathon

Einleitung: Es ist schon seit längerem bekannt, dass es nach Ultraläufen zu ausgeprägte Veränderungen unterschiedlichster Laborparameter kommt (z.B. Entzündung, Muskelstoffwechsel, Flüssigkeits-/Elektrolythaushalt, kardiale Marker). Endokrinologische Parameter sind weniger gut untersucht und kommen zu teils heterogenen Ergebnissen. Ziel des FAMOS-Projekts ist eine umfassende und zusammenhängende Darstellung laborchemischer Veränderungen nach einem 160 km Lauf. Methodik: 16 Finisher (m=13, w=3) des 5. Berliner Mauerweglaufs wurden an 3 Zeitpunkten untersucht: Rund eine Woche vor dem Lauf (PRE), im Ziel (POST) und nach ca. einer Woche der Regeneration (RE). Erhoben wurden Anamnese, Leistungsdiagnostik, EKG, Echokardiografie und Anthropometrie sowie umfängliche Labordiagnostik von 67 Parametern. Ergebnisse: Signifikante (sig.) Unterschiede ergaben sich für rund 2/3 der Laborparameter zwischen den 3 Messzeitpunkten. Zu POST stiegen Muskel-, Leberstoffwechsel-, Retentionsparameter, Entzündungs- und kardiale Marker sig. an, viele auf Werte oberhalb des Normbereichs. Zusätzlich zeigte sich ein sig. Anstieg des stabilen ADH-Äquivalents, Copeptins. Sig. Mittelwertveränderungen der Elektrolyte traten nicht auf. Alpha Amylase, Indikator der sympathischen Stressantwort, zeigte einen sig. Abfall. Hormonell fanden sich sig. Anstiege von Cortisol, DHEA-S und ACTH. Testosteron, Estrogen und der freie Androgenindex fielen sig. ab, ebenso die Testosteron:Cortisol-Ratio. Gonadotropine und Inhibin B zeigten die höchsten Mittelwerte bei RE. IGF und IGF-BP3 fielen von PRE auf POST sig. ab, Somatotropin wies niedrigste Mittelwerte bei RE auf. Die Schilddrüsenhormone zeigten sig. Veränderungen im Normbereich. Korrelationen fanden sich für Natrium mit Copeptin, Körperfettgehalt mit Leptin und LDH mit CK bei POST. Zusammenfassung: Ultralauf induziert Veränderungen von Laborparametern aller untersuchten Organsysteme, die meisten normalisieren sich nach einer Woche. Deutliche Unterschiede zu bisherigen Studien finden sich insbesondere bei den untersuchten Hormonen. Viele Veränderungen deuten v.a. auf eine katabole Stoffwechsellage hin. Die lange Laufdauer scheint besonderen Einfluss auf die Regulation des Wasserhaushaltes, die Wachstumshormone und die Hypophysen-Hypothalamus-Nebennierenrinden/Gonaden Achse zu haben.Introduction: It is well-known that Ultamarathon running induces enormous changes in different laboratory parameters (e.g. Inflammation, muscle metabolism, fluid and electrolyte balance, cardiac markers). Endocrinological markers are less well examined and lead to in parts heterogenous results. Aim of the FAMOS Project is an extensive and related presentation of biochemical changes after a 160 km run. Methods: 16 finisher (m=13, w=3) participating in the 5. Berliner Mauerweglauf were examined at the following three occasions: About one week before the run (PRE), straight after crossing the finish line (POST) and after about one week of regeneration (RE). Data included natural history information, performance diagnostics, ECG, echocardiography and anthropometry as well as extensive laboratory diagnostics of 67 parameters. Results: Signifikant changes were found in around 2/3 of all biomarkers between the three examination dates. At POST muscle-, liver-, retention parameters, inflammation- and cardiac markers were significantly elevated, most of them beyond normal range. Additionally significant elevation of the stable ADH-aqivalent, Copeptin, was shown. There were no significant changes in mean values of electrolytes. Alpha Amylase, an indicator of sympatic stress reaction, showed a significant decrease. Endokrinological markers showed significant elevations in Cortisol, DHEA-S and ACTH. Testosteron and the free Androgen Index decreased, as well as the Cortisol:Testosteron Ratio. Values for Gonadotrophins and Inhibin-B were mostly elevated at RE. IGF and IGF-BP3 decreased significantly from PRE to POST, Somatotrophin showed lowests mean values at RE. Thyroid hormones showed significant changes within normal ranges. Correlations were found for Sodium with Copeptin, bodyfat content with Leptin and LDH with CK at POST. Conclusion: Ultramarathon running induces changes of biochemical markers in all examined organic systems, most of them returning to prerace values after a week. Notable differences in comparison to earlier studies were found especially in terms of endocrinological markers. Many changes indicate in particular a catabolic metabolic state. The extreme length of the run seems to have a special impact on the regulation of fluid balance, growth hormones and the hypothalamic-pituitary-adrenal/gonadal axis

Salivary Diagnostic for Monitoring Strenuous Exercise—A Pilot Study in a Cohort of Male Ultramarathon Runners

Intense physical stress, such as that in ultramarathon running, affects the immune system. For monitoring in sports medicine, non-invasive methods, e.g., salivary analysis, are of interest. This pilot cohort study aimed to assess changes in salivary parameters in response to an ultramarathon. The results were compared to blood parameters. Male, healthy finishers (n = 9, mean age: 48 ± 8.8 years, mean height: 1.8 ± 0.1 m, mean weight: 72.5 ± 7.2 kg, mean BMI: 23.5 ± 1.9 kg/cm²) of a 160 km ultramarathon were included. Saliva and blood samples were collected at three time points: T1 (baseline), T2 (shortly after the ultramarathon) and T3 (after recovery). In saliva, cortisol, testosterone, IL-1β, IL-6, IL-8, IL-10, TNF-α, albumin, IgA, α-amylase, aMMP-8, and neopterin were assessed via ELISA. In blood, cortisol, testosterone, IL-1β, IL-6, IL-8, IL-10, TNF-α, blood cell counts, procalcitonin, CRP, osmolality, albumin, and α-amylase were analyzed. The statistical evaluation comprised longitudinal testing and cross-sectional testing between saliva and blood using ratios of T2 and T3 to baseline values. Various parameters in saliva and blood changed in response to the ultramarathon. Comparing blood and saliva, the longitudinal changes of testosterone (p = 0.02) and α-amylase (p = 0.03) differed significantly. Despite the limitations of the study, it underlines that saliva is an interesting option for comprehensive monitoring in sports medicine and necessitates further studies

Salivary Diagnostic for Monitoring Strenuous Exercise—A Pilot Study in a Cohort of Male Ultramarathon Runners

Intense physical stress, such as that in ultramarathon running, affects the immune system. For monitoring in sports medicine, non-invasive methods, e.g., salivary analysis, are of interest. This pilot cohort study aimed to assess changes in salivary parameters in response to an ultramarathon. The results were compared to blood parameters. Male, healthy finishers (n = 9, mean age: 48 ± 8.8 years, mean height: 1.8 ± 0.1 m, mean weight: 72.5 ± 7.2 kg, mean BMI: 23.5 ± 1.9 kg/cm²) of a 160 km ultramarathon were included. Saliva and blood samples were collected at three time points: T1 (baseline), T2 (shortly after the ultramarathon) and T3 (after recovery). In saliva, cortisol, testosterone, IL-1β, IL-6, IL-8, IL-10, TNF-α, albumin, IgA, α-amylase, aMMP-8, and neopterin were assessed via ELISA. In blood, cortisol, testosterone, IL-1β, IL-6, IL-8, IL-10, TNF-α, blood cell counts, procalcitonin, CRP, osmolality, albumin, and α-amylase were analyzed. The statistical evaluation comprised longitudinal testing and cross-sectional testing between saliva and blood using ratios of T2 and T3 to baseline values. Various parameters in saliva and blood changed in response to the ultramarathon. Comparing blood and saliva, the longitudinal changes of testosterone (p = 0.02) and α-amylase (p = 0.03) differed significantly. Despite the limitations of the study, it underlines that saliva is an interesting option for comprehensive monitoring in sports medicine and necessitates further studies