Gastrointestinal Cell Injury and Percieved Symptoms after Running the Boston Marathon

Gastrointestinal (GI) disturbances are a prevalent cause of marathon related complaints, and in extreme cases can promote life-threatening conditions such as exertional heat stroke. PURPOSE: Our aim was to study intestinal cell injury (via intestinal fatty acid binding protein [I-FABP]) and perceived GI distress symptoms among marathon runners. Potential risk factors (e.g., inadequate sleep) that could exacerbate GI disturbances in healthy, trained endurance runners were also examined. METHODS: A parallel mixed-methods study design was utilized. 2019 Boston Marathon participants were recruited via email. Before the race subjects completed surveys describing demographics and training history. Immediately pre-race, post-race, and 24-hours post-race participants completed a GI questionnaire to assess presence and severity of symptoms, a survey regarding risk factors (e.g., recent illness, medications) that could promote GI disturbances, and provided a urine sample. Due to weather, blood samples were only collected immediately and 24-hours post-race. RESULTS: A total of 40 runners (males: n = 19, age = 44.9 ± 10.8 years; females: n = 21, age = 44.8 ± 10.6 years) completed this study. I-FABP significantly decreased from post-race (3367.5 ± 2633.5 pg/ml) to 24-hours post-race (1657.3 ± 950.7 pg/ml, t(39) = -4.228, p \u3c .001, d = -.669). A significant difference in overall GI symptom scores across the three time points occurred (F(2, 39) = 41.37, p \u3c .001). Compared to pre-race (.09 ± .12) and 24-hour post-race (.44 ± .28), the highest average score occurred post-race (.84 ± .68). Post-race I-FABP (r = .31, p = .048) and post-race urine specific gravity (r = .33, p = .041) were significantly correlated with post-race GI symptom scores. CONCLUSION: Our study further supports the individualized presentation of GI disturbances, with participants experiencing a wide range of risk factors that can influence the extent of GI damage and perceived symptoms during and after exercise

Medical encounters (including injury and illness) at mass community-based endurance sports events: an international consensus statement on definitions and methods of data recording and reporting

Mass participation endurance sports events are popular but a large number of participants are older and may be at risk of medical complications during events. Medical encounters (defined fully in the statement) include those traditionally considered 'musculoskeletal' (eg, strains) and those due to 'illness' (eg, cardiac, respiratory, endocrine). The rate of sudden death during mass endurance events (running, cycling and triathlon) is between 0.4 and 3.3 per 100 000 entrants. The rate of other serious medical encounters (eg, exertional heat stroke, hyponatraemia) is rarely reported; in runners it can be up to 100 times higher than that of sudden death, that is, between 16 and 155 per 100 000 race entrants. This consensus statement has two goals. It (1) defines terms for injury and illness-related medical encounters, severity and timing of medical encounters, and diagnostic categories of medical encounters, and (2) describes the methods for recording data at mass participation endurance sports events and reporting results to authorities and for publication. This unifying consensus statement will allow data from various events to be compared and aggregated. This will inform athlete/patient management, and thus make endurance events safer

SEX DIFFERENCES IN HYDRATION AND ACUTE KIDNEY INJURY BIOMARKERS AT THE 2019 B.A.A. BOSTON MARATHON

Whitley C. Atkins1, Cory L. Butts2, Melani R. Kelly3, Chris Troyanos4, R. Mark Laursen5, Andrew Duckett5, Dawn M. Emerson3, Brendon P. McDermott1, FACSM 1University of Arkansas, Fayetteville, Arkansas; 2Weber State University, Ogden, Utah; 3University of Kansas, Lawrence, Kansas; 4Boston Athletic Association, Boston, Massachusetts; 5Boston University, Boston, Massachusetts There are several studies demonstrating that acute kidney injury (AKI) is common immediately following marathon running. Many studies further suggest complete biomarker recovery within 24-hr. To date, however, sex differences in distance runners have received little investigation. Purpose: To evaluate sex differences on hydration and AKI biomarker changes surrounding running a marathon. Methods: Sixty-three participants (32 males and 31 females) in the Boston Athletic Association’s Boston Marathon (45.9 ± 9 y, 65.4 ± 10.8 kg, finishing time 3.78 ± 0.55 h) provided urine samples at three time points (pre-marathon, post-marathon and 24-hr postmarathon) for this study. Urine specific gravity (USG) was analyzed via refractometry and AKI biomarkers were evaluated using commercially available enzyme-linked immunosorbent assays. A 2 x 3 (sex x time) RM-ANOVA was used for statistical analysis post-hoc comparisons were completed with Bonferroni adjustments due to multiple time point comparisons. Results: Female USG (1.020 ± .001) was significantly greater post-marathon than male USG (1.016 ± .001; p = .028), yet male USG (1.024 ± .002) was significantly elevated 24-hr post-marathon compared to females (1.017 ± .002; p=.008). Female uCr values (186.91 ± 32.08 mg/dL) were significantly greater 24-hr post-marathon than males (59.24 ± 34.76 mg/dL, p ). Urinary neutrophil gelatinase-associated lipocalin (uNGAL) post-marathon was greater for both males (33.94 ± 10.84 ng/mL) and females (48.02 ± 10.00 ng/mL, p≤.001) compared to baseline (males: 4.27 ± 5.75 ng/mL, females: 22.68 ± 5.19 ng/mL). Twenty-four-hr post-marathon uNGAL was greater for both sexes (males: 65.76 ± 5.61 ng/mL, females: 60.16 ± 5.16 ng/mL, p=.004) compared to pre-marathon and post-marathon values but the effect of sex on uNGAL was not significant (p=.300). Conclusions: We identified persistent elevations in AKI biomarkers beyond 24-hr, regardless of sex. Further, this study highlights apparent sex differences in hydration and AKI outcomes of runners completing marathons. The need to further investigate sex differences and potential interactions between marathon running, hydration outcomes, hormone levels and AKI is warranted

ACCIRT/WRC Newsletter [26 September, 2012]

Marathon running commonly causes a transient elevation of creatine kinase and cardiac troponin I (cTnI). The use of statins before marathon running exacerbates the release of creatine kinase from skeletal muscle, but the effect of statin use on exercise-induced cTnI release is unknown. We therefore measured cTnI concentrations in statin-using (n = 30) and nonstatin-using (n = 41) runners who participated in the 2011 Boston Marathon. All runners provided venous blood samples the day before, within an hour of finishing, and 24 hours after the marathon. cTnI was assessed at each time point via both a contemporary cTnI and high-sensitivity cTnI (hsTnI) assay. Before the marathon, cTnI was detectable in 99% of runners with the use of the hsTnI assay. All participants completed the marathon (finish time: 4:04:09 +/- 0:41:10), and none had symptoms of an acute coronary syndrome. cTnI increased in all runners (p <0.001) immediately after the marathon, and half (hsTnI = 54% vs contemporary cTnI = 47%) exceeded the diagnostic cut-point for an acute myocardial infarction. Statin use did not affect the magnitude of cTnI release (group*time p = 0.47) or the incidence of runners with cTnI elevation greater than the diagnostic cut-point for myocardial infarction (57% vs 51%, p = 0.65). In addition, there was no significant association between statin potency and cTnI release (r = 0.09, p = 0.65). In conclusion, marathon-induced cTnI increases are not altered by statin use

Acute Kidney Injury Biomarkers and Hydration Outcomes at the Boston Marathon

The purpose of our field study was to investigate the effects of running the Boston Marathon on acute kidney injury (AKI) biomarkers. We hypothesized that biomarker values would be elevated immediately post-marathon but would resolve in the 24-h post-marathon. Secondarily, we sought to identify sex differences related to renal stress. Participants were 65 runners who completed the Boston Marathon (46 ± 9 years, 65.4 ± 10.8 kg). Urine samples were collected at three different time points (pre-marathon, post-marathon, and 24-h post-marathon). Blood samples were collected post-marathon and 24-h post-marathon. Urine specific gravity (USG) and AKI biomarkers were evaluated. Pre-marathon USG (1.012 ± 0.007) was significantly less than post-marathon (1.018 ± 0.008) and 24-h post-marathon (1.020 ± 0.009; P \u3c 0.001). Male USG (1.024 ± 0.009) was significantly greater 24-h post-marathon than females (1.017 ± 0.008; P = 0.019). Urinary neutrophil gelatinase-associated lipocalin values were significantly greater over time (P \u3c 0.001), and there was a main effect of sex with female urinary creatinine (UCr) greater than males at all three time points (P = 0.040). Post-marathonUCr (366.24 ± 295.16 mg/dl) was significantly greater than pre-marathon (206.65 ± 145.28.56 mg/dl; p \u3c 0.001) and 24-h post-marathon was significantly lower than other time-points (93.90 ± 125.07 mg/dl; P \u3c 0.001). FemaleUCr values were significantly greater than males 24-h post-marathon (P \u3c 0.001). There was no difference in serum cystatin C (SCys) values post- or 24-h post-marathon (P = 0.178). Serum creatinine (SCr) significantly decreased between post-marathon and 24-h post-marathon, (P \u3c 0.001). We can infer that the characteristics unique to the Boston Marathon may have attributed to prolonged elevations in AKI biomarkers. Sex differences were observed during the Boston Marathon warranting further investigation

Practical Hydration Solutions for Sport

Personalized hydration strategies play a key role in optimizing the performance and safety of athletes during sporting activities. Clinicians should be aware of the many physiological, behavioral, logistical and psychological issues that determine both the athlete’s fluid needs during sport and his/her opportunity to address them; these are often specific to the environment, the event and the individual athlete. In this paper we address the major considerations for assessing hydration status in athletes and practical solutions to overcome obstacles of a given sport. Based on these solutions, practitioners can better advise athletes to develop practices that optimize hydration for their sports

Physiological and molecular responses to magnesium nutritional imbalance in plants

BackgroundMagnesium (Mg) is pivotal for many biochemical and physiological processes in plants. Mg biological functions include a key role in photosynthesis, in protein synthesis, as well as in nucleotide metabolism. However, Mg nutrition of plants remains little examined compared with other essential elements.ScopeThe review summarizes the current knowledge on physiological targets of Mg imbalances. Recently generated transcriptome profiles in response to Mg shortage and excess are also presented.ConclusionsSugar accumulation in source leaves is a major consequence of Mg shortage that can limit plant growth most probably by down regulation of photosynthesis activity. Newly identified molecular targets of Mg imbalance are appraised in relation to their potential contribution to Mg deficiency phenotypic emergence. In particular a potential role of the circadian clock and change in phytohormones concentration and/or signalling in the orchestration of the Mg deficiency response is possible. The development of markers for incipient Mg deficiency appears to be a challenging taskSCOPUS: ar.jinfo:eu-repo/semantics/publishe