题名

Higher Prevalence of Exercise-Associated Hyponatremia in Triple Iron Ultra-Triathletes Than Reported for Ironman Triathletes

DOI

10.4077/CJP.2012.BAA010

作者

Christoph Alexander Rüst;Beat Knechtle;Patrizia Knechtle;Thomas Rosemann

关键词

ultra-endurance ; electrolyte ; plasma sodium ; dehydration

期刊名称

The Chinese Journal of Physiology

卷期/出版年月

55卷3期(2012 / 06 / 01)

页次

147 - 155

内容语文

英文

英文摘要

In a recent study of male and female ultra-marathoners in a 161-km ultra-marathon, the prevalence of exercise-associated hyponatremia (EAH) was higher than reported for marathoners. Regarding triathletes, the prevalence of EAH has been investigated in Ironman triathletes, but not in Triple Iron ultra-triathletes. The aim of this study was to investigate the prevalence of EAH in male ultra-triathletes competing in a Triple Iron ultra-triathlon over 11.4 km swimming, 540 km cycling, and 126.6 km running. Changes in body mass, fat mass, skeletal muscle mass, total body water, haematocrit, plasma volume, plasma sodium concentration ([Na(superscript +)]) and urine specific gravity were determined in 31 male athletes with (means ±standard deviation) 42.1 ±8.1 years of age, 77.0 ±7.0 kg body mass, 1.78 ±0.06 m body height and a BMI of 24.3 ±1.7 kg/m^2 in the 'Triple Iron Triathlon Germany'. Of the 31 finishers, eight athletes (26%) developed asymptomatic EAH. Body mass, fat mass, skeletal muscle mass, and haematocrit decreased, plasma volume increased (P < 0.05), plasma [Na(superscript +)], total body water and urine specific gravity remained stable. The decrease in body mass was related to both the decrease in fat mass and skeletal muscle mass (P < 0.05), but was not related to overall race time, the change in plasma [Na(superscript +)], post-race plasma [Na(superscript +)], or urine specific gravity. The prevalence of EAH was higher in these Triple Iron ultra-triathletes compared to existing reports on Ironman triathletes. Body fluid homeostasis remained stable in these ultra-triathletes although body mass decreased.

主题分类 醫藥衛生 > 基礎醫學
参考文献
  1. Almond, C. S.,Shin, A. Y.,Fortescue, E. B.,Mannix, R. C.,Wypij, D.,Binstadt, B. A.,Duncan, C. N.,Olson, D. P.,Salerno, A. E.,Newburger, J. W.,Greenes, D. S.(2005).Hyponatremia among runners in the Boston marathon.N. Engl. J. Med.,252,1550-1556.
  2. Beaumont, van W.(1972).Evaluation of hemoconcentration from hematocrit measurements.J. Appl. Physiol.,31,712-713.
  3. Becque, M. D.,Katch, V. L.,Moffatt, J.(1986).Time course of skinplus- fat compression in males and females.Human Biol.,58,33-42.
  4. Bingham, D.,Kendall, J.,Clancy, M.(1999).The portable laboratory: an evaluation of the accuracy and reproducibility of i-STAT.Ann. Clin. Biochem.,36,66-71.
  5. Chorley, J.,Cianca, J.,Divine, J.(2007).Risk factors for exerciseassociated hyponatremia in non-elite marathon-runners.Clin. J. Sport Med.,17,471-477.
  6. Davis, D. P.,Videen, J. S.,Marino, A.,Vilke, G. M.,Dunford, J. V.,Van Camp, S. P.,Maharam, L. G.(2001).Exercise-associated hyponatremia in marathon runners: A two-year experience.J. Emerg. Med.,21,47-57.
  7. Fallon, K. E.,Sivyer, G.,Sivyer, K.,Dare, A.(1999).The biochemistry of runners in a 1,600 km ultramarathon.Brit. J. Sports Med.,33,264-269.
  8. Fellmann, N.,Bedu, M.,Giry, J.,Pharmakis-Amadieu, M.,Bezou, M. J.,Barlet, J. P.,Coudert, J.(1989).Hormonal, fluid and electrolyte changes during a 72-h recovery from a 24-h endurance run.Int. J. Sports Med.,10,406-412.
  9. Fellmann, N.,Ritz, P.,Ribeyre, J.,Beaufrère, B.,Delaître, M.,Coudert, J.(1999).Intracellular hyperhydration induced by a 7-day endurance race.Eur. J. Appl. Physiol.,80,353-359.
  10. Glace, B. W.,Murphy, C. A.,McHugh, M. P.(2002).Food intake and electrolyte status of ultramarathoners competing in extreme heat.J. Am. Coll. Nutr.,21,553-559.
  11. Hew, T. D.,Chorley, J. N.,Cianca, J. C.,Divine, J. G.(2003).The incidence, risk factors and clinical manifestations of hyponatremia in marathon runners.Clin. J. Sport Med.,13,41-47.
  12. Hew-Butler, T.,Almond, C.,Ayus, J.C.,Dugas, J.,Meeuwisse, W.,Noakes, T.,Reid, S.,Siegel, A.,Speedy, D.,Stuempfle, K.,Verbalis, J.,Weschler, L.(2005).Exercise-associated hyponatremia (EAH) consensus panel. Consensus statement of the 1st International Exercise-Associated Hyponatremia Consensus Development Conference, Cape Town, South Africa 2005.Clin. J. Sport Med.,15,208-213.
  13. Hew-Butler, T.,Ayus, J. C.,Kipps, C.,Maughan, R. J.,Mettler, S.,Meeuwisse, W. H.,Page, A. J.,Reid, S. A.,Rehrer, N. J.,Roberts, W. O.,Rogers, I. R.,Rosner, M. H.,Siegel, A. J.,Speedy, D. B.,Stuempfle, K. J.,Verbalis, J. G.,Weschler, L. B.,Wharam, P.(2008).Statement of the Second International Exercise-Associated Hyponatremia Consensus Development Conference, New Zealand, 2007.Clin. J. Sport Med.,18,111-121.
  14. Hew-Butler, T.,Collins, M.,Bosch, A.,Sharwood, K.,Wilson, G.,Armstrong, M.,Jennings, C.,Swart, J.,Noakes, T.(2007).Maintenance of plasma volume and serum sodium concentration despite body weight loss in ironman triathletes.Clin. J. Sport Med.,17,116-122.
  15. Hew-Butler, T.,Jordaan, E.,Stuempfle, K. J.,Speedy, D. B.,Siegel, A. J.,Noakes, T. D.,Soldin, S. J.,Verbalis, J. G.(2008).Osmotic and nonosmotic regulation of arginine vasopressin during prolonged endurance exercise.J. Clin. Endocrinol. Metab.,93,2072-2078.
  16. Irving, R. A.,Noakes, T. D.,Buck, R.,van Zyl Smit, R.,Raine, E.,Godlonton, J.,Norman, R. J.(1991).Evaluation of renal function and fluid homeostasis during recovery from exercise-induced hyponatremia.J. Appl. Physiol.,70,342-348.
  17. Kavouras, S. A.(2002).Assessing hydration status.Curr. Opin. Clin. Nutr. Metab. Care,5,519-524.
  18. Kipps, C.,Sharma, S.,Tunstall Pedoe, D.(2011).The incidence of exercise-associated hyponatremia in the London Marathon.Brit. J. Sports Med.,45,14-19.
  19. Knechtle, B.,Duff, B.,Amtmann, G.,Kohler, G.(2007).Cycling and running performance, not anthropometric factors, are associated with race performance in a Triple Iron Triathlon.Res. Sports Med.,15,257-269.
  20. Knechtle, B.,Duff, B.,Schulze, I.,Rosemann, T.,Senn, O.(2009).Anthropometry and pre-race experience of finishers and nonfinishers in a multistage ultra-endurance run-Deutschlandlauf 2007.Percept. Mot. Skills,109,105-118.
  21. Knechtle, B.,Joleska, I.,Wirth, A.,Knechtle, P.,Rosemann, T.,Senn, O.(2010).Intra- and inter-judge reliabilities in measuring the skinfold thicknesses of ultra-runners under field conditions.Percept. Mot. Skills,111,105-106.
  22. Knechtle, B.,Knechtle, P.,Rosemann, T.(2010).No exercise-associated hyponatremia found in an observational field study of male ultra-marathoners participating in a 24-hour ultra-run.Phys. Sports Med.,38,94-100.
  23. Knechtle, B.,Knechtle, P.,Rosemann, T.(2011).Do male 100 km ultra-marathoners overdrink?.Int. J. Sports Physiol. Perform,6,195-207.
  24. Knechtle, B.,Knechtle, P.,Rosemann, T.,Oliver, S.(2010).A Triple Iron triathlon leads to a decrease in total body mass but not to dehydration.Res. Q. Exerc. Sport,81,319-327.
  25. Knechtle, B.,Kohler, G.(2009).Running performance, not anthropometric factors, is associated with race success in a Triple Iron Triathlon.Brit. J. Sports Med.,43,437-441.
  26. Knechtle, B.,Senn, O.,Imoberdorf, R.,Joleska, I.,Wirth, A.,Knechtle, P.,Rosemann, T.(2011).No fluid overload in male ultrarunners during a 100 km ultra-run.Res. Sports Med.,19,14-27.
  27. Knechtle, B.,Wirth, A.,Knechtle, P.,Rosemann, T.(2009).Increase of total body water with decrease of body mass while running 100 km nonstop- formation of edema?.Res. Q. Exerc. Sport,80,593-603.
  28. Knechtle, B.,Wirth, A.,Knechtle, P.,Rosemann, T.,Senn, O.(2011).Do ultra-runners in a 24-h run really dehydrate?.Ir. J. Med. Sci.,180,129-134.
  29. Lebus, D. K.,Casazza, G. A.,Hoffman, M. D.,Van Loan, M. D.(2010).Can changes in body mass and total body water accurately predict hyponatremia after a 161-km running race?.Clin. J. Sport Med.,20,193-199.
  30. Lee, R. C.,Wang, Z.,Heo, M.,Ross, R.,Janssen, I.,Heymsfield, S. B.(2000).Total-body skeletal muscle mass: development and crossvalidation of anthropometric prediction models.Am. J. Clin. Nutr.,72,796-803.
  31. Maughan, R. J.,Whiting, P. H.,Davidson, R. J.(1985).Estimation of plasma volume changes during marathon running.Brit. J. Sports Med.,19,138-141.
  32. Mettler, S.,Rusch, C.,Frey, W. O.,Bestmann, L.,Wenk, C.,Colombani, P. C.(2008).Hyponatremia among runners in the Zurich Marathon.Clin. J. Sport Med.,18,344-349.
  33. Mock, T.,Morrison, D.,Yatscoff, R.(1995).Evaluation of the i-STAT system: a portable chemistry analyzer for the measurement of sodium, potassium, chloride, urea, glucose and hematocrit.Clin. Biochem,28,187-192.
  34. Noakes, T. D.(2011).Changes in body mass alone explain almost all of the variance in the serum sodium concentrations during prolonged exercise. Has commercial influence impeded scientific endeavour?.Brit. J. Sports Med.,45,475-477.
  35. Noakes, T. D.,Goodwin, N.,Rayner, B. L.,Branken, T.,Taylor, R. K.(1985).Water intoxication: a possible complication during endurance exercise.Med. Sci. Sports Exerc.,17,370-375.
  36. Noakes, T. D.,Sharwood, K.,Collins, M.,Perkins, D. R.(2004).The dipsomania of great distance: water intoxication in an Ironman triathlete.Brit. J. Sports Med.,38,E16.
  37. Noakes, T. D.,Sharwood, K.,Speedy, D.,Hew, T.,Reid, S.,Dugas, J.,Almond, C.,Wharam, P.,Weschler, L.(2005).Three independent biological mechanisms cause exercise-associated hyponatremia: evidence from 2,135 weighed competitive athletic performances.Proc. Natl. Acad. Sci. USA,102,18550-18555.
  38. Noakes, T.D.(2010).Is drinking to thirst optimum?.Ann. Nutr. Metab.,57,9-17.
  39. Page, A. J.,Reid, S. A.,Speedy, D. B.,Mulligan, G. P.,Thompson, J.(2007).Exercise-associated hyponatremia, renal function and nonsteroidal anti-inflammatory drug use in an ultraendurance mountain run.Clin. J. Sport Med.,17,43-48.
  40. Rehrer, N. J.,Brouns, F.,Beckers, E. J.,Frey, W. O.,Villiger, B.,Riddoch, C. J.,Menheere, P. P.,Saris, W. H.(1992).Physiological changes and gastro-intestinal symptoms as a result of ultra-endurance running.Eur. J. Appl. Physiol.,64,1-8.
  41. Reid, S. A.,King, M. J.(2007).Serum biochemistry and morbidity among runners presenting for medical care after an Australian mountain ultramarathon.Clin. J. Sport Med.,17,307-310.
  42. Reid, S. A.,Speedy, D. B.,Thompson, J. M.,Noakes, T. D.,Mulligan, G.,Page, T.,Campbell, R. G.,Milne, C.(2004).Study of haematological and biochemical parameters in runners completing a standard marathon.Clin. J. Sport Med.,14,344-353.
  43. Sharwood, K. A.,Collins, M.,Goedecke, J. H.,Wilson, G.,Noakes, T. D.(2004).Weight changes, medical complications and performance during an Ironman triathlon.Brit. J. Sports Med.,38,718-724.
  44. Shirreffs, S. M.(2003).Markers of hydration status.Eur. J. Clin. Nutr.,57,S6-S9.
  45. Siegel, A. J.,Verbalis, J. G.,Clement, S.,Mendelson, J. H.,Mello, N. K.,Adner, M.,Shirey, T.,Glowacki, J.,Lee-Lewandrowski, E.,Lewandrowski, K. B.(2007).Hyponatremia in marathon runners due to inappropriate arginine vasopressin secretion.Am. J. Med.,120,461-467.
  46. Speedy, D. B.,Campbell, R.,Mulligan, G.,Robinson, D. J.,Walker, C.,Gallagher, P.,Arts, J. H.(1997).Weight changes and serum sodium concentrations after an ultradistance multisport triathlon.Clin. J. Sport Med.,7,100-103.
  47. Speedy, D. B.,Faris, J. G.,Hamlin, M.,Gallagher, P. G.,Campbell, R. G.(1997).Hyponatremia and weight changes in an ultradistance triathlon.Clin. J. Sport Med.,7,180-184.
  48. Speedy, D. B.,Noakes, T. D.,Boswell, T.,Thompson, J. M.,Rehrer, N.,Boswell, D. R.(2001).Response to a fluid load in athletes with a history of exercise induced hyponatremia.Med. Sci. Sports Exerc.,33,1434-1442.
  49. Speedy, D. B.,Noakes, T. D.,Rogers, I. R.,Thompson, J. M.,Campbell, R. G.,Kuttner, J. A.,Boswell, D. R.,Wright, S.,Hamlin, M.(1999).Hyponatremia in ultradistance triathletes.Med. Sci. Sports Exerc.,31,809-815.
  50. Speedy, D. B.,Rogers, I. R.,Noakes, T. D.,Thompson, J. M.,Guirey, J.,Safih, S.,Boswell, D. R.(2000).Diagnosis and prevention of hyponatremia at an ultradistance triathlon.Clin. J. Sport Med.,10,52-58.
  51. Stewart, A. D.,Hannan, W. J.(2000).Prediction of fat and fat-free mass in male athletes using dual X-ray absorptiometry as the reference method.J. Sports Sci.,18,263-274.
  52. Stuempfle, K. J.,Lehmann, D. R.,Case, H. S.,Bailey, S.,Hughes, S. L.,McKenzie, J.,Evans, D.(2002).Hyponatremia in a cold weather ultraendurance race.Alaska Med.,44,51-55.
  53. Stuempfle, K. J.,Lehmann, D. R.,Case, H. S.,Hughes, S. L.,Evans, D.(2003).Change in serum sodium concentration during a cold weather ultradistance race.Clin. J. Sport Med.,13,171-175.
  54. Verbalis, J. G.(2007).Renal function and vasopressin during marathon running.Sports Med.,37,455-458.
  55. Weschler, L. B.(2005).Exercise-associated hyponatraemia: a mathematical review.Sports Med.,35,899-922.
  56. Wharam, P. C.,Speedy, D. B.,Noakes, T. D.,Thompson, J. M.,Reid, S. A.,Holtzhausen, L. M.(2006).NSAID use increases the risk of developing hyponatremia during an Ironman triathlon.Med. Sci. Sports Exerc.,38,618-622.
  57. Whithing, P. H.,Maughan, R.J.,Miller, J. D.(1984).Dehydration and serum biochemical changes in marathon runners.Eur. J. Appl. Physiol.,52,183-187.
被引用次数
  1. Salihu, Lejla,Rüst, Christoph Alexander,Rosemann, Thomas,Knechtle, Beat(2016).Sex Difference in Draft-Legal Ultra-Distance Events - A Comparison between Ultra-Swimming and Ultra-Cycling.中國生理學雜誌,59(2),87-99.