题名

Pre- and Post-Race Hydration Status in Hyponatremic and Non-Hyponatremic Ultra-Endurance Athletes

DOI

10.4077/CJP.2016.BAE391

作者

Daniela Chlíbková；Thomas Rosemann；Lenka Posch；Radek Matou□ek；Beat Knechtle

关键词

mountain bikers ； plasma sodium ； runners ； urinary sodium

期刊名称

The Chinese Journal of Physiology

卷期/出版年月

59卷3期（2016 / 06 / 30）

页次

173 - 183

内容语文

英文
英文摘要

The monitoring of body mass (BM) plasma sodium concentration ([Na^+]) and urinary specific gravity (U_(sg)) are com-monly used to help detect and prevent over- or dehydration in endurance athletes. We investigated pre-and post-race hydration status in 113 amateur 24-h ultra-runners, 100-km ultra-runners, multi-stage mountain bikers and 24-h mountain bikers, which drank ad libitum without any intervention and compared results of hyponatremic and non-hyponatremic finishers. On average, pre-race plasma [Na^+] and both pre- and post-race levels of U_(sg) and BM were not significantly different between both groups. However, nearly 86% of the post-race hyponatremic (exercise-associated hyponatremia, EAH) and 68% of the normonatremic (non-EAH) ultra-athletes probably drank prior the race greater volumes than their thirst dictated regarding to individual prerace U_(sg) levels. Fluid intake during the race was equal and was not related to plasma [Na^+], U_(sg) or BM changes. A significant decrease in post-race plasma [Na^+], BM and an increasement in post-race U_(sg) was observed in EAH and non-EAH finishers. Moreover, pre-race plasma [Na^+] was inversely associated with post - race percentage change in p lasma [Na^+], and pre-race U_(sg) and urinary [Na+] with percentage change in U_(sg) in both groups with and without post-race EAH. Thirteen (11.5%) finishers developed post-race EAH (plasma [Na+] ＜ 135 mM). The incidence of EAH in ultra-endurance athletes competing in the Czech Republic was higher than reported previously.
主题分类 醫藥衛生 > 基礎醫學
参考文献
  1. Knechtle, B.,Knechtle, P.,Roseman, T.(2011).No case of exerciseassociated hyponatraemia in male ultra-endurance mountain bikers in the 'Swiss Bike Masters'.Chinese J. Physiol.,54,379-384.
    連結：
  2. Almond, C.S.,Shin, A.Y.,Fortesque, E.B.,Rebekah, C.M.,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.,352,1550-1556.
  3. American College of Sports Medicine,Sawka, M.N.,Burke, L.M.,Eichner, E.R.,Maughan, R.J.,Montain, S.J.,Stachenfeld, N.S.(2007).American College of Sports Medicine Position Stand. Exercise and fluid replacement.Med. Sci. Sports Exerc.,39,377-390.
  4. Armstrong, L.E.(2007).Assessing hydration status. The elusive gold standard.J. Am. Coll. Nutr.,26,575S-584S.
  5. Armstrong, L.E.,Maresh, C.M.,Castellani, J.W.,Bergeron, M.F.,Kenefick, R.W.,LaGasse, K.E.,Riebe, D.(1994).Urinary indices of hydration status.Int. J. Sport Nutr.,4,265-279.
  6. Armstrong, L.E.,Pumerantz, A.C.,Fiala, K.A.,Roti, M.W.,Kavouras, S.A.,Casa, D.J.,Maresh, C.M.(2010).Human hydration indices: acute and longitudinal reference values.Int. J. Sport Nutr. Exerc. Metab.,20,145-153.
  7. Armstrong, L.E.,Soto, J.A.H.,Hacker, F.T.,Casa, D.J.,Kavouras, S.A.,Maresh, C.M.(1998).Urinary indices during dehydration, exercise and rehydration.Int. J. Sport Nutr.,8,345-355.
  8. Bennett, B.L.,Hew-Butler, T.,Hoffman, M.D.,Rogers, I.R.,Rosner, M.H.(2013).Wilderness medical society practice guidelines for treatment of exercise-associated hyponatremia.Wilderness Environ. Med.,24,228-240.
  9. Bircher, S.,Enggist, A.,Jehle, T.,Knechtle, B.(2006).Effects of an extreme endurance race on energy balance and body composition - a case study.J. Sports Sci. Med.,5,154-162.
  10. Black, K.E.,Skidmore, P.,Brown, R.C.(2014).Fluid balance of cyclists during a 387-km race.Eur. J. Sport Sci.,14,421-428.
  11. Bracher, A.,Knechtle, B.,Gnädinger, M.,Bürge, J.,Rüst, C.A.,Knechtle, P.,Rosemann, T.(2012).Fluid intake and changes in limb volumes in male ultra-marathoners: does fluid overload lead to peripheral oedema?.Eur. J. Appl. Physiol.,112,991-1003.
  12. Casa, D.J.,Armstrong, L.E.,Hillman, S.K.,Montain, S.J.,Reiff, R.V.,Rich, B.S.E.,Roberts, W.O.,Stone, J.A.(2000).National athletic trainers' association position statement: fluid replacement for athletes.J. Athl. Train.,35,212-224.
  13. Cheuvront, S.N.,Montain, S.J.,Sawka, M.N.(2007).Fluid replacement and performance during the marathon.Sports Med.,37,353-357.
  14. Chlíbková, D.,Knechtle, B.,Rosemann, T.,Tomášková, I.,Chadim, V.,Shortall, M.(2014).Nutrition habits in 24-h mountain bike racers.Springerplus,3,715-725.
  15. Chlíbková, D.,Knechtle, B.,Rosemann, T.,Tomášková, I.,Novotný, J.,Žákovská, A.,Uher, T.(2015).Rhabdomyolysis and exercise-associated hyponatremia in ultra-bikers and ultra-runners.J. Int. Soc. Sports Nutr.,12,29.
  16. Chlíbková, D.,Knechtle, B.,Rosemann, T.,Žákovská, A.,Tomášková, I.(2014).The prevalence of exercise-associated hyponatremia in 24-h ultra-mountain bikers, 24-h ultra-runners and multistage ultra-mountain bikers in the Czech Republic.J. Int. Soc. Sports Nutr,11,3.
  17. Chlíbková, D.,Knechtle, B.,Rosemann, T.,Žákovská, A.,Tomášková, I.,Shortall, M.,Tomášková, I.(2014).Changes in foot volume, body composition, and hydration status in male and female 24-h ultra-mountain bikers.J. Int. Soc. Sports Nutr.,11,12.
  18. Chorley, J.,Cianca, J.,Divine, J.(2007).Risk factors for exerciseassociated hyponatremia in non-elite marathon runners.Clin. J. Sport Med.,17,471-477.
  19. Chung, H.M.,Kluge, R.,Schrier, R.W.,Anderson, R.J.(1987).Clinical assessment of extracellular fluid volume in hyponatremia.Am. J. Med.,83,905-908.
  20. Conley, S.B.(1990).Hypernatremia.Pediatr. Clin. North Am.,37,365-372.
  21. Feld, L.G.(ed.),Kaskel, F.J.(ed.),Frederick, J.(ed.)(2010).Fluids and Electrolytes in Pediatrics.New York:Humana Press.
  22. Goulet, E.D.B.(2011).Effect of exercise-induced dehydration on time-trial exercise performance: a meta-analysis.Brit. J. Sports Med.,45,1149-1156.
  23. Hamouti, N.,Del Coso, J.,Avila, A.,Mora-Rodrigues, R.(2010).Effects of athletes' muscle mass on urinary markers of hydration status.Eur. J. Appl. Physiol.,109,213-219.
  24. 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 regulative of arginine vasopressin during prolonged endurance exercise.J. Clin. Endocrinol. Metab.,93,2072-2078.
  25. Hew-Butler, T.D.,Ayus, J.C.,Kipps, C.,Maughan, R.J.,Mettler, S.,Meeuwisse, W.,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.
  26. Hew-Butler, T.D.,Rosner, M.H.,Fowkes-Godek, S.,Dugas, J.P.,Hoffman, M.D.,Lewis, D.P.,Maughan, R.J.,Miller, K.C.,Montain, S.J.,Rehrer, N.J.,Roberts, W.O.,Rogers, I.R.,Siegel, A.J.,Stuempfle, K.J.,Winger, J.M.,Verbalis, J.G.(2015).Statement of the third international exercise-associated hyponatremia consensus development conference, Carlsbad, California, 2015.Clin. J. Sport Med.,25,303-320.
  27. Hoffman, M.D.,Fogard, K.,Winger, J.,Hew-Butler, T.,Stuempfle, K.J.(2013).Characteristics of 161-km ultramarathon finishers developing exercise-associated hyponatremia.Res. Sports Med.,21,164-175.
  28. Hoffman, M.D.,Hew-Butler, T.,Stuempfle, K.J.(2013).Exerciseassociated hyponatremia and hydration status in 161-km ultramarathoners.Med. Sci. Sports Exerc.,45,784-791.
  29. Hoffman, M.D.,Stuempfle, K.J.(2014).Hydration strategies, weight change and performance in a 161 km ultramarathon.Res. Sports Med.,22,213-225.
  30. Hoffman, M.D.,Stuempfle, K.J.,Rogers, I.R.,Weschler, L.B.,Hew-Butler, T.(2012).Hyponatremia in the 2009 161-km Western States Endurance Run.Int. J. Sports Physiol. Perform.,7,6-10.
  31. Kao, W.F.,Shyu, C.L.,Yang, X.W.,Hsu, T.F.,Chen, J.J.,Kao, W.C.,Polun, C.,Huang, Y.J.,Kuo, F.C.,Huang, C.I.,Lee, C.H.(2008).Athletic performance and serial weight changes during 12- and 24-h ultra-marathons.Clin. J. Sports Med.,18,155-158.
  32. Kavouras, S.A.(2002).Assessing hydration status.Curr. Opin. Clin. Nutr. Metab. Care,5,519-524.
  33. King, R.F.G.J.,Cooke, S.,Carroll, S.,O'Harra, J.(2008).Estimating changes in hydration status from changes in body mass: consideration regarding metabolic water and glycogen storage.J. Sports Sci.,26,1361-1363.
  34. 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.
  35. Knechtle, B.,Enggist, A.,Jehle, T.(2005).Energy turnover at the Race Across America (RAAM) - a case report.Int. J. Sports Med.,26,499-503.
  36. Knechtle, B.,Gnädinger, M.,Knechtle, P.,Imoberdorf, R.,Kohler, G.,Ballmer, P.,Rosemann, T.,Senn, O.(2011).Prevalence of exerciseassociated hyponatremia in male ultraendurance athletes.Clin. J. Sport Med.,21,226-232.
  37. Knechtle, B.,Kiouplidis, K.,Knechtle, P.,Kohler, G.,Imoberdorf, R.,Ballmer, P.(2010).Does a multi-stage ultra-endurance run cause de-or hyperhydration?.J. Hum. Sport Exerc.,5,59-70.
  38. Knechtle, B.,Knechtle, P.,Rosemann, T.(2010).No exerciseassociated hyponatremia found in an observational field study of male ultra-marathoners participating in a 24-h ultra-run.Phys. Sportsmed.,38,94-100.
  39. Knechtle, B.,Knechtle, P.,Rosemann, T.,Senn, O.(2009).No dehydration in mountain bike ultra-marathoners.Clin. J. Sport Med.,19,415-420.
  40. Knechtle, B.,Knechtle, P.,Rűst, C.A.,Gnädinger, M.,Imoberdorf, R.,Kohler, G.,Rosemann, T.,Ballmer, P.(2012).Regulation of electrolyte and fluid metabolism in multi-stage ultra-marathoners.Horm. Metab. Res.,44,919-926.
  41. Knechtle, B.,Knechtle, P.,Wirth, A.,Rüst, C.A.,Rosemann, T.(2012).A faster running speed is associated with a greater body weight loss in 100-km ultra-marathoners.J. Sports Sci.,30,1131-1140.
  42. Knechtle, B.,Kohler, G.(2007).Running 338 kilometres within five days has no effect on body mass and body fat but reduces skeletal muscle mass - the Isarrun 2006.J. Sports Sci. Med.,6,401-407.
  43. Knechtle, B.,Morales, N.P.,Gonzáles, E.R.,Gutierrez, A.A.,Sevilla, J.N.,Gómez, R.A.,Robledo, A.R.,Rodríguez, A.L.,Fraire, O.S.,Antonie, J.L.,Lopez, L.C.,Kohler, G.,Rosemann, T.(2012).Effects of a multistage ultraendurance triathlon on aldosterone, vasopressin, extracellular water and urine electrolytes.Scott. Med. J.,57,26-32.
  44. Knechtle, B.,Senn, O.,Imoberdorf, R.,Joleska, I.,Wirth, A.,Knechtle, P.,Rosemann, T.(2010).Maintained total body water content and serum sodium concentrations despite body mass loss in female ultra-runners drinking ad libitum during a 100 km race.Asia Pac. J. Clin. Nutr.,19,83-90.
  45. Knechtle, B.,Wirth, A.,Knechtle, P.,Rosemann, T.(2009).An ultracycling race leads to no decrease in skeletal muscle mass.Int. J. Sports Med.,30,163-167.
  46. 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.
  47. Knechtle, B.,Wirth, A.,Knechtle, P.,Rosemann, T.,Senn, O.(2011).Do ultra-runners in a 24-h run really dehydrate?.Irish J. Med. Sci.,180,129-134.
  48. Kruesman, M.,Bucher, S.,Bovard, M.,Kayser, B.,Bovier, A.(2005).Nutrient intake and performance during a mountain marathon: an observational study.Eur. J. Appl. Physiol.,94,151-157.
  49. 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.
  50. Lee, J.K.W.,Nio, A.Q.X.,Ang, W.H.,Johnson, C.,Aziz, A.R.,Lim, C.L.,Hew-Butler, T.(2011).First reported cases of exercise-associated hyponatremia in Asia.Int. J. Sports Med.,32,297-302.
  51. Linderman, J.,Demchak, T.,Dallas, J.,Buckworth, J.(2003).Ultraendurance cycling: a field study of human performance during a 12-h mountain bike race.J. Exerc. Physiol. Online,6,14-23.
  52. Mahon, E.,Hackett, A.,Stott, T.,George, K.,Davies, I.(2014).An assessment of the hydration status of recreational endurance athletes during mountain marathon events.Am. J. Sports Sci.,2,77-86.
  53. Mertens, D.J.,Rhind, S.,Berkhoff, F.,Dugmore, D.,Shek, P.N.,Shephard, R.J.(1996).Nutritional, immunologic and psychological responses to a 7250 km run.J. Sports Med. Phys. Fitness,36,132-138.
  54. 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.
  55. Noakes, T.(2012).Waterlogged: The Serious Problem of Overhydration in Endurance Sports.New Zealand:Human Kinetics.
  56. 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.
  57. Nolte, H.W.,Noakes, T.D.,van Vuuren, B.(2011).Protection of total body water content and absence of hyperthermia despite 2% body mass loss ('voluntary dehydration') in soldiers drinking ad libitum during prolonged exercise in cool environmental conditions.Brit. J. Sports Med.,45,1106-1112.
  58. Opplinger, R.A.,Bartok, C.(2002).Hydration testing of athletes.Sports Med.,32,959-971.
  59. 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 ultra endurance mountain run.Clin. J. Sport Med.,17,43-48.
  60. Rico-Sanz, J.,Frontera, W.R.,Rivera, M.A.,Rivera-Brown, A.,Mole, P.A.,Meredith, C.N.(1996).Effects of hyperhydration on total body water, temperature regulation and performance of elite young soccer players in a warm climate.Int. J. Sports Med.,17,85-91.
  61. Rose, S.C.,Peters-Futre, E.M.(2010).Ad libitum adjustments to fluid intake during cool environmental conditions maintain hydration status during a 3-day mountain bike race.Brit. J. Sports Med.,44,430-436.
  62. Rosner, M.H.(2009).Exercise-associated hyponatremia.Semin. Nephrol.,29,271-281.
  63. Rosner, M.H.,Kirven, J.(2007).Exercise-associated hyponatremia.Clin. J. Am. Soc. Nephrol.,2,151-161.
  64. Rüst, C.A.,Knechtle, B.,Knechtle, P.,Rosemann, T.(2012).No case of exercise-associated hyponatraemia in top male ultra-endurance cyclists: the 'Cycling Marathon'.Eur. J. Appl. Physiol.,112,689-697.
  65. Schenk, K.,Gatterer, H.,Ferrari, M.,Ferrari, P.,Cascio, V.L.,Burtscher, M.(2010).Bike Transalp 2008: liquid intake and its effect on the body's fluid homeostasis in the course of a multistage, cross country, MTB marathon race in the central Alps.Clin. J. Sport Med.,20,47-52.
  66. Scotney, B.,Reid, S.(2015).Body weight, serum sodium levels, and renal function in an ultra-distance mountain run.Clin. J. Sport Med.,25,341-346.
  67. Shirreffs, S.M.(2003).Markers of hydration status.Eur. J. Clin. Nutr.,57,56-59.
  68. Siegel, A.J.,Verbalis, J.G.,Clement, S.,Mendelson, J.H.,Mello, N.K.,Adner, M.,Shirey, T.,Glowacki, J.,Lewandrowski, E.L.(2007).Hyponatremia in marathon runners due to inappropriate arginine vasopressin secretion.Am. J. Med.,120,11-17.
  69. Stuempfle, K.J.,Lehmann, D.R.,Case, H.S.,Bailey, S.,Hughes, S.L.,McKenzie, J.,Evans, D.(1999).Hyponatremia in ultradistance triathletes.Med. Sci. Sports Exerc.,31,809-815.
  70. Verbalis, J.G.(2003).Disorders of body water homeostasis.Best Pract. Res. Clin. Endocrinol. Metab.,17,471-503.
  71. Zouhal, H.,Groussard, C.,Minter, G.,Vincent, S.,Cretual, A.,Gratas-Delamarche, A.,Delamarche, P.,Noakes, T.D.(2011).Inverse relationship between percentage body weight change and finishing time in 643 forty-two kilometer marathon runners.Brit. J. Sports Med.,45,1101-1105.
print cancel