Mountain Ultramarathon Induces Early Increases of Muscle Damage, Inflammation, and Risk for Acute Renal Injury

Author(s)

Belli, Taisa ^[1] ; Macedo, Denise Vaz ^[2] ; de Araujo, Gustavo Gomes ^[1] ; Masselli dos Reis, Ivan Gustavo ^[1] ; Menezes Scariot, Pedro Paulo ^[1] ; Lazarim, Fernanda Lorenzi ^[2] ; Soares Nunes, Lazaro Alessandro ^[2] ; Brenzikofer, Rene ^[3] ; Gobatto, Claudio Alexandre ^[1]

Affiliation

^[1] Univ Estadual Campinas, Sch Appl Sci, Lab Appl Sport Physiol LAFAE, Limeira - Brazil

^[2] Univ Estadual Campinas, Biol Inst, Biochem Dept, Lab Exercise Biochem LABEX, Campinas, SP - Brazil

^[3] Univ Estadual Campinas, Fac Phys Educ, LIB, Campinas, SP - Brazil

• Document type: Journal article
• Source: FRONTIERS IN PHYSIOLOGY; v. 9, OCT 8 2018.
• Web of Science Citations: 3

Abstract

Purpose: This study aimed to investigate changes in muscle damage during the course of a 217-km mountain ultramarathon (MUM). In an integrative perspective, inflammatory response and renal function were also studied. Methods: Six male ultra-runners were tested four times: pre-race, at 84 km, at 177 km, and immediately after the race. Blood samples were analyzed for serum muscle enzymes, acute-phase protein, cortisol, and renal function biomarkers. Results: Serum creatine kinase (CK), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) increased significantly throughout the race (P < 0.001, P < 0.001; P = 0.002, respectively), and effect size (ES) denoted a large magnitude of muscle damage. These enzymes increased from pre-race (132 +/- 18, 371 +/- 66, and 28 +/- 3 U/L, respectively) to 84 km (30, 1.8, and 3.9-fold, respectively); further increased from 84 to 177 km (4.6, 2.9, and 6.1-fold, respectively), followed by a stable phase until the finish line. Regarding the inflammatory response, significant differences were found for C-reactive protein (CRP) (P < 0.001) and cortisol (P < 0.001). CRP increased from pre-race (0.9 +/- 0.3 mg/L) to 177 km (243-fold), cortisol increased from pre-race (257 +/- 30 mmol/L) to the 84 km (2.9-fold), and both remained augmented until the finish line. Significant changes were observed for creatinine (P = 0.03), urea (P = 0.001), and glomerular filtration rate (GFR) (P < 0.001), and ES confirmed a moderate magnitude of changes in renal function biomarkers. Creatinine and urea increased, and GFR decreased from pre-race (1.00 +/- 0.03 mg/dL, 33 +/- 6 mg/dL, and 89 +/- 5 ml/min/1.73 m(2), respectively) to 84 km (1.3, 3.5, and 0.7-fold, respectively), followed by a plateau phase until the finish line. Conclusion: This study shows evidence that muscle damage biomarkers presented early peak levels and they were followed by a plateau phase during the last segment of a 217-km MUM. The acute-phase response had a similar change of muscle damage. In addition, our data showed that our volunteers meet the risk criteria for acute kidney injury from 84 km until they finished the race, without demonstrating any clinical symptomatology. (AU)

• FAPESP's process: 09/08535-5 - Standardization and validity of aerobic and anaerobic tests in field and laboratory, using free, tethered and half-tethered running, in endurance and sprint runners
• Grantee: Claudio Alexandre Gobatto
• Support Opportunities: Regular Research Grants
• FAPESP's process: 16/50250-1 - The secret of playing football: Brazil versus the Netherlands
• Grantee: Sergio Augusto Cunha
• Support Opportunities: Research Projects - Thematic Grants