Influence of a 100-km Ultra-Marathon on Hepatitis B Carrier Runners

Y.-H. Chiu; S.-K. Hou; C.-K. How; L.-H. Li; W.-F. Kao; C.-C. Yang; S.-L. Chou; Y.-T. S. Shiau; C. Lam; R.-J. Chen

doi:10.1055/s-0032-1331769

International Journal of Sports Medicine, Table of Contents

Int J Sports Med 2013; 34(09): 841-845
DOI: 10.1055/s-0032-1331769

Clinical Sciences

Influence of a 100-km Ultra-Marathon on Hepatitis B Carrier Runners

Y.-H. Chiu

¹Department of Emergency Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

²Institute of Environmental and Occupational Health Sciences, National Yang-Ming University School of Medicine, Taipei, Taiwan

,

S.-K. Hou

²Institute of Environmental and Occupational Health Sciences, National Yang-Ming University School of Medicine, Taipei, Taiwan

³Department of Emergency & Critical Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan

,

C.-K. How

⁴Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan

,

L.-H. Li

⁵Institute of Biophotonics, National Yang-Ming University School of Medicine, Taipei, Taiwan

,

W.-F. Kao

²Institute of Environmental and Occupational Health Sciences, National Yang-Ming University School of Medicine, Taipei, Taiwan

³Department of Emergency & Critical Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan

,

C.-C. Yang

²Institute of Environmental and Occupational Health Sciences, National Yang-Ming University School of Medicine, Taipei, Taiwan

,

S.-L. Chou

⁶Institute of Emergency and Critical Care, National Yang-Ming University, School of Medicine, Taipei, Taiwan

,

Y.-T. S. Shiau

⁴Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan

,

C. Lam

¹Department of Emergency Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

,

R.-J. Chen

¹Department of Emergency Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

› Author Affiliations

Abstract

This study compares the serological markers between runners who are hepatitis B virus carries (HBVc) and runners who are non-HBVc in a 100-km ultra-marathon race. Blood samples of 8 HBVc and 18 non-HBVc runners were drawn 1 week before, immediately following, and 24 h after the race. Samples were analyzed and compared between the 2 groups for liver function tests, muscle damage markers and oxidative stress cytokines. For HBVc runners, HBV-DNA (hepatitis B virus-deoxyribonucleic acid) levels were also evaluated for virus reactivation. The results demonstrate a statistically significant increase in both immediate and 24-h post-race values for alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), compared with pre-race values. No statistically significant difference was observed between the 2 groups for the values of AST, LDH, CK, hs-CRP, IL-6 and TNF-α either before or after the race. There was also no statistically significant change in the levels of HBV-DNA in HBVc runners. These findings suggest that HBVc runners do not have higher risks of liver function impairment, muscle breakdown and inflammatory response compared to non-HBVc runners in such endurance races.

Key words

clinical sports medicine - hepatitis B virus carrier runner - liver function impairment - inflammatory response - ultra-marathon

Full Text

References

References
1 Asplund CA, O’Connor FG, Noakes TD. Exercise-associated collapse: an evidence-based review and primer for clinicians. Br J Sports Med 2011; 45: 1157-1162
2 Bernecker C, Scherr J, Schinner S, Braun S, Scherbaum WA, Halle M. Evidence for an exercise induced increase of TNF-α and IL-6 in marathon runners. Scand J Med Sci Sports 2011; [Epub ahead of print]
3 Chu CJ, Hussain M, Lok AS. Quantitative serum HBV DNA levels during different stages of chronic hepatitis B infection. Hepatology 2002; 36: 1408-1415
4 Clarkson PM. Exertional rhabdomyolysis and acute renal failure in marathon runners. Sports Med 2007; 37: 361-363
5 Fallon KE, Sivyer G, Sivyer K, Dare A. The biochemistry of runners in a 1600 km ultramarathon. Br J Sports Med. 1999 33. 264-269
6 Fischer CP. Interleukin-6 in acute exercise and training: what is the biological relevance?. Exerc Immunol Rev 2006; 12: 6-33
7 Harriss DJ, Atkinson G. Update – ethical standards in sport and exercise science research. Int J Sports Med 2011; 32: 819-821
8 Hoofnagle JH. Reactivation of hepatitis B. Hepatology 2009; 49: S156-S165
9 Hou J, Liu Z, Gu F. Epidemiology and prevention of hepatitis B virus infection. Int J Med Sci 2005; 2: 50-57
10 Kao WF, Shyu CL, Yang XW, Hsu TF, Chen JJ, Kao WC, Polun-Chang, Huang YJ, Kuo FC, Huang CI, Lee CH. Athletic performance and serial weight changes during 12- and 24-hour ultra-marathons. Clin J Sport Med 2008; 18: 155-158
11 Kipps C, Sharma S, Pedoe DT. The incidence of exercise-associated hyponatraemia in the London marathon. Br J Sports Med 2011; 45: 14-19
12 Knechtle B, Gnädinger M, Knechtle P, Imoberdorf R, Kohler G, Ballmer P, Rosemann T, Senn O. Prevalence of exercise-associated hyponatremia in male ultraendurance athletes. Clin J Sport Med 2011; 21: 226-232
13 Kratz A, Lewandrowski KB, Siegel AJ, Chun KY, Flood JG, Van Cott EM, Lee-Lewandrowski E. Effect of marathon running on hematologic and biochemical laboratory parameters, including cardiac markers. Am J Clin Pathol 2002; 118: 856-863
14 Lippi G, Schena F, Montagnana M, Salvagno GL, Banfi G, Guidi GC. Significant variation of traditional markers of liver injury after a half-marathon run. Eur J Intern Med 2011; 22: e36-e38
15 Liu CJ, Chen PJ, Lai MY, Kao JH, Chang CF, Wu HL, Shau WY, Chen DS. A prospective study characterizing full-length hepatitis B virus genomes during acute exacerbation. Gastroenterology 2003; 124: 80-90
16 Lok AS, McMahon BJ. Chronic hepatitis B. Hepatology 2007; 45: 507-539
17 McGarvey J, Thompson J, Hanna C, Noakes TD, Stewart J, Speedy D. Sensitivity and specificity of clinical signs for assessment of dehydration in endurance athletes. Br J Sports Med 2010; 44: 716-719
18 Meyering C, Howard T. Hypercoagulability in athletes. Curr Sports Med Rep 2004; 3: 77-83
19 Nagel D, Seiler D, Franz H, Jung K. Ultra-long-distance running and the liver. Int J Sports Med 1990; 11: 441-445
20 Nieman DC. Marathon training and immune function. Sports Med 2007; 37: 412-415
21 Nieman DC, Dumke CI, Henson DA, McAnulty SR, McAnulty LS, Lind RH, Morrow JD. Immune and oxidative changes during and following the Western States Endurance Run. Int J Sports Med 2003; 24: 541-547
22 Roberts WO. Exertional heat stroke in the marathon. Sports Med 2007; 37: 440-443
23 Siegel AJ, Januzzi J, Sluss P, Lee-Lewandrowski E, Wood M, Shirey T, Lewandrowski KB. Cardiac biomarkers, electrolytes, and other analytes in collapsed marathon runners: implications for the evaluation of runners following competition. Am J Clin Pathol 2008; 129: 948-951
24 Smith JE, Garbutt G, Lopes P, Pedoe DT. Effects of prolonged strenuous exercise (marathon running) on biochemical and haematological markers used in the investigation of patients in the emergency department. Br J Sports Med 2004; 38: 292-294
25 Tunstall Pedoe DS. Marathon cardiac deaths: the London experience. Sports Med 2007; 37: 448-450
26 Waśkiewicz Z, Kłapcińska B, Sadowska-Krępa E, Czuba M, Kempa K, Kimsa E, Gerasimuk D. Acute metabolic responses to a 24-h ultra-marathon race in male amateur runners. Eur J Appl Physiol 2012; 112: 1679-1688
27 Yim HJ, Lok AS. Natural history of chronic hepatitis B virus infection: what we knew in 1981 and what we know in 2005. Hepatology. 2006 43. S173-S181