The DOI matches its Crossref record; 40 of the 41 references it cites were found in a registry or an index.
Incidence of Exercise-Associated Hyponatremia and Its Association With Nonosmotic Stimuli of Arginine Vasopressin in the GNW100s Ultra-endurance Marathon
Abstract
OBJECTIVES: (1) To examine the incidence of exercise-associated hyponatremia (EAH) during and after an ultramarathon and (2) to evaluate hypothesized nonosmotic stimuli [interleukin-6 (IL-6), hypoglycemia, ambient temperature] with arginine vasopressin (AVP) concentrations in hyponatremic versus normonatremic runners. DESIGN: Prospective cohort study. SETTING: The Great North Walk 100s ultramarathons. PARTICIPANTS: Fifteen runners participated in either 103.7- or 173.7-km ultramarathons. MAIN OUTCOME MEASURES: Serum sodium concentration ([Na]) and AVP concentration. Secondary outcome measures included IL-6, blood glucose, ambient temperature, weight change, fluid consumption, and use of nonsteroidal anti-inflammatory drugs (NSAIDs). RESULTS: Postrace EAH incidence was 4 of 15 runners, whereas EAH incidence at any point during the race was in 10 of 15 runners. A significant positive correlation was noted between AVP and IL-6 (r = 0.31, P < 0.05) but not between AVP and blood glucose (r = 0.09, nonsignificant) or ambient temperature (r = -0.12, NS). Subgroup analysis revealed that the correlation between AVP and IL-6 was significant in hyponatremic (r = 0.37, P < 0.05) but not normonatremic runners (r = 0.31, NS). Hyponatremic runners lost less weight than normonatremic runners (2.5 vs. 3.7 kg, P < 0.05, respectively) despite similar fluid consumption. Seven of 10 hyponatremic runners consumed NSAIDs versus 0 of 5 normonatremic runners. CONCLUSIONS: Exercise-associated hyponatremia incidence mid-race is higher than postrace, suggesting that 40% of runners are able to self-correct low serum [Na] status during an ultramarathon. Interleukin-6 seems to be the main nonosmotic stimulus associated with AVP in hyponatremic runners. Nonsteroidal anti-inflammatory ingestion is more common in hyponatremic versus normonatremic runners. CLINICAL RELEVANCE: Exercise-associated hyponatremia associated with nonosmotic AVP secretion may be more common during ultramarathon races without discriminatory clinical symptomatology.
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“which in some endurance and ultra-endurance competitions has affected as many as 30% of the participants [12].”
From Nutrition-Related Adverse Outcomes in Endurance Sports Competitions: A Review of Incidence and Practical Recommendations (2020) · cites this paper as [12]
In the citing paper
“However, the signs and symptoms of EAH are nonspecific and can be superimposed on or confused with those of other diseases such as EHS, GI symptoms, and hypoglycemia, which are also frequent in these types of event.”
From Nutrition-Related Adverse Outcomes in Endurance Sports Competitions: A Review of Incidence and Practical Recommendations (2020) · cites this paper as [12]
In the citing paper
“The risk factors that have been identified regarding the development of EAH include: female sex, alcohol consumption, excess of fluid replacement, weight gain during exercise, low body weight, slow running performance and inexperience in endurance events [12].”
From Nutrition-Related Adverse Outcomes in Endurance Sports Competitions: A Review of Incidence and Practical Recommendations (2020) · cites this paper as [12]
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Périard, J. D., Eijsvogels, T. M. H., & Daanen, H. A. M. (2021) · Physiological Reviews · doi:10.1152/physrev.00038.2020 · Cited by 774
Physiology and Pathophysiology in Ultra-Marathon Running
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Self-citationHew‐Butler, T., Rosner, M. H., Godek, S. F., Dugas, J. P., Hoffman, M. D., Lewis, D. P., Maughan, R. J., Miller, K. C., Montain, S. J., Rehrer, N. J., et al. (2015) · British Journal of Sports Medicine · doi:10.1136/bjsports-2015-095004 · Cited by 129
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Metadata
- Authors
- Cairns, R. S., & Hew-Butler, T.
- Affiliations
- Oakland University (US)
- Corresponding author
- Cairns, Ross S.
- Venue
- Clinical Journal of Sport Medicine
- Published
- 2015-07
- Volume
- 25
- Issue
- 4
- Pages
- 347-354
- ISSN
- 1050-642X (ISSN-L)
- OpenAlex
- W2320619157
- Cited by
- 37
- References
- 41
- Citations by year
- 2025: 1 · 2024: 2 · 2022: 3 · 2021: 3 · 2020: 4 · 2019: 9 · 2018: 3 · 2017: 4 · 2016: 3 · 2015: 5
- FWCI
- 3.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Journal of Sport Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Electrolyte and hormonal disorders
- Health Sciences › Medicine › Physiology (medical) › Thermoregulation and physiological responses
- Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
- Keywords
- exercise-associated hyponatremia, vasopressin, interleukin-6, ultramarathon, marathon runners, serum sodium, hypoglycemia, ambient temperature, weight loss, NSAID use, fluid intake
- MeSH terms
- Adult, Anti-Inflammatory Agents, Non-Steroidal, Arginine Vasopressin, Blood Glucose, Body Weight, Drinking Behavior, Humans, Hypoglycemia, Hyponatremia, Middle Aged, Prospective Studies, Risk Factors, Running, Sodium, Temperature, Cohort Studies, Interleukin-6, Incidence, Linear Models
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