Shang-Lin Chou1, Ming-Yueh Chou2, Yu-Hsuan Wang3, Fon-Chu Kuo4, Wei-Fong Kao5. 1. Department of Emergency Medicine, Fooyin University Hospital, Pingtung, Taiwan, ROC. 2. Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. 3. Department of Nursing, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC. 4. Department of Computer Science and Information Management, Soochow University, Taipei, Taiwan, ROC. 5. Department of Emergency and Critical Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan, ROC; Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC. Electronic address: wfkao100a@hotmail.com.tw.
Abstract
BACKGROUND: Several changes in physiological characteristics occur during long-distance and 24-hour ultramarathons, including hyponatremia, skeletal muscle breakdown, plasma volume changes, iron depletion, anemia, and possible hepatic damage. The purpose of this study was to investigate the impact of hepatitis B virus (HBV) carrier status on liver function during multi-day races. METHODS: This prospective study recruited 10 Taiwanese runners who were scheduled to participate in the 7-day 2008 Athens Ultramarathon Festival Race, and three of them were chronic carriers of HBV. Blood samples were collected before, during, and 3 days after the race, including alkaline phosphatase (ALP), albumin (ALB), total protein (TP) levels, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (T-BIL) RESULTS: Ten Taiwanese runners (40% female; average age 52.3 ± 7.9 years) who all planned to run in the race were recruited. Three runners were chronic carriers of HBV (HBV carrier), and all participants were anti-HCV antibody-negative and anti-hepatitis A virus (HAV) IgG-positive. There were no significant time-by-group effects on ALP, ALB, and TP levels, but the change over time effects were significant (p < 0.001, p = 0.001 and p = 0.010, respectively). ALT, AST, and T-BIL increased significantly to markedly higher levels in the HBV carrier group compared to the non-carrier group (group effect p = 0.009, p = 0.004, and p = 0.05, respectively), and the time-by-group interaction was also significant for these liver function markers (p < 0.001, p < 0.001, and p = 0.001, respectively). CONCLUSION: Compared to their counterparts, runners who are HBV carriers had significantly greater increases in levels of ALT, AST, and T-BIL during a 7-day ultramarathon, indicating that the liver function of carriers is more highly impacted in these races.
BACKGROUND: Several changes in physiological characteristics occur during long-distance and 24-hour ultramarathons, including hyponatremia, skeletal muscle breakdown, plasma volume changes, iron depletion, anemia, and possible hepatic damage. The purpose of this study was to investigate the impact of hepatitis B virus (HBV) carrier status on liver function during multi-day races. METHODS: This prospective study recruited 10 Taiwanese runners who were scheduled to participate in the 7-day 2008 Athens Ultramarathon Festival Race, and three of them were chronic carriers of HBV. Blood samples were collected before, during, and 3 days after the race, including alkaline phosphatase (ALP), albumin (ALB), total protein (TP) levels, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (T-BIL) RESULTS: Ten Taiwanese runners (40% female; average age 52.3 ± 7.9 years) who all planned to run in the race were recruited. Three runners were chronic carriers of HBV (HBV carrier), and all participants were anti-HCV antibody-negative and anti-hepatitis A virus (HAV) IgG-positive. There were no significant time-by-group effects on ALP, ALB, and TP levels, but the change over time effects were significant (p < 0.001, p = 0.001 and p = 0.010, respectively). ALT, AST, and T-BIL increased significantly to markedly higher levels in the HBV carrier group compared to the non-carrier group (group effect p = 0.009, p = 0.004, and p = 0.05, respectively), and the time-by-group interaction was also significant for these liver function markers (p < 0.001, p < 0.001, and p = 0.001, respectively). CONCLUSION: Compared to their counterparts, runners who are HBV carriers had significantly greater increases in levels of ALT, AST, and T-BIL during a 7-day ultramarathon, indicating that the liver function of carriers is more highly impacted in these races.