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Journal of the International Society of Sports Nutrition

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Open Access 01-12-2014 | Research article

The prevalence of exercise-associated hyponatremia in 24-hour ultra-mountain bikers, 24-hour ultra-runners and multi-stage ultra-mountain bikers in the Czech Republic

Authors: Daniela Chlíbková, Beat Knechtle, Thomas Rosemann, Alena Žákovská, Ivana Tomášková

Published in: Journal of the International Society of Sports Nutrition | Issue 1/2014

Abstract

Background

To assess the prevalence of exercise-associated hyponatremia (EAH) in two 24-hour mountain bike (MTB) (R1,R2), one 24-hour running (R3) and one multi-stage MTB (R4) races held in the Czech Republic in a cluster of four cross-sectional studies.

Methods

In 27 ultra-mountain bikers (ultra-MTBers), 12 ultra-runners, and 14 multi-stage MTBers, fluid intake, changes (Δ) in body mass, hematocrit, plasma volume, plasma [Na⁺], plasma [K⁺], plasma osmolality, urine [Na⁺], urine [K⁺], urine specific gravity, urine osmolality, K⁺/Na⁺ ratio in urine, transtubular potassium gradient and glomerular filtration rate were measured and calculated. The use of non-steroidal anti-inflammatory drugs and symptoms of EAH were recorded using post-race questionnaires.

Results

Of the 53 finishers, three (5.7%) developed post-race EAH, thereof one (3.7%) ultra-MTBer, one (8.3%) ultra-runner and one (7.1%) multi-stage MTBer. Plasma [Na⁺] decreased significantly (p < 0.001) only in R4. Urine osmolality (R1, R3, R4 p < 0.001; R2 p < 0.05) and glomerular filtration rate (p < 0.001) increased, and body mass decreased in all races (p < 0.05). Δ body mass was inversely related to the number of kilometers achieved (p < 0.001) in R2 where better ultra-MTBers tended to lose more weight. Δ body mass (p < 0.001) and %Δ body mass (p = 0.05) were positively related to lower post-race plasma [Na⁺] in R3 that was associated with increased loss in body mass. Fluid intake was positively related to race performance in R1 and R2 (R1: p = 0.04; R2: p = 0.01) where ultra-MTBers in R1 and R2 who drank more finished ahead of those who drank less. Post-race plasma [Na⁺] was negatively associated with race performance in ultra-MTBers in R2 (p < 0.05), similarly ultra-runners in R3 (p < 0.05) where finishers with more kilometres had lower post-race plasma [Na⁺].

Conclusions

The prevalence of EAH in the Czech Republic was no higher compared to existing reports on ultra-endurance athletes in other countries. Lower plasma [Na⁺] and development of EAH may be attributed to overdrinking, a pituitary secretion of vasopressin, an impaired mobilization of osmotically inactive sodium stores, and/or an inappropriate inactivation of osmotically active sodium.

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Title: The prevalence of exercise-associated hyponatremia in 24-hour ultra-mountain bikers, 24-hour ultra-runners and multi-stage ultra-mountain bikers in the Czech Republic
Authors: Daniela Chlíbková
Beat Knechtle
Thomas Rosemann
Alena Žákovská
Ivana Tomášková
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Journal of the International Society of Sports Nutrition / Issue 1/2014
Electronic ISSN: 1550-2783
DOI: https://doi.org/10.1186/1550-2783-11-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The prevalence of exercise-associated hyponatremia in 24-hour ultra-mountain bikers, 24-hour ultra-runners and multi-stage ultra-mountain bikers in the Czech Republic

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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