Meeusen R, Piacentini M F, Busschaert B, Buyse L, De Schutter G, Stray-Gundersen J
Department of Human Physiology and Sportsmedicine, Free University of Brussels, Pleinlaan 2, 1050, Brussels, Belgium.
Eur J Appl Physiol. 2004 Mar;91(2-3):140-6. doi: 10.1007/s00421-003-0940-1. Epub 2003 Oct 2.
In overtrained athletes, several signs and symptoms have been associated with the imbalance between training and recovery. However, reliable diagnostic markers for distinguishing between well-trained, overreached (OR) and overtrained (OT) athletes are lacking. A hallmark feature of overtraining syndrome (OTS) is the inability to sustain intense exercise and recover for the next training or competition session. We therefore devised a test protocol utilizing two bouts of maximal work. With this test protocol we tried to establish a difference in hormonal responses between the training status of T and OR athletes. Seven well-trained cyclists participated in this study and were tested before and after a training camp. We also present the data of one OT motocross athlete who was clinically diagnosed as overtrained. All athletes performed two maximal exercise tests separated by 4 h. Blood was analyzed for cortisol, adrenocorticotrophic hormone (ACTH), growth hormone and prolactin (PRL). Performance decreased by 6% between the first and the second exercise test in the OR group and by 11% in the OT subject. Moreover, during the second exercise test there were more marked differences between the T and OR athletes; in particular, the OT subject did not show an increase in some of the hormonal responses. PRL increased only by 14% in the OT subject's second test and there was a 7% decrease in ACTH. The two exercise approach enables us to detect subtle performance decrements that will not be identified by one exercise trigger. The hormonal responses to the second exercise test were different between the T and OR athletes (the increase in the T group was higher than in the OR that was higher than in the OT). The results of the case presentation of an overtrained athlete provide evidence of an altered and dysfunctional hypothalamic-pituitary axis response to two bouts of maximal exercise. These findings can be used to develop markers for diagnosis of OTS and to begin to address the pathologic mechanism operative in the syndrome, as well as providing an outcome measure to evaluate possible therapeutic regimes.
在过度训练的运动员中，多种体征和症状与训练和恢复之间的失衡有关。然而，目前缺乏可靠的诊断标志物来区分训练有素、过度疲劳（OR）和过度训练（OT）的运动员。过度训练综合征（OTS）的一个标志性特征是无法维持高强度运动并为下一次训练或比赛进行恢复。因此，我们设计了一个测试方案，利用两次最大负荷运动。通过这个测试方案，我们试图确定训练状态为T和OR的运动员在激素反应上的差异。七名训练有素的自行车运动员参与了这项研究，并在训练营前后接受了测试。我们还展示了一名临床诊断为过度训练的OT摩托车越野运动员的数据。所有运动员都进行了两次间隔4小时的最大运动测试。对血液中的皮质醇、促肾上腺皮质激素（ACTH）、生长激素和催乳素（PRL）进行了分析。在OR组中，第一次和第二次运动测试之间的表现下降了6%，在OT受试者中下降了11%。此外，在第二次运动测试期间，T组和OR组运动员之间的差异更为明显；特别是，OT受试者的一些激素反应没有增加。在OT受试者的第二次测试中，PRL仅增加了14%，ACTH下降了7%。两次运动的方法使我们能够检测到单次运动触发无法识别的细微表现下降。T组和OR组运动员对第二次运动测试的激素反应不同（T组的增加高于OR组，OR组高于OT组）。一名过度训练运动员的病例展示结果提供了证据，表明下丘脑-垂体轴对两次最大运动的反应发生了改变且功能失调。这些发现可用于开发OTS诊断标志物，开始探讨该综合征中起作用的病理机制，并提供一种结果测量方法来评估可能的治疗方案。
