Schlader Zachary J, Chapman Christopher L, Sarker Suman, Russo Lindsey, Rideout Todd C, Parker Mark D, Johnson Blair D, Hostler David
1Department of Exercise and Nutrition Sciences, Center for Research and Education in Special Environments, University at Buffalo, Buffalo, NY; and 2Department of Physiology and Biophysics, University at Buffalo, Buffalo, NY.
Med Sci Sports Exerc. 2017 Aug;49(8):1745-1753. doi: 10.1249/MSS.0000000000001254.
We tested the hypothesis that elevations in biomarkers of acute kidney injury are influenced by the magnitude of hyperthermia and dehydration elicited by two common firefighter work durations.
Twenty-nine healthy adults (10 females) wearing firefighter protective clothing completed two randomized trials where they walked at 4.8 km·h, 5% grade in a 38°C, 50% RH environment. In the short trial, subjects completed two 20-min exercise bouts. In the long trial (LONG), subjects completed three 20-min exercise bouts. Each exercise bout was separated by 10 min of standing rest in an ~20°C environment. Venous blood samples were obtained before and immediately after exercise, and after 1 h recovery. Dependent variables included changes in core temperature, body weight, plasma volume, serum creatinine, and plasma neutrophil gelatinase-associated lipocalin, a marker of renal tubule injury.
Changes in core temperature (+2.0°C ± 0.7°C vs +1.1°C ± 0.4°C, P < 0.01), body weight (-0.9% ± 0.6% vs -0.5% ± 0.5%, P < 0.01), and plasma volume (-11% ± 5% vs -8% ± 6%, P < 0.01) during exercise were greater in LONG. Increases in creatinine were higher in LONG postexercise (0.18 ± 0.15 vs 0.08 ± 0.07 mg·dL, P < 0.01) and after recovery (0.21 ± 0.16 vs 0.14 ± 0.10 mg·dL, P < 0.01). Increases in neutrophil gelatinase-associated lipocalin were greater in LONG postexercise (27.0 ± 20.5 vs 12.7 ± 18.0 ng·mL, P = 0.01) and after recovery (16.9 ± 15.6 vs 1.5 ± 15.1 ng·mL, P = 0.02).
Biomarkers of acute kidney injury are influenced by the magnitude of hyperthermia and hypovolemia elicited by exercise in the heat.
我们检验了这样一种假设，即急性肾损伤生物标志物的升高受两种常见消防员工作时长所引发的高温及脱水程度的影响。
29名身着消防员防护服的健康成年人（10名女性）完成了两项随机试验，他们在38°C、相对湿度50%的环境中以4.8千米/小时、坡度5%的速度行走。在短时间试验中，受试者完成两组20分钟的运动回合。在长时间试验中，受试者完成三组20分钟的运动回合。每个运动回合之间在约20°C的环境中站立休息10分钟。在运动前、运动后即刻以及恢复1小时后采集静脉血样。因变量包括核心体温、体重、血浆量、血清肌酐以及血浆中性粒细胞明胶酶相关脂质运载蛋白（一种肾小管损伤标志物）的变化。
长时间试验中运动期间核心体温的变化（+2.0°C±0.7°C对+1.1°C±0.4°C，P<0.01）、体重的变化（-0.9%±0.6%对-0.5%±0.5%，P<0.01）以及血浆量的变化（-11%±5%对-8%±6%，P<0.01）更大。长时间试验运动后肌酐的升高更高（0.18±0.15对0.08±0.07毫克/分升，P<0.01）以及恢复后（0.21±0.16对0.14±0.10毫克/分升，P<0.01）。长时间试验运动后中性粒细胞明胶酶相关脂质运载蛋白的升高更大（27.0±20.5对12.7±18.0纳克/毫升，P = 0.01）以及恢复后（16.9±15.6对1.5±15.1纳克/毫升，P = 0.02）。
急性肾损伤的生物标志物受高温环境下运动所引发的高温及血容量减少程度的影响。
