Institute of Respiratory Medicine and Exercise Physiology, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA.
Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ.
Med Sci Sports Exerc. 2022 Oct 1;54(10):1647-1656. doi: 10.1249/MSS.0000000000002962. Epub 2022 Jun 11.
Despite a growing body of literature on the physiological responses to ultramarathon, there is a paucity of data in females. This study assessed the female physiological response to ultramarathon and compared the frequency of perturbations to a group of race- and time-matched males.
Data were collected from 53 contestants of an ultramarathon trail race at the Ultra-Trail du Mont-Blanc (UTMB®) in 2018/19. Before and within 2 h of the finish, participants underwent physiological assessments, including blood sampling for biomarkers (creatine kinase-MB isoenzyme [CK-MB], cardiac troponin I [cTnI], brain natriuretic peptide [BNP], and creatinine [Cr]), pulmonary function testing (spirometry, exhaled NO, diffusing capacities, and mouth pressures), and transthoracic ultrasound (lung comet tails, cardiac function). Data from eight female finishers (age = 36.6 ± 6.9 yr; finish time = 30:57 ± 11:36 h:min) were compared with a group of eight time-matched males (age = 40.3 ± 8.3 yr; finish time = 30:46 ± 10:32 h:min).
Females exhibited significant pre- to postrace increases in BNP (25.8 ± 14.6 vs 140.9 ± 102.7 pg·mL -1 ; P = 0.007) and CK-MB (3.3 ± 2.4 vs 74.6 ± 49.6 IU·L -1 ; P = 0.005), whereas males exhibited significant pre- to postrace increases in BNP (26.6 ± 17.5 vs 96.4 ± 51.9 pg·mL -1 ; P = 0.002), CK-MB (7.2 ± 3.9 vs 108.8 ± 37.4 IU·L -1 ; P = 0.002), and Cr (1.06 ± 0.19 vs 1.23 ± 0.24 mg·dL -1 ; P = 0.028). Lung function declined in both groups, but males exhibited additional reductions in lung diffusing capacities (DL CO = 34.4 ± 5.7 vs 29.2 ± 6.9 mL⋅min -1 ⋅mm Hg -1 , P = 0.004; DL NO = 179.1 ± 26.2 vs 152.8 ± 33.4 mL⋅min -1 ⋅mm Hg -1 , P = 0.002) and pulmonary capillary blood volumes (77.4 ± 16.7 vs 57.3 ± 16.1 mL; P = 0.002). Males, but not females, exhibited evidence of mild postrace pulmonary edema. Pooled effect sizes for within-group pre- to postrace changes, for all variables, were generally larger in males versus females ( d = 0.86 vs 0.63).
Ultramarathon negatively affects a range of physiological functions but generally evokes more frequent perturbations, with larger effect sizes, in males compared to females with similar race performances.
尽管有越来越多的文献研究了超长马拉松比赛中的生理反应，但女性的数据仍然很少。本研究评估了女性在超长马拉松比赛中的生理反应，并将她们的生理反应与一组性别和时间匹配的男性进行了比较。
2018/19 年，在 UTMB®超长马拉松比赛中，收集了 53 名参赛选手的数据。在比赛前和完赛后 2 小时内，参与者接受了生理评估，包括血液采样以测量生物标志物（肌酸激酶同工酶 MB 型 [CK-MB]、心肌肌钙蛋白 I [cTnI]、脑钠肽 [BNP]和肌酐 [Cr]）、肺功能测试（肺活量测定、呼出气一氧化氮、弥散能力和口腔压力）和经胸超声（肺彗星尾、心功能）。将 8 名完赛女性（年龄 = 36.6 ± 6.9 岁；完赛时间 = 30:57 ± 11:36 小时：分钟）的数据与 8 名性别和时间匹配的男性（年龄 = 40.3 ± 8.3 岁；完赛时间 = 30:46 ± 10:32 小时：分钟）进行了比较。
女性在赛前到赛后的 BNP（25.8 ± 14.6 与 140.9 ± 102.7 pg·mL -1 ；P = 0.007）和 CK-MB（3.3 ± 2.4 与 74.6 ± 49.6 IU·L -1 ；P = 0.005）方面均出现显著的升高，而男性在赛前到赛后的 BNP（26.6 ± 17.5 与 96.4 ± 51.9 pg·mL -1 ；P = 0.002）、CK-MB（7.2 ± 3.9 与 108.8 ± 37.4 IU·L -1 ；P = 0.002）和 Cr（1.06 ± 0.19 与 1.23 ± 0.24 mg·dL -1 ；P = 0.028）方面均出现显著的升高。两组肺功能均下降，但男性在肺弥散能力（DL CO = 34.4 ± 5.7 与 29.2 ± 6.9 mL·min -1 ⋅mm Hg -1 ；P = 0.004；DL NO = 179.1 ± 26.2 与 152.8 ± 33.4 mL·min -1 ⋅mm Hg -1 ；P = 0.002）和肺毛细血管血容量（77.4 ± 16.7 与 57.3 ± 16.1 mL；P = 0.002）方面也出现了额外的下降。男性表现出轻度赛后肺水肿的迹象，但女性则没有。所有变量的组内赛前到赛后变化的合并效应大小，男性一般比女性更大（ d = 0.86 比 0.63）。
超长马拉松比赛对一系列生理功能产生负面影响，但与性别和时间匹配的男性相比，女性的生理反应通常更频繁，效应大小更大。
