title: The impact of chronic carrier of hepatitis B virus on liver function in a 7-day ultramarathon race.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Emergency Medicine, Fooyin University Hospital, Pingtung, Taiwan, ROC.
authors.forename: Shang-Lin
authors.initials: SL
authors.lastname: Chou
authors.affiliation: Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Ming-Yueh
authors.initials: MY
authors.lastname: Chou
authors.affiliation: Department of Nursing, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
authors.forename: Yu-Hsuan
authors.initials: YH
authors.lastname: Wang
authors.affiliation: Department of Computer Science and Information Management, Soochow University, Taipei, Taiwan, ROC.
authors.forename: Fon-Chu
authors.initials: FC
authors.lastname: Kuo
authors.affiliation: 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.
authors.forename: Wei-Fong
authors.initials: WF
authors.lastname: Kao
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002353:Carrier State / Q000503:physiopathology*; D005260:Female; D019694:Hepatitis B, Chronic / Q000097:blood / Q000503:physiopathology*; D006801:Humans; D008099:Liver / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012420:Running / Q000502:physiology*
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin
keywords: 7-day races; hepatitis B virus (HBV); liver function; ultramarathon