scholarly journals SAT-LB4 Novel Hormonal and Metabolic Markers of Recovery From Overtraining Syndrome Unveiled by the Longitudinal ARM of the Eros Study - the Eros-Longitudinal Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Flavio Cadegiani ◽  
Pedro Luiz H da Silva ◽  
Tatiana P C Abrao ◽  
Claudio E Kater
Keyword(s):  
Caloric Intake ◽  
Tolerance Test ◽  
Hydration Status ◽  
Cortisol Awakening Response ◽  
Hormonal Responses ◽  
Metabolic Markers ◽  
Urinary Catecholamines ◽  
Overtraining Syndrome ◽  
Insulin Tolerance ◽  
Inadequate Sleep

Abstract Background: Overtraining Syndrome (OTS) is an unexplained underperformance syndrome triggered by excessive training, insufficient caloric intake, inadequate sleep, and excessive cognitive and social demands. Investigations of markers of the challenging recovery from OTS have not been reported to date. The objective of the present study is to describe novel markers, and biochemical and clinical behaviors during the restoration process of OTS.Design: A 12-week interventional protocol in 12 athletes affected by OTS was conducted, including increased food intake, transitory interruption of the trainings, improvement of sleep quality, and management of stress.Methods: We assessed 50 parameters, including hormonal responses to an insulin tolerance test (ITT), basal hormonal and non-hormonal biochemical markers, body metabolism and composition. Results: In response to an ITT, early cortisol (p = 0.026), early GH (p = 0.004), and late GH (p = 0.037) improved significantly. Basal estradiol (p = 0.0002) and nocturnal urinary catecholamines, (p = 0.043) reduced, while testosterone (p = 0.014), testosterone:estradiol (T:E) ratio (p = 0.0005), freeT3 (p = 0.043), IGF-1 (p = 0.003), and cortisol awakening response (CAR) (p = 0.001) increased significantly. All basal parameters and early responses to ITT normalized, when compared to healthy athletes. Basal metabolic rate, fat oxidation, body fat, muscle mass, and hydration status had partial but non-significant improvements. Conclusion: After 12 weeks, athletes affected by actual OTS demonstrated substantial improvements, remarkably IGF-1, freeT3, CAR, testosterone, estradiol testosterone:estradiol ratio, CK and catecholamines, and early cortisol, early prolactin, and overall GH responses to stimulations.

Novel Markers of Recovery From Overtraining Syndrome: The EROS-LONGITUDINAL Study

2020 ◽  
pp. 1-10
Author(s):  
Flavio A. Cadegiani ◽  
Pedro Henrique L. Silva ◽  
Tatiana C.P. Abrao ◽  
Claudio E. Kater
Keyword(s):  
Caloric Intake ◽  
Recovery Process ◽  
Tolerance Test ◽  
Hormonal Responses ◽  
Urinary Catecholamines ◽  
Overtraining Syndrome ◽  
Recovery Processes ◽  
Insulin Tolerance ◽  
Inadequate Sleep ◽  
Late Growth

Purposes: Overtraining syndrome (OTS) is an unexplained underperformance syndrome triggered by excessive training, insufficient caloric intake, inadequate sleep, and excessive cognitive and social demands. Investigation of the recovery process from OTS has not been reported to date. The objective was to unveil novel markers and biochemical and clinical behaviors during the restoration process of OTS. Methods: This was a 12-week interventional protocol in 12 athletes affected by OTS, including increase of caloric intake, transitory interruption of training, improvement of sleep quality, and management of stress, followed by the assessment of 50 parameters including basal and hormonal responses to an insulin tolerance test and nonhormonal biochemical markers, and body metabolism and composition. Results: Early cortisol (P = .023), late ACTH (adrenocorticotrophic hormone) (P = .024), and early and late growth hormone (P = .005 and P = .038, respectively) responses, basal testosterone (P = .038), testosterone:estradiol ratio (P = .0005), insulinlike growth factor 1 (P = .004), cortisol awakening response (P = .001), and free thyronine (P = .069) increased, while basal estradiol (P = .033), nocturnal urinary catecholamines (P = .038), and creatine kinase (P = .071) reduced. Conversely, markers of body metabolism and composition had slight nonsignificant improvements. Conclusion: After a 12-week intervention, athletes affected by actual OTS disclosed a mix of non-, partial, and full recovery processes, demonstrating that remission of OTS is as complex as its occurrence.

scholarly journals Novel causes and consequences of overtraining syndrome: the EROS-DISRUPTORS study

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Flavio A. Cadegiani ◽  
Claudio E. Kater
Keyword(s):  
Caloric Intake ◽  
Cognitive Effort ◽  
Calorie Intake ◽  
Hydration Status ◽  
Full Data ◽  
Hormonal Responses ◽  
Overtraining Syndrome ◽  
Hormone Responses ◽  
Independent Risk Factors ◽  
Independent Variable

Abstract Background Hormonal physiology in athletes, dysfunctional paths leading to overtraining syndrome (OTS), and clinical and biochemical behaviors that are independently modified by the presence of OTS remain unclear. Although multiple markers of OTS have recently been identified, the independent influence of OTS on hormones and metabolism have not been assessed. Hence, the objective of the present study was to uncover the previously unrecognized independent predictors of OTS and understand how OTS independently modifies the behaviors of clinical and biochemical parameters. Methods In a total of 39 athletes (OTS-affected athletes (OTS) = 14 and healthy athletes (ATL) = 25), we performed two clusters of statistical analyses using the full data of the Endocrine and Metabolic Responses on Overtraining Syndrome (EROS) study, in a total of 117 markers. We first used logistic regression to analyze five modifiable parameters (carbohydrate, protein, and overall caloric intake, sleep quality, and concurrent cognitive effort) as potential additional independent risk factors for OTS, and OTS as the outcome. We then used multivariate linear regression to analyze OTS as the independent variable and 38 dependent variables. Training patterns were found to be similar between OTS and ATL, and therefore excessive training was not a risk, and consequently not a predictor, for OTS. Results Each of the three dietary patterns (daily carbohydrate, daily protein, and daily overall calorie intake) were found to be the independent triggers of OTS, while sleeping, social, and training characteristics depended on other factors to induce OTS. Once triggered, OTS independently induced multiple changes, including reductions of cortisol, late growth hormone and adrenocorticotropic hormone responses to stimulations, testosterone-to-estradiol ratio, neutrophils, neutrophil-to-lymphocyte ratio, vigor levels, hydration status, and muscle mass, while increase of tension levels and visceral fat. Conclusions OTS can be independently triggered by eating patterns, regardless of training patterns, while the occurrence of OTS reduced late hormonal responses and the testosterone-to-estradiol ratio, worsened mood, and affected the immunology panel. These novel findings may explain underperformance, which is the key characteristic of OTS.

scholarly journals Diagnosis of Overtraining Syndrome: Results of the Endocrine and Metabolic Responses on Overtraining Syndrome Study: EROS-DIAGNOSIS

2020 ◽  
Vol 2020 ◽  
pp. 1-17 ◽  
Author(s):  
Flavio Adsuara Cadegiani ◽  
Pedro Henrique Luiz da Silva ◽  
Tatiana Camargo Pereira Abrao ◽  
Claudio Elias Kater
Keyword(s):  
Tolerance Test ◽  
Population Based ◽  
Metabolic Responses ◽  
Initial Assessment ◽  
Diagnostic Tools ◽  
Clinical Parameters ◽  
Hormonal Responses ◽  
Overtraining Syndrome ◽  
Insulin Tolerance ◽  
Stimulation Tests

Objectives. Overtraining syndrome (OTS), a common dysfunction among elite athletes, causes decreased performance and fatigue and has no standardized diagnostic criteria. The Endocrine and Metabolic Responses on Overtraining Syndrome (EROS) study identified more than 45 potential biomarkers of OTS. In the present study, we hypothesized that combinations of these biomarkers could be an accurate diagnostic tool for OTS. Methods. We selected parameters with largest difference and fewest overlapping results compared to healthy athletes and highest feasibility and reproducibility. Among the multiple combinations attempted, we chose those that did not show overlapping results, according to the objective. Results. We included 11 clinical parameters, 4 basal hormones, and 5 hormonal responses in Insulin Tolerance Test (ITT). The three selected diagnostic tools were the (i) EROS-CLINICAL, with only clinical parameters, which was suitable as an initial assessment for athletes suspected of OTS; (ii) EROS-SIMPLIFIED, with clinical parameters and basal hormones, when the EROS-CLINICAL was inconclusive; and (iii) EROS-COMPLETE, with basal and hormonal responses to stimulation tests, which was valuable for population-based screening, research purposes, and unusual presentations of OTS. Conclusion. We identified innovative tools with 100% accuracy for the diagnosis of OTS, without the need to exclude confounding disorders.

Influence of insulin-induced hypoglycemia on the hemostatic and fibrinolytic system in patients with hypothalamicpituitary disorders

1998 ◽  
Vol 18 (02) ◽  
pp. 74-79
Author(s):  
K.-H. Zurborn ◽  
H. D. Bruhn ◽  
H. Mönig
Keyword(s):  
Factor Viii ◽  
Plasminogen Activator ◽  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Fibrinolytic System ◽  
Tissue Type ◽  
Insulin Tolerance ◽  
Factor Viii Antigen ◽  
Pai 1 ◽  
D Dimer

SummaryIn order to study the acute and prolonged effects of hypoglycemia on the hemostatic and fibrinolytic system we measured prothrombin fragment (F1+2), thrombin-antithrombin III complex (TAT), platelet factor 4 (PF4), β-thromboglobulin (âTG), factor VIII antigen (F VIII antigen), D-dimer, tissue-type plasminogen activator (t-PA) antigen, and plasminogen activator inhibitor (PAI-1) in 22 patients during insulin tolerance test. F1+2 and TAT increased significantly 15 and 90 minutes after administration of insulin, as did PF4 and âTG. At 4 and 24 hours, these parameters were not different from baseline. Factor VIII antigen was not significantly altered. D-dimer concentration did not change. However, the D-dimer/TAT ratio significantly decreased at 15 and 90 minutes but increased markedly above baseline at 4 and 24 hours. t-PA antigen was also found to be elevated at 15 and 90 minutes but had returned to baseline at 4 and 24 hours. PAI-1 concentration did not change. We conclude from these data that both coagulation and fibrinolysis are activated in the short-term response to acute insulin-induced hypoglycemia, followed by a prolonged activation of fibrinolysis. Our study may explain why patients undergoing insulin tolerance test, despite marked clotting and platelet activation, almost never develop thromboembolic complications.

Reproducibility of the Short Insulin Tolerance Test

1993 ◽  
Vol 10 (9) ◽  
pp. 839-842 ◽  
Author(s):  
S. Hirst ◽  
D.I.W. Phillips ◽  
S.K. Vines ◽  
P.M. Clark ◽  
C.N. Hales
Keyword(s):  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Insulin Tolerance

The insulin tolerance test (ITT) in the assessment of the adrenal axis

2021 ◽  
Author(s):  
Sahar Abidi ◽  
Wafa Grira ◽  
Nadia Khessairi ◽  
Ibtissem Oueslati ◽  
Meriem Yazidi ◽  
...  
Keyword(s):  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Adrenal Axis ◽  
Insulin Tolerance

ENDOCRINE DISTURBANCES IN PATIENTS WITH CONGENITAL AQUEDUCTAL STENOSIS

1975 ◽  
Vol 80 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Robert Fiedler ◽  
Dorothy T. Krieger
Keyword(s):  
Present Report ◽  
Aqueductal Stenosis ◽  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Endocrine Function ◽  
Insulin Tolerance ◽  
Endocrine Disturbances ◽  
Reversible Lesion ◽  
Hormone Responses

ABSTRACT Congenital stenosis of the aqueduct of Sylvius is reported to be associated with sella turcia enlargement and clinical and laboratory abnormalities of the hypothalamic-pituitary-target-organ axis. It is a surgically reversible lesion. In the present report, 3 female patients with this lesion were studied with tests of basal endocrine function, as well as insulin tolerance tests, response to metyrapone and determination of circadian periodicity of plasma cortisol levels. In one patient all testing was normal and no surgery was performed. In 2 other patients the insulin tolerance test revealed either abnormal cortisol or growth hormone responses and in one patient urinary gonadotrophins were absent. All tests became normal post-operatively although in one instance not completely so until 5 years after surgery.

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