目的:运动相关低钠血症(EAH)在超耐力事件中很常见,严重的情况在女性中更常见。本文的目的是比较超耐力比赛中男女铁人三项运动员EAH的临床表现。
方法:回顾了1989-2019年IRONMAN®世界锦标赛钠浓度(n=3138)的医疗记录,包括男性(n=2253)和女性(n=885)竞争对手。采用Logistic回归分析探讨性别与性别、性别之间的关系。钠浓度,和各种临床表现。
结果:比较男女铁人三项运动员时,发现与钠浓度有不同关系的临床变量包括精神状态改变(男性负相关,女性不相关),腹痛,肌肉痉挛,低血压,和心动过速(男性直接相关,女性不相关),呕吐和低钾血症(男性无关,女性成反比)。总的来说,男性比女性明显减肥,尤其是,大约一半的运动员脱水和体重减轻.
结论:精神状态改变,呕吐,腹痛,肌肉痉挛,低血压,心动过速,在比较低钠血症和高钠血症运动员时,性别之间的高钾血症似乎有所不同。尽管过度水合是高血容量低钠血症的最常见病因,低血容量低钠血症包括大量低钠血症三人组。进一步了解EAH如何呈现有助于运动员和医疗专业人员及早识别并预防危及生命的并发症。
OBJECTIVE: Exercise-associated hyponatremia (EAH) is common in ultra-endurance events and severe cases are more common in females. The purpose of this paper is to compare the clinical presentation of EAH between male and female triathletes in ultra-endurance competitions.
METHODS: Medical records with sodium concentrations (n = 3138) from the IRONMAN® World Championships over the timeframe of 1989-2019 were reviewed for both male (n = 2253) and female (n = 885) competitors. Logistic regression was used to explore the relationships between sex, sodium concentration, and various clinical presentations.
RESULTS: When comparing male and female triathletes, clinical variables found to have a different relationship with sodium concentration include altered mental status (inversely related in males and not related in females), abdominal pain, muscle cramps, hypotension, and tachycardia (directly related in males and not related in females), and vomiting and hypokalemia (not related in males and inversely related in females). Overall, males lost significantly more weight than females, and notably, approximately half of all athletes were dehydrated and lost weight.
CONCLUSIONS: Altered mental status, vomiting, abdominal pain, muscle cramps, hypotension, tachycardia, and hyperkalemia appear to present differently between sexes when comparing hyponatremic to eunatremic athletes. Although overhydration is the most common etiology of hypervolemic hyponatremia, hypovolemic hyponatremia comprises a significant amount of hyponatremic triathletes. Further understanding of how EAH presents helps athletes and medical professionals identify it early and prevent life-threatening complications.