Author(s): LE GOFF, C., PAPICCIO, L., LAGES, Y., KAUX, J.F., BREVERS, E., DELEERSNYDER, J., GINOUX, C., MASSONNET, P., CAVALIER, E., CARNICELLA, S., FAUVELLE, F., DOUTRELEAU, S., BAUD, C., Institution: UNIVERSITY HOSPITAL OF LIÈGE (CHU), Country: BELGIUM, Abstract-ID: 754

INTRODUCTION:
Regular physical activity is known to benefit health, yet the physiological impact of extreme endurance exercise remains incompletely understood. This study examined the acute and short term effects of a prolonged ultratrail race on several biological systems by monitoring biomarkers related to cardiac stress, inflammation, renal function, and muscle damage, together with a targeted lipidomic analysis. The aim was to characterize the magnitude, time course, and reversibility of the body’s response to an exceptionally demanding endurance challenge.
METHODS:
Eighteen athletes competing in the Ultra Tour des Quatre Massifs (Grenoble, France), a 160 km ultratrail with major elevation gain (9500m D+), were enrolled. Blood samples were collected at four time points: pre race baseline (T1), immediately after finishing (T2), 48 hours post race (T3), and one week later (T4). The biomarker panel included high sensitivity Troponin T, NT proBNP, high sensitivity C reactive protein, creatine kinase MB, interleukin 6, myeloperoxidase, soluble ST2, nucleosomes, and catecholamines, providing insights into myocardial strain, systemic inflammation, skeletal muscle injury, and adrenergic activation. In parallel, a UPLC MS/MS method was developed to quantify selected lipid species, particularly ceramides, to assess their potential relevance as indicators of physiological strain or performance related stress.
RESULTS:
The extreme effort induced marked disturbances across multiple physiological domains. At race completion, substantial increases were observed in biomarkers reflecting myocardial load, muscle damage, inflammation, and renal stress, highlighting the acute multisystem burden of prolonged endurance exercise. Most biomarkers progressively returned toward baseline within one week, indicating that these alterations were largely transient and reversible in highly trained athletes. Regarding lipid metabolism, quantified ceramides did not provide meaningful added value for monitoring acute physiological stress or performance. However, their integration into a cardiovascular risk oriented score such as the CERT score may be useful for pre participation assessment or long term athlete monitoring.
CONCLUSION:
This study offers an integrated view of the acute multisystem responses triggered by an extreme ultratrail event and underscores the value of combining conventional biomarkers with targeted lipidomics to improve our understanding of endurance related physiological stress.