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Hormonal response to a non-exercise stress test in athletes with overtraining syndrome: results from the Endocrine and metabolic Responses on Overtraining Syndrome (EROS) — EROS-STRESS

  • Flavio A. Cadegiani
    Affiliations
    Adrenal and Hypertension Unit, Division of Endocrinology and Metabolism, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), Federal University of São Paulo Medical School, Brazil
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  • Claudio E. Kater
    Correspondence
    Corresponding author.
    Affiliations
    Adrenal and Hypertension Unit, Division of Endocrinology and Metabolism, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), Federal University of São Paulo Medical School, Brazil
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Published:November 15, 2017DOI:https://doi.org/10.1016/j.jsams.2017.10.033

      Abstract

      Objectives

      Overtraining syndrome (OTS) leads to worsened sports performance and fatigue. The pathophysiology of OTS has not been entirely elucidated, and there is a lack of accurate markers for its diagnosis. Changes in hormonal responses implicated in OTS were stimulated by exercise, which has limited their interpretation. Hence, we aimed to evaluate growth hormone (GH) and prolactin responses to a gold-standard and exercise-independent stimulation test, the insulin tolerance test (ITT).

      Design

      Volunteers were recruited and divided into OTS-affected athletes (OTS), healthy athletes (ATL), and healthy non-active subjects (NCS) groups, after general and specific inclusion and exclusion criteria.

      Methods

      We evaluated the responses of growth hormone (GH) and prolactin to the ITT, and compared between groups.

      Results

      A total of 51 subjects were included (OTS, n = 14, ATL, n = 25, and NCS, n = 12). OTS disclosed significantly lower basal levels of GH (p = 0.003) and prolactin (p = 0.048), and GH (p = 0.001) and prolactin (p < 0.001) responses to ITT (p = 0.001), compared to ATL, but similar to NCS. OTS showed a later rise in GH levels in response to hypoglycemia, compared to ATL, but not to NCS. We suggest cutoffs for GH and prolactin levels to aid in the diagnosis of OTS.

      Conclusions

      OTS-affected athletes show reduced GH and prolactin basal levels and responses to a non-exercise stress test compared to healthy athletes, but not to sedentary subjects.

      Keywords

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