Research Papers:

Sympatho-adrenergic activation by endurance exercise: Effect on metanephrines spillover and its role in predicting athlete’s performance

Elisa Danese _, Cantor Tarperi, Gian Luca Salvagno, Alessandra Guzzo, Fabian Sanchis-Gomar, Luca Festa, Luciano Bertinato, Martina Montagnana, Federico Schena and Giuseppe Lippi

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Oncotarget. 2018; 9:15650-15657. https://doi.org/10.18632/oncotarget.24584

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Elisa Danese1,*, Cantor Tarperi2,*, Gian Luca Salvagno1, Alessandra Guzzo1, Fabian Sanchis-Gomar3,4, Luca Festa2, Luciano Bertinato2, Martina Montagnana1, Federico Schena2,# and Giuseppe Lippi1,#

1Laboratory of Clinical Biochemistry, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy

2School of Sport and Exercise Sciences, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy

3Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, New York, USA

4Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia, Spain

*These authors equally contributed to this work

#These authors have equal senior authorship on this work

Correspondence to:

Elisa Danese, email: [email protected]

Keywords: sympathoadrenal system; plasma metanephrines; endurance exercise; running performance

Received: December 20, 2017     Accepted: February 20, 2018     Epub: February 26, 2018     Published: March 20, 2018


Background: The sympatho-adrenergic activation during exercise is implicated in many cardiovascular respiratory and metabolic adaptations which have been thought to partially explain the different levels of performance observed between trained and untrained subjects. To date, no evidence exists about the association between competition performance and markers of “acute stress response”. We designed this study to investigate; (i) the acute sympatho-adrenergic activation during endurance exercise in recreational runners by measuring plasma levels of free metanephrine (MN) and normethanephrine (NMN) before and after a half-marathon run; (ii) the association between the metanephrines levels and the running time.

Methods: 26 amateur runners (15 males, 11 females) aged 30 to 63 years were enrolled. The quantification of MN and NMN was performed by LC-MS/MS. Anthropometric ergonomic and routine laboratory data were recorded. Statistical analyses included paired T-test, univariate and multivariate regressions.

Results: The post-run values of MN and NMN displayed a nearly 3.5 and 7 fold increase respectively compared to the baseline values (p < 0.0001 for both). NMN pre-run values and pre/post run delta values showed a significant direct and inverse association (p = 0.021 and p = 0.033, respectively) with running performance. No correlations were found for MN values.

Conclusion: NMN is a reliable marker of sympatho-adrenergic activation by exercise and can predict endurance performance in the individual athlete. Adaptation phenomenon occurring not only in the adrenal medulla might represent the biological mechanism underlying this association. Further studies on sympatho-adrenergic activation, competition performance and training status should contemplate the measurement of these metabolites instead of their unstable precursors.

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