Investigation of Skeletal Muscle Mitochondrial Function Following an Ultramarathon: A Case Study in Monozygotic Twins
Erik Marchant, fasebj.2021.35.S1.05432
The primary objective of this case study was to investigate the changes in skeletal muscle mitochondria that occur in response to a 100-km ultramarathon in monozygotic twins. Secondarily, we sought to determine if periodically consuming a low-carbohydrate, high-fat diet (LCHFD) during training would affect these changes. To accomplish these objectives, one pair of male monozygotic twins ran 100 km side-by-side on treadmills.
During 8 weeks of training leading up to this event, twin 1 (T1) and twin 2 (T2) consumed a calorie and macronutrient-matched, high-carbohydrate diet, with the exception of 2 consecutive days per week for the final 4 weeks where T2 consumed a calorie and protein-matched LCHFD. Training load was matched between the subjects, most of which they completed together. The subjects were extremely well-matched in VO2 max (61.2 and 60.3 ml/kg/min), BMI (20.4 and 20.6 kg/m2), and body mass (62 and 61.9 kg). During the 100-km run, food and fluid intake were matched, as well as the pace of the run. The run took 16 hours and 3 minutes to complete. Blood draws and muscle biopsies from the vastus lateralis were collected 4 weeks prior to the run, as well as 4- and 52-hours post-run. During the last 4 weeks of training, T2 lost an average of ~1 kg of body weight (BW) over the two days of LCHFD each week (comparing BW of 4 consecutive Mondays to Wednesdays, p=0.02), which was regained two days after reintroduction of carbohydrate, consistent with fluctuating glycogen levels. Though T2 trained with periodically low glycogen levels, respiratory-exchange ratio was no different from T1 throughout the 100-km run.
Four hours post-run, state 3, uncoupled, and fatty acid-supported mitochondrial respiration were reduced in T1 by 22.3%, 34.1% and 25.7%, respectively, and by 28.4%, 49.4% and 39.9% in T2, which was associated with a decrease of 15-20% in citrate synthase (CS) activity. Both twins exhibited decreases in mitochondrial complex proteins, though this was more marked in T2. Blood CPK, CRP, and AST levels were also elevated post-run.
Possibly the most novel finding from this study was that 52 hours post-run, respiratory capacity, mitochondrial proteins, CS activity and blood markers showed signs of rapid recovery. It is currently unclear by what mechanism mitochondrial respiration and content was reduced 4 hours post-run, or how it recovered in 2 days. Interestingly, maximal mitochondrial ROS production (glutamate, malate and succinate-supported) was decreased post-run at both timepoints but was increased compared to baseline with the addition of ADP (12.5 μM – 100 μM). This suggests that the mitochondria were less sensitive to ADP-induced reductions in ROS. Neither diet resulted in better preservation of mitochondrial function 4-hours post-run, though T2 showed some signs of supercompensation 52 hours-post run. This study is valuable because it provides evidence of an acute reduction in mitochondrial content and function following ultra-endurance activity, followed by rapid recovery.