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RESEARCH ARTICLE
Post-Exercise Ketosis, Salivary Uric Acid and Interleukin-6 after a Simu-
lated Wheelchair Basketball Match
Anna Raguzzini
1
, Elisabetta Toti
1
, Marco Bernardi
2,3
, Fabio Castellucci
3
, Valentina Cavedon
4
, Anna
Lucia Fedullo
1
, Chiara Milanese
4
, Tommaso Sciarra
5
and Ilaria Peluso
1,*
1
Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), Rome, Italy;
2
Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Italy;
3
Italian
Wheelchair Basketball Federation (Federazione Italiana Pallacanestro in Carrozzina, FIPIC, Rome, Italy);
4
Depart-
ment of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy;
5
Joint Veteran Cen-
ter, Scientific Department, Army Medical Center, Rome, Italy
ARTICLE HISTORY
Received: August 04, 2020
Revised: November 02, 2020
Accepted: November 03, 2020
DOI:
10.2174/1871530321999210111202724
Abstract: Background: Interleukin (IL)-6, total antioxidant capacity (TAC) and uric acid (UA) in-
crease after exercise in able-bodied individuals. Wheelchair Basketball Athletes (WBA), having
low muscle mass, could be at risk of post-exercise ketosis.
Objective: This study aimed to evaluate the post-exercise ketosis, IL-6, and antioxidant response,
in WBA of the Italian National team, after a simulated match.
Methods: Dietary intakes, Starvation Symptoms Inventory (SSI), percentage of fat mass (FM%)
and basal Respiratory Exchange Ratio (RER) and Basal Energy Expenditure (BEE), were evaluat-
ed. Salivary TAC, UA and IL-6 were measured: before (PreM), at the end (EM) and 20 minutes af-
ter (PostM) the match. Capillary glucose and β-hydroxybutyrate (βHB) were monitored. Percent-
age of Heart Rate Reserve (%HRR) was measured to evaluate exercise intensity.
Results: WBA had low carbohydrates (43.5% of daily energy intake (En)) and high fat (36.3% En)
intakes. The increase in UA at PostM correlated with En (0.810, p<0.01) and was inversely related
to βHB at EM (-0.719, p<0.05). Furthermore, at PostM growing IL-6 levels correlated with BEE
(0.778, p<0.05) and inversely related to FM% (-0.762, p<0.5) were found, which in turn was corre-
lated to SSI (0.781, p<0.05). Also βHB PostM correlated with SSI (0.761, p<0.05) but was inverse-
ly related to RER (-0.745, p<0.05) and En (-0.826, p<0.01).
Conclusion : Our study suggests that some WBA should improve their dietary habit in order to pre-
vent post-exercise ketosis and ameliorate the endogenous antioxidant response after exercise.
Keywords: Antioxidant capacity, body composition, carbohydrates, fat, inflammation, motor impairment, Paralympics, sport.
1. INTRODUCTION
Oxidative stress plays a role in the development of chron-
ic low-grade inflammation and age-related diseases [ 1, 2].
Smoking habit [3], exposure to environmental contaminants
[4] and diet influence redox and inflammatory status [5-7].
On the other hand, in addition to anti-inflammatory and
analgesic drugs [8], antioxidant and/or anti-inflammatory ef-
fects have been suggested for metformin [9], statins [10] and
antihypertensive drugs [10].
Circadian hormones, melatonin [ 11] and cortisol [ 12],
are endogenous anti-inflammatory mediators and uric acid
* Address correspondence to this author at the Research Centre for Food
and Nutrition, Council for Agricultural Research and Economics (CREA-
AN), Via Ardeatine 546, Rome, Italy. Country; Tel/Fax: +39- 06 51494
426; E-mail: ilaria.peluso@crea.gov.it
(UA) is a non-enzymatic antioxidant in body fluids and the
major contributor of the total antioxidant capacity (TAC)
[13, 14].
Markers of inflammation and oxidative stress follow a
circadian rhythm [15, 16] that can be affected by the diurnal
distribution of fat and carbohydrate consumption [17], eat-
ing time [18] and short sleep duration [19].
Although exercise training has sleep-promoting effects
[20], increases immune defenses and decreases oxidative
stress [21], exhaustive exercise induces oxidative stress and
a systemic inflammatory response [ 22, 23]. In elite able-
bodied basketball players, interleukin (IL)-6 is among the in-
flammatory mediators that are involved in the short-lived
performance deterioration after the match [24]. The same au-
thors also found increases in UA after the basketball match
[24]. Other studies carried out in able-bodied individuals re-