Longitudinal changes in haemoglobin mass and VO(2max) in adolescents

Predicting Future Athletic Performance in Young Female Road Cyclists Based on Aerobic Fitness and Hematological Variables

PURPOSE

This study aimed to determine whether the initial levels of aerobic fitness and hematological variables in young female road cyclists are related to their athletic performance development during their careers.

METHODS

Results of graded exercise tests on a cycle ergometer and total hemoglobin mass (tHb-mass) measurements were analyzed in 34 female road cyclists (age 18.6 [1.9] y). Among them, 2 groups were distinguished based on their competitive performance (Union Cycliste Internationale world ranking) over the following 8 years. Areas under the curve in receiver-operating-characteristic curves were calculated as indicators of elite-performance prediction.

RESULTS

Initial graded exercise test variables (peak power, peak oxygen uptake, and power at 4 mmol/L blood lactate) were not significantly different in elite (n = 13) versus nonelite (n = 21) riders. In contrast, elite riders had higher tHb-mass expressed either in absolute measures (664 [75] vs 596 [59] g, P = .006) or normalized to body mass (11.2 [0.8] vs 10.3 [0.7] g/kg, P = .001) and fat-free mass (14.4 [0.9] vs 13.1 [0.9] g/kg, P < .001). Absolute and relative erythrocyte volumes were significantly higher in elite subjects (P ranged from < .001 to .006). Of all the variables analyzed, the relative tHb-mass had the highest predictive ability to reach the elite level (area under the curve ranged from .82 to .85).

CONCLUSION

Measurement of tHb-mass can be a helpful tool in talent detection to identify young female road cyclists with the potential to reach the elite level in the future.

Effect of hypobaric hypoxia on hematological parameters related to oxygen transport, blood volume and oxygen consumption in adolescent endurance-training athletes

Objective

To analyze the effect of altitude on hematological and cardiorespiratory variables in adolescent athletes participating in aerobic disciplines.

Methods

21 females and 89 males participated in the study. All were adolescent elite athletes engaged in endurance sports (skating, running and cycling) belonging to two groups: permanent residents in either low altitude (LA, 966 m) or moderate altitude (MA, 2640 m). Hematocrit (Hct), hemoglobin concentration ([Hb]), total hemoglobin mass (Hbt), blood, plasma and erythrocyte volumes (BV, PV and EV), VO₂peak and other cardiorespiratory parameters were evaluated.

Results

Sex differences were evident both in LA and HA skating practitioners, the males having higher significant values than the females in oxygen transport-related hematological parameters and VO₂peak. The effect of altitude residence was also observed in Hct, [Hb], Hbt and EV with increased (14%–18%) values in the hematological parameters and higher EV (5%–24%). These results matched the significantly higher values of VO₂peak measured in MA residents. However, BV and PV did not show differences between LA and MA residents in any case. Sports discipline influenced neither the hematological variables nor most of the cardiorespiratory parameters.

Conclusions

LA and MA adolescent skaters showed sex differences in hematological variables. Endurance-trained male adolescent residents at MA had an increased erythropoietic response and a higher VO₂peak compared to their counterparts residing and training at LA. These responses are similar in the three aerobic sports studied, indicating that the variables described are highly sensitive to hypoxia irrespective of the sports discipline.

JA, Duque L, Chaves-Gomez S, Cristancho-Mejía E, Schmidt WFJ. Hemoglobin Mass, Blood Volume and VO2max of Trained and Untrained Children and Adolescents Living at Different Altitudes

Introduction: To a considerable extent, the magnitude of blood volume (BV) and hemoglobin mass (Hbmass) contribute to the maximum O2-uptake (VO2max), especially in endurance-trained athletes. However, the development of Hbmass and BV and their relationships with VO2max during childhood are unknown. The aim of the present cross-sectional study was to investigate Hbmass and BV and their relationships with VO2max in children and adolescents. In addition, the possible influence of endurance training and chronic hypoxia was evaluated.

Methods: A total of 475 differently trained children and adolescents (girls n = 217, boys n = 258; untrained n = 171, endurance trained n = 304) living at two different altitudes (∼1,000 m, n = 204, ∼2,600 m, n = 271) and 9–18 years old participated in the study. The stage of puberty was determined according to Tanner; Hbmass and BV were determined by CO rebreathing; and VO2max was determined by cycle ergometry and for runners on the treadmill.

Results: Before puberty, there was no association between training status and Hbmass or BV. During and after puberty, we found 7–10% higher values in the trained groups. Living at a moderate altitude had a uniformly positive effect of ∼7% on Hbmass in all groups and no effect on BV. The VO2max before, during and after puberty was strongly associated with training (pre/early puberty: boys +27%, girls +26%; mid puberty: +42% and +45%; late puberty: +43% and +47%) but not with altitude. The associated effects of training in the pre/early pubertal groups were independent of Hbmass and BV, while in the mid- and late pubertal groups, 25% of the training effect could be attributed to the elevated Hbmass.

Conclusions: The associated effects of training on Hbmass and BV, resulting in increased VO2max, can only be observed after the onset of puberty.

Longitudinal changes in maximal oxygen uptake in adolescent girls and boys with different training backgrounds

The purpose of this study was to investigate the effects of high-volume endurance training on the development of maximal oxygen uptake (VO_2max ) in physically active boys and girls between the ages of 12 and 15 years, using a longitudinal design. The children participated in organized training in sports clubs for an average of 7-10 hours per week, with one group undertaking a high volume of endurance training (~7 hours per week; End boys, n = 23 and End girls, n = 17) and the other group having a primary focus on technical and tactical skill development, undertaking low volumes of endurance training (~1.6 hours per week; non-End boys, n = 29 and non-End girls, n = 9). VO_2max and anthropometrics were assessed at age 12, 13, and 15. At age 12, VO_2max was 58.9 (5.6), 65.5 (7.2), 56.5 (6.5), and 58.8 (7.9) mL·kg^-1 ·min^-1 in End girls, End boys, non-End girls, and non-End boys, respectively. Over the three years, there was no difference between the training groups in the development of VO_2max independent of scaling. In boys, VO_2max relative to body mass (BM) did not change from age 12 to 15, while VO_2max tended to decrease relative to fat-free mass (FFM). In girls, VO_2max relative to BM decreased slightly from age 12 to 15, with no changes over the years relative to FFM. The present longitudinal study suggests that in growing active children during puberty, high volumes of systematic endurance training do not have an additional effect on VO_2max compared with similar volume of training mainly aiming at developing motor skills.

Relationships Between Aerobic Performance, Hemoglobin Levels, and Training Load During Small-Sided Games: A Study in Professional Soccer Players

The purposes of this study were (1) to analyze between-session variations of external and internal load measures during small-sided games (SSGs) and (2) to test the relationships between the maximum speed reached (VIFT) during the last stage of the 30-15 Intermittent Fitness Test, hemoglobin levels, and training load measures during SSG intervals among professional soccer players. Sixteen professional soccer players (mean ± SD; age 27.2 ± 3.4 years, height 174.2 ± 3.6 cm, body mass 69.1 ± 6.4 kg, and body fat 10.4 ± 4.1%) participated in this study. Hemoglobin and aerobic performance were first tested, and then a 3-week SSG program was applied using a 3 vs. 3 format. During those 3 weeks, internal and external load of entire sessions were also monitored for all training sessions. Trivial-to-small, standardized differences were observed between sessions for external and internal measures during SSGs. Total distance (TD) and mechanical work (MW) were the only variables that indicated small changes. Large-to-very-large relationships were found between VIFT and external loads: TD (r range: 0.69; 0.87), high-intensity running (HIR; r range: 0.66; 0.75), and MW (r range: 0.56; 0.68). Moderate-to-large negative relationships were found between hemoglobin levels and internal loads: Edwards' TRIMP (r range: -0.36; -0.63), %HRmax (r range: -0.50; -0.61), and red zone (r range: -0.50; -0.61). VIFT had unclear relationships with overall internal loads, while hemoglobin levels presented unclear relationships with overall external loads. In conclusion, no meaningful changes were found between sessions considering the format of play used. Additionally, the detected relationships indicate that VIFT and hemoglobin levels are good indicators of the performance capacity and physiological profile of players during SSGs. Also, the use of SSGs protocols as a monitoring complement of the 30-15IFT is suggested.

A 2-year longitudinal follow-up of performance characteristics in Chinese male elite youth athletes from swimming and racket sports

Training in elite sport aims at the optimization of the athletic performance, and to control the athletes`progress in physiological, anthropometrical and motor performance prerequisites. However, in most sports, the value of longitudinal testing is unclear. This study evaluates the longitudinal development and the influence of intense training over 2-years on specific physiological performance prerequisites, as well as certain body dimensions and motor abilities in elite youth athletes. Recruited between 11-13 years of age at Shanghai Elite Sport school, the sample of student-athletes (N = 21) was categorized as the swimming group (10 athletes), and the racket sports group (11 players: 7 table tennis and 4 badminton players). The performance monitoring took place over two years between September 2016 and September 2018 and included 5 test waves. In all the test waves, the athletes were assessed by means of three physiological measurements (vital capacity, hemoglobin concentration, heart rate at rest), three anthropometric parameters (body height, body weight, chest girth), and two motor tests (back strength, complex reaction speed). Seven out of eight diagnostic methods exhibit medium to high validity to discriminate between the different levels of performance development in the two sports groups. The investigated development of the performance characteristics is attributed partly to the inherited athletic disposition as well as to the different sport-specific training regimens of the two sports groups.

Hematological, Hormonal and Fitness Indices in Youth Swimmers: Gender-Related Comparisons

This study objective was to evaluate gender differences in hematological, hormonal and fitness variables among youth swimmers and to explore relationships between erythrocyte indices and aerobic and anaerobic capacity. 137 girls and 171 boys participated in the study and were divided into three groups based on their training experience. Blood samples were obtained to determine red blood cell counts, hemoglobin concentration, hematocrit, and plasma erythropoietin and testosterone levels. VO_2max was assessed using a submaximal cycle protocol. 76 girls and 102 boys also undertook a Wingate test to determine their peak anaerobic power. Boys had higher (p < 0.05) means than girls for all hematological variables except for erythropoietin and these variables demonstrated an increase with training in boys. The average VO_2max in l∙min^-1 and peak anaerobic power in watts were also higher in boys (2.91 ± 0.08 and 547 ± 28, respectively) than girls (2.25 ± 0.07 and 450 ± 26, respectively). Modest but significant (p < 0.05) correlations were found between VO_2max and red blood cell counts (r = 0.252), hemoglobin concentration (r = 0.345), or hematocrit (r = 0.345) and between peak anaerobic power and red blood cell counts (r = 0.304), hemoglobin concentration (r = 0.319) or hematocrit (r = 0.351). This study revealed relatively lower yet age- and gender-appropriate hematological, hormonal and fitness indices in youth swimmers. The gender-related differences in erythrocyte indices seem unrelated to erythropoietin and may be explained by the higher testosterone levels seen in boys. Given their correlation to both aerobic and anaerobic capacity, erythrocyte indices may be used as part of talent identification for sports.

Effect of Endurance Training on Hemoglobin Mass and V˙O2max in Male Adolescent Athletes

Supplemental digital content is available in the text.

Purpose

It is unknown, whether endurance training stimulates hemoglobin mass (Hb_mass) and maximal oxygen uptake (V˙O_2max) increases during late adolescence. Therefore, this study assessed the influence of endurance training on Hb_mass, blood volume parameters, and V˙O_2max in endurance athletes and control subjects from age 16 to 19 yr.

Methods

Hemoglobin mass, blood volume parameters, V˙O_2max and anthropometric parameters were measured in male elite endurance athletes from age 16 to 19 yr in 6-month intervals (n = 10), as well as in age-matched male controls (n = 12).

Results

Neither the level of Hb_mass per lean body mass (LBM) (P = 0.80) nor the development of Hb_mass during the 3 yr (P = 0.97) differed between athletes and controls. Hb_mass at age 16 yr was 13.24 ± 0.89 g·kg⁻¹ LBM and increased by 0.74 ± 0.58 g·kg⁻¹ LBM (P < 0.01) from age 16 to 19 yr. There was a high correlation between Hb_mass at age 16 and 19 yr (r = 0.77; P < 0.001). Plasma volume, blood volume, and V˙O_2max were higher in athletes compared to controls (P < 0.05). Blood volume and V˙O_2max increased with age (P < 0.01, similarly in both groups).

Conclusions

Endurance training volumes do not explain individual differences in Hb_mass levels nor Hb_mass and V˙O_2max development in the age period from 16 to 19 yr. The higher V˙O_2max levels of athletes may be partially explained by training-induced higher plasma and blood volumes, as well as other training adaptations. Since Hb_mass at age 16 yr varies substantially and the development of Hb_mass in late adolescence is comparably small and not influenced by endurance training, Hb_mass at age 16 yr is an important predictor for Hb_mass at adult age and possibly for the aptitude for high-level endurance performance.

Determination of hemoglobin mass in humans by measurement of CO uptake during inhalation of a CO-air mixture: a proof of concept study

Measuring hemoglobin mass (Hbmass) using the carbon monoxide (CO) bolus rebreathing method is frequently used in research but has yet to be widely used in the clinical practice. The estimation of an adequate CO bolus may be difficult in patients with unknown Hbmass. In the present pilot study, a progressive inhalation technique for CO that leads to a linear individual adjusted COHb increase was evaluated. Sixteen healthy test subjects participated in the study (preliminary investigation: six; main study: ten). The reliability and validity of the new method were evaluated using multiple measurements of Hbmass with and without a defined blood donation and compared to a CO bolus method. The participants inhaled a CO-air mixture (CO concentration: 1500 ppm) for a specific breathing duration. The CO uptake and COHb change were determined simultaneously. The typical error (reliability) in the repeated measurements was 2.4% (CI ± 4.7). The mean difference between the new method and the bolus method was 34 g (±41; P = 0.026). The measured hemoglobin loss in 490 mL of blood was 74 g (±35), and the calculated hemoglobin loss was 77 g (±4) (mean difference 3 g ± 34; P = 0.820). The new method was reliable and valid in a proof of concept study with healthy subjects. The total amount of CO and as a result the COHb increase is individually adjustable. Future studies in clinical settings are needed to determine if the method could be used in disease-specific pathologies associated with changes in Hbmass.

Influence of Endurance Training During Childhood on Total Hemoglobin Mass

Elite endurance athletes are characterized by markedly increased hemoglobin mass (Hbmass). It has been hypothesized that this adaptation may occur as a response to training at a very young age. Therefore, the aim of this study was to monitor changes in Hbmass in children aged 8–14 years following systematic endurance training. In the first study, Hbmass, VO2max, and lean body mass (LBM) were measured in 17 endurance-trained children (13 boys and 4 girls; aged 9.7 ± 1.3 years; training history 1.5±1.8 years; training volume 3.5 ± 1.6 h) twice a year for up to 3.5 years. The same parameters were measured once in a control group of 18 age-matched untrained children. Hbmass and blood volume (BV) were measured using the optimized CO-rebreathing technique, VO2max by an incremental test on a treadmill, and LBM by skin-fold measurements. In the second pilot study, the same parameters were measured in 9 young soccer athletes (aged 7.8 ± 0.2 years), and results were assessed in relation to soccer performance 2.5 years later. The increase in mean Hbmass during the period of study was 50% which was closely related to changes in LBM (r = 0.959). A significant impact of endurance training on Hbmass was observed in athletes exercising more than 4 h/week [+25.4 g compared to the group with low training volume (<2 h/week)]. The greatest effects were related to LBM (11.4 g·kg⁻¹ LBM) and overlapped with the effects of age. A strong relationship was present between absolute Hbmass and VO2max (r = 0.939), showing that an increase of 1 g hemoglobin increases VO2max by 3.6 ml·min⁻¹. Study 2 showed a positive correlation between Hbmass and soccer performance 2.5 years later at age 10.3 ± 0.3 years (r = 0.627, p = 0.035). In conclusion, children with a weekly training volume of more than 4 h show a 7% higher Hbmass than untrained children. Although this training effect is significant and independent of changes in LBM, the major factor driving the increase in Hbmass is still LBM.

NO ASSOCIATION BETWEEN tHbmass AND POLYMORPHISMS IN THE HBB GENE IN ENDURANCE ATHLETES

The aim of this study was to examine the association between tHbmass and HBB gene polymorphisms in athletes of endurance disciplines. Eighty-two well-trained athletes (female n=36, male n=46), aged 19.3 ± 2.7 years, representing cross country skiing (n=37) and middle- and long-distance running (n=45), participated in the study. Genotyping for 2 polymorphisms in the HBB gene (- 551C/T and intron 2, +16 C/G) was performed using restriction fragment length polymorphism analysis. Total haemoglobin mass (tHbmass) was determined by the optimized carbon monoxide rebreathing method. Blood morphology, indices of iron status (ferritin, transferrin receptor and total iron binding capacity) and C reactive protein were also determined. No differences were found in the HBB genotype and allele frequencies between male and female athletes. Regardless of the polymorphisms, no relationships were found between HBB genotypes as well as alleles and relative values of tHbmass, expressed per body mass (g · kg^-1 BM), both in female and male athletes. Our results demonstrated that -551 C/T and intron 2, +16 C/G polymorphisms of the HBB gene have no association with total haemoglobin mass in endurance athletes. It cannot be ruled out that several polymorphisms, each with a small but significant contribution, may be responsible for the amount of haemoglobin.

Total haemoglobin mass, blood volume and morphological indices among athletes from different sport disciplines

INTRODUCTION

Haemoglobin is a key determinant of maximal oxygen uptake. This study's objective was to assess total haemoglobin mass (tHb-mass), as well as blood volume and morphological indices in athletes training different sports disciplines.

MATERIAL AND METHODS

This study was conducted on 176 endurance and non-endurance athletes (males and females). tHb-mass, blood volume (BV), plasma volume (PV), and red cell volume (RCV) were determined by optimized carbon monoxide rebreathing method. Haemoglobin concentration (Hb), haematocrit (Hct), red blood count (RBC) were also determined.

RESULTS

In endurance sports, gender regardless, no significant differences in relative mean values of tHb-mass (12.8-13.1 g/kg - males; 10.4-10.6 g/kg - females), BV (90.8-94.0 ml/kg - males; 82.7-86.9 ml/kg - females), RCV (36.6-38.0 ml/kg - males; 31.1-31.5 ml/kg - females) or of PV in males (54.2-56.4 ml/kg) were observed. The above indices' relative values, gender regardless, were significantly lower in judo (11.2 ±0.7 g/kg, 81.8 ±5.9 ml/kg, 48.6 ±4.5 ml/kg and 33.1 ±2.0 ml/kg - males; 9.3 ±0.7 g/kg, 74.3 ±5.6 ml/kg, 46.4 ±4.0 ml/kg and 27.9 ±2.1 ml/kg - females) compared to endurance sports (p < 0.001). No substantial differences were observed in morphological blood indices in males, whereas this differentiation was found between certain sports in female athletes.

CONCLUSIONS

The lack of differences in tHb-mass, BV, PV and RCV in endurance sports and presence of this differentiation between various sports shows that the types of training might affect levels of mentioned indices. Measurements of tHb-mass and BV parameters prove Hb, Hct and RBC to have limited value for haematological status evaluations.

Total haemoglobin mass and red blood cell profile in endurance-trained and non-endurance-trained adolescent athletes

To evaluate differences in total haemoglobin mass (tHb mass) and in red blood cell profile between elite endurance-trained (END) and non-endurance-trained (nEND) male and female adolescent athletes, tHb mass (CO rebreathing) and specific variables of red blood cell profile (haemoglobin concentration, haematocrit, erythrocyte indices) were determined in 59 elite junior athletes (29 END, 30 nEND). We hypothesized that at the age of 15-17 years, regular endurance training might induce a significant increase in tHb mass and changes in red blood cell profile. Therefore, all parameters were again determined after 6, 12 and 18 months in a subset of 27 subjects (17 END, 10 nEND). In END, tHb mass related to body weight was ~15% greater than in nEND (11.2 ± 1.6  vs. 9.7 ± 1.3 g kg(-1), P < 0.001), whereas no significant differences were observed for the red blood cell profile. In both groups, tHb mass related to body weight and the variables of red blood cell profile had not changed significantly after 6, 12 and 18 months of regular training. In conclusion, in elite junior athletes, differences in tHb mass between END and nEND were similar, however, smaller compared with previously in adult athletes reported values. At the age of 15-17 years, 18 months of regular training did not induce significant changes in tHb mass beyond alterations explained by physical growth and also variables of red blood cell profile did not change significantly.

Stability of hemoglobin mass during a 6-day UCI ProTour cycling race

OBJECTIVE

Blood doping in endurance sport is a growing problem. The purpose of this study was to determine the reliability of total hemoglobin mass (Hb(mass)) measurement in the field and to establish the variability of Hb(mass) during a cycling race, to assess its viability as an additional antidoping detection parameter.

DESIGN

Control-matched longitudinal study.

SETTING

International Cycling Union's (UCI) ProTour stage race.

PARTICIPANTS

Six professional cyclists and 5 recreationally active controls.

INTERVENTIONS

Seventy-two Hb(mass) tests using the optimized carbon monoxide rebreathing method were performed over 7 consecutive days, before and throughout the tour. Fasted venous blood was obtained for measurement of hematocrit (Hct) and hemoglobin concentration [Hb] in the morning before stages 1, 3, and 6 (D1, D3, and D6).

MAIN OUTCOME MEASURES

Reliability of Hb(mass) measurement was established using typical error calculated from 2 baseline measures. Individual change scores and coefficients of variation were used to assess stability during racing.

RESULTS

Typical error for Hb(mass) was 1.3% [95% confidence limits (CL): 0.9%, 2.5%]. Calculated 95% and 99.99% CL for percent change in Hb(mass) were +/-3.6% and +/-7.2%, respectively. Mean Hb(mass) remained within +/-1.9% of baseline in cyclists and +/-0.5% in controls. In all cases, individual change scores for both cyclists and controls fell within the 95% CL. There was a decrease in Hct (8.1% +/- 2.8%) and [Hb] (9.7% +/- 3.2%) throughout the tour in cyclists but not in controls.

CONCLUSIONS

We demonstrate that Hb(mass) can be measured reliably via CO-rebreathing during a cycling tour. Unlike [Hb] and Hct, Hb(mass) remains stable over 6 days of racing in professional cyclists and may have potential in an antidoping context.