Iron, transferrin, and haptoglobin levels after a single bout of exercise in men

The relationship between hemoglobin and [Formula: see text]: A systematic review and meta-analysis

OBJECTIVE

There is widespread agreement about the key role of hemoglobin for oxygen transport. Both observational and interventional studies have examined the relationship between hemoglobin levels and maximal oxygen uptake ([Formula: see text]) in humans. However, there exists considerable variability in the scientific literature regarding the potential relationship between hemoglobin and [Formula: see text]. Thus, we aimed to provide a comprehensive analysis of the diverse literature and examine the relationship between hemoglobin levels (hemoglobin concentration and mass) and [Formula: see text] (absolute and relative [Formula: see text]) among both observational and interventional studies.

METHODS

A systematic search was performed on December 6th, 2021. The study procedures and reporting of findings followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Article selection and data abstraction were performed in duplicate by two independent reviewers. Primary outcomes were hemoglobin levels and [Formula: see text] values (absolute and relative). For observational studies, meta-regression models were performed to examine the relationship between hemoglobin levels and [Formula: see text] values. For interventional studies, meta-analysis models were performed to determine the change in [Formula: see text] values (standard paired difference) associated with interventions designed to modify hemoglobin levels or [Formula: see text]. Meta-regression models were then performed to determine the relationship between a change in hemoglobin levels and the change in [Formula: see text] values.

RESULTS

Data from 384 studies (226 observational studies and 158 interventional studies) were examined. For observational data, there was a positive association between absolute [Formula: see text] and hemoglobin levels (hemoglobin concentration, hemoglobin mass, and hematocrit (P<0.001 for all)). Prespecified subgroup analyses demonstrated no apparent sex-related differences among these relationships. For interventional data, there was a positive association between the change of absolute [Formula: see text] (standard paired difference) and the change in hemoglobin levels (hemoglobin concentration (P<0.0001) and hemoglobin mass (P = 0.006)).

CONCLUSION

These findings suggest that [Formula: see text] values are closely associated with hemoglobin levels among both observational and interventional studies. Although our findings suggest a lack of sex differences in these relationships, there were limited studies incorporating females or stratifying results by biological sex.

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.

Effects of acute creatine supplementation on iron homeostasis and uric acid-based antioxidant capacity of plasma after wingate test

Background

Dietary creatine has been largely used as an ergogenic aid to improve strength and athletic performance, especially in short-term and high energy-demanding anaerobic exercise. Recent findings have also suggested a possible antioxidant role for creatine in muscle tissues during exercise. Here we evaluate the effects of a 1-week regimen of 20 g/day creatine supplementation on the plasma antioxidant capacity, free and heme iron content, and uric acid and lipid peroxidation levels of young subjects (23.1 ± 5.8 years old) immediately before and 5 and 60 min after the exhaustive Wingate test.

Results

Maximum anaerobic power was improved by acute creatine supplementation (10.5 %), but it was accompanied by a 2.4-fold increase in pro-oxidant free iron ions in the plasma. However, potential iron-driven oxidative insult was adequately counterbalanced by proportional increases in antioxidant ferric-reducing activity in plasma (FRAP), leading to unaltered lipid peroxidation levels. Interestingly, the FRAP index, found to be highly dependent on uric acid levels in the placebo group, also had an additional contribution from other circulating metabolites in creatine-fed subjects.

Conclusions

Our data suggest that acute creatine supplementation improved the anaerobic performance of athletes and limited short-term oxidative insults, since creatine-induced iron overload was efficiently circumvented by acquired FRAP capacity attributed to: overproduction of uric acid in energy-depleted muscles (as an end-product of purine metabolism and a powerful iron chelating agent) and inherent antioxidant activity of creatine.

Novel serum biomarkers for erythropoietin use in humans: a proteomic approach

Erythropoietin (Epo) is produced primarily in the kidneys upon low blood oxygen availability and stimulates erythropoiesis in the bone marrow. Recombinant human Epo (rHuEpo), a drug developed to increase arterial oxygen content in patients, is also illicitly used by athletes to improve their endurance performance. Therefore, a robust and sensitive test to detect its abuse is needed. The aim of the present study was to investigate potential human serum biomarkers of Epo abuse employing a proteomic approach. Eight healthy male subjects were injected subcutaneously with rHuEpo (5,000 IU) every second day for a 16-day period. Serum was collected before starting the treatment regime and again at days 8 and 16 during the treatment period. Samples were homogenized and proteins separated by two-dimensional gel electrophoresis (2DE). Spots that changed significantly in response to rHuEpo treatment were identified by mass spectrometry. Both the number of reticulocytes and erythrocytes increased throughout the study, leading to a significant increase in hematocrit and hemoglobin content. In addition, transferrin levels increased but the percentage of iron bound to transferrin and ferritin levels decreased. Out of 97 serum proteins, seven were found to decrease significantly at day 16 compared with pre-Epo administration, and were identified as four isoforms of haptoglobin, two isoforms of transferrin, and a mixture of hemopexin and albumin. In support, total serum haptoglobin levels were found to be significantly decreased at both days 8 and 16. Thus a 2DE proteomic approach for discovery of novel markers of Epo action appears feasible.

Hand Strike-Induced Hemolysis and Adaptations in Iron Metabolism in Basque Ball Players

INTRODUCTION

Basque ball players (BBPs) make repeated hand strikes to the ball which involves continuous mechanical trauma.

OBJECTIVE

The aim of this work is to describe the hematological variations and changes in iron metabolism occurring in BBPs as a result of acute and continuous practice of this special sport native to Northern Spain.

METHODS

40 healthy male subjects volunteered to participate in this study: 11 subjects who exercise moderately (control group) but do not play Basque ball sport and 29 professional BBPs were studied in two situations: before a match (BM group) and after a match (AM group). The following hematological parameters were determined: red blood cell count (RBC), hemoglobin and hematocrit; MCV, MCH and MCHC. The following variables were measured in serum: iron, ferritin, transferrin, transferrin saturation, proteins, and lactate dehydrogenase (LDH). Proteins and hemoglobin were determined in urine.

RESULTS

The BM group showed lower hematocrit, MCV, hemoglobin and serum transferrin levels, and higher LDH than controls. The AM group showed higher RBC, hemoglobin, serum proteins, iron, transferrin and LDH levels, lower plasma volume, and higher urine hemoglobin and protein levels than the BM group.

CONCLUSIONS

Basque ball playing induces hemolysis and increases the plasma capability to quench free iron, but its clinical consequences on iron metabolism do not seem to be enough to take an iron intake proportional to the caloric intake. In order to prevent, in the long term, the development of anemia in these peculiar sportsmen, it would be useful that medical teams observe urine blood losses and oxidative stress in these BBPs.

Red blood cell variables in highly trained pubescent athletes: a comparative analysis

BACKGROUND

A suboptimal haematological status has often been recorded in athletes involved in intensive physical activity. There have even been reports of "sports anaemia" associated with intensive physical exercise. However, studies on the effect of different types of exercise practiced over a long period of time on the red blood cell variables in pubescent athletes are very few.

AIM

To assess the basic red blood cell variables in highly trained pubescent athletes from different sports and to compare the results with those for a control untrained group. Sex related differences in these variables were also assessed.

METHODS

876 highly trained athletes (559 boys and 317 girls) were included in the study. Their mean (SEM) age, weight, and duration of training were: 14.01 (0.06) years, 56.24 (0.52) kg, and 3.52 (0.07) years respectively. The control group consisted of 357 untrained subjects (171 boys and 186 girls) with mean (SEM) age and weight of 14.58 (0.09) years and 57.75 (0.67) kg. The group of athletes was divided into seven subgroups according to the sport practiced: athletics (105), swimming (107), rowing (230), wrestling (225), weight lifting (47), various team sports (92), and other sports (67). Venous blood samples were drawn from the cubital vein, and the red blood cell count, packed cell volume, haemoglobin concentration, and mean corpuscular volume were measured. Statistical indices were computed for each group and for each variable, and analysis of variance factorial analysis was performed to evaluate the statistical significance of the differences detected.

RESULTS

The highly trained group was found to have lower red blood cell count, packed cell volume, and haemoglobin concentration (p<0.001) than the control untrained group (4.61 (0.01) x 10(12)/l v 4.75 (0.02) x 10(12)/l, 0.389 (0.001) v 0.404 (0.002) l/l, and 133.01 (0.38) v 139.9 (0.62) g/l respectively). These variables were lower for the boys of the trained group than for the boys of the control group (p<0.001), and similarly for the girls (p<0.001). The lowest red blood cell count, packed cell volume, and haemoglobin concentration were measured in blood samples from the boys of the swimming subgroup (4.54 (0.06) x 10(12)/l, 0.386 (0.006) l/l, and 129.38 (1.80) g/l respectively) and the rowing subgroup (4.66 (0.03) x 10(12)/l, 0.400 (0.003) l/l, and 136.21 (0.94) respectively). The same distribution was found for the girls: lowest in the rowing subgroup (4.32 (0.04) x 10(12)/l, 0.314 (0.003) l/l, and 124.27 (0.93) g/l) and the swimming subgroup (4.40 (0.05) x 10(12)/l, 0.375 (0.005) l/l, and 125.90 (1.30) g/l). No differences were found in the mean corpuscular volume.

CONCLUSIONS

Continuous (more than one year) high intensity sports training (twice a day/five days a week) results in a decrease in the basic red blood cell variables in pubescent boys and girls, this being most pronounced in the submaximal sports.

Decrease of serum iron in acutely psychotic schizophrenic patients

Iron deficiency has been shown to effect the dopaminergic system. Iron deficient rats have low dopamine D2 receptor levels and modified dopamine-mediated behaviors, including reversal of circadian cycles of these behaviors. Abnormal iron deposits have been found in the brains of schizophrenics in CT and post mortum studies. We examined serum iron levels at 0800, 1700 and 2400 hours in 26 medication free schizophrenic patients in acute psychotic relapse and compared them to iron levels in a normal control group. The results show significant decreases in the iron levels at 1700 and 2400, and a non significant drop in the 0800 levels. A feedback mechanism involving iron and dopamine is proposed.