Comparison of hematologic data in world elite junior speed skaters and in non-athletic juniors

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.

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.

Influence of endurance exercise on serum concentrations of iron and acute phase proteins in racing sled dogs

OBJECTIVE

To determine effects of long-distance racing exercise on iron status in endurance racing sled dogs, with or without anemia.

DESIGN

Prospective cohort study.

ANIMALS

114 dogs that participated in the 2007 Iditarod Trail Sled Dog Race (59 and 55 dogs that did or did not complete the race, respectively).

PROCEDURES

Stored serum samples obtained from 85 endurance-racing sled dogs that were expected to participate in the race were used to establish study reference intervals and prerace group values for iron-related variables. Blood samples collected from 114 study dogs before (ie, baseline) and after participation in the race were used to determine PCV and serum total protein concentrations before and after racing and assess iron-related variables after racing.

RESULTS

Mean values for PCV and serum total protein concentration were decreased after racing, compared with baseline values in the same dogs. Mean serum iron concentration was low, and mean serum ceruloplasmin and C-reactive protein (CRP) concentrations were high in dogs after racing, compared with prerace group values. Mean serum ferritin concentration was high in dogs that did not complete the race, compared with the prerace group value and that of dogs that finished the race; 4 of 113 (3.5%) study dogs had low ferritin concentrations (< 73 ng/mL) after racing, suggestive of possible iron deficiency.

CONCLUSIONS AND CLINICAL RELEVANCE

Decreased PCV and serum total protein concentrations were consistently detected, whereas iron deficiency appeared to be uncommon, in study dogs after race participation. High serum concentrations of ceruloplasmin and CRP after racing suggested that changes indicative of iron deficiency may be masked by inflammation. Alternatively, changes in serum iron and CRP concentrations may reflect a physiologic response.

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.

Seasonal variations of haematological parameters in athletes

The influence of training and competition workloads is crucial for evaluation of longitudinal haematological data in athletes. There are only a few papers on the variation of haematological parameters during long-lasting periods and, especially, during an entire competitive season. We summarized that some haematological parameters can be influenced by long-term training and competition periods. Haemoglobin (Hb) and haematocrit (Ht) are decreased during the more intense periods of training, throughout the season. In different sport disciplines, the decline of Hb ranges from 3 to 8% during the competition season, while the range of reticulocytes (Ret%) varies from 5 to 21%. Reticulocytes are also decreased after long periods of training and competitions, but their variation is not necessarily associated with that of Hb. The qualitative variations (trend of modifications) of haematological parameters are roughly independent of the sport discipline, but quantitatively (amount of modifications) dependent on sport discipline. The modifications are more evident in cycling, running, swimming than they are in football and rugby. The variations of haematological parameters within the same sport discipline are qualitatively concordant and quantitatively different among separate but consecutive competitive seasons. These findings are described in aerobic and team sports sportsmen. The definition of reliable reference ranges in sportsmen would only be possible by following the best laboratory practices. For antidoping purposes more studies investigating haematological modifications during the season are advisable.

Responses of hematological parameters and aerobic performance of elite men and women swimmers during a 14-week training program

The main purpose of the present investigation was to verify the responses of hematological parameters in men and women competitive swimmers during a 14-week training program. Twenty-three Olympic and international athletes were evaluated 4 times during the experiment: at the beginning of the endurance training phase (T1), at the end of the endurance training phase (T2), at the end of the quality phases (T3), and at the end of the taper period (T4). On the first day at 8:00 AM, each swimmer had a blood sample taken for the determination of hematological parameters. At 3:00 PM, the athletes had their aerobic performance measured by anaerobic threshold. On the second day at 8:00 AM, the swimmers had their aerobic performance measured by critical velocity. Hematocrit and mean corpuscular volume diminished (p < or = 0.05) from T1 to T2 (men: 5.8 and 7.2%; women: 11.6 and 6.8%), and increased (p < or = 0.05) from T2 to T3 (men: 7.2 and 6.0%; women: 7.4 and 5.2%). These results were related to the plasma volume changes of the athletes. However, these alterations do not seem to affect the swimmers' aerobic performance. For practical applications, time-trial performance is better than aerobic performance (i.e., anaerobic threshold and critical velocity) for monitoring training adaptations.

Hematological parameters and anaerobic threshold in Brazilian soccer players throughout a training program

We assessed the responses of hematological parameters and their relationship to the anaerobic threshold of Brazilian soccer players during a training program. Twelve athletes were evaluated at the beginning (week 0, T1), in the middle (week 6, T2), and at the end (week 12, T3) of the soccer training program. On the first day at 7:30 am, before collecting the blood sample at rest for the determination of the hematological parameters, the athletes were conducted to the anthropometric evaluation. On the second day at 8:30 am, the athletes had their anaerobic threshold measured. Analysis of variance with Newman-Keuls'post hoc was used for statistical comparisons between the parameters measured during the soccer training program. Correlations between the parameters analyzed were determined using the Pearson's correlation coefficient. Erythrocytes concentration, hemoglobin, and hematocrit were significantly increased from T1 to T2. The specific soccer training program led to a rise in erythrocytes, hemoglobin, and hematocrit from T1 to T2. We assumed that these results occurred due to the plasma volume reduction and may be explained by the soccer training program characteristics. Furthermore, we did not observe any correlation between the anaerobic threshold and the hematological parameters.

Reticulocytes in sports medicine

Reticulocytes are the transitional cells from erythroblasts to mature erythrocytes. Reticulocytes are present in blood for a period of 1-4 days and can be recognized by staining with supravital dyes, such as new methylene blue, or fluorescent markers, which couple residual nucleic acid molecules, a hallmark of the immature forms of erythrocytes. Although reticulocytes could be counted through a microscope (there is a standard of International Committee for Standardisation in Haematology for manual counting), this method is reported to be time consuming, inaccurate and imprecise. The integration of the reticulocyte count in automated haematology systems allowed the widespread use of these parameters, although the lack of calibration material and different markers, technologies and software used in automated systems could engender discrepancies among data obtained from different analytical systems.The importance of reticulocytes in sports medicine derives from their sensitivity, the highest among haematology parameters, in identifying the bone marrow stimulation, especially when recombinant human erythropoietin is fraudulently used. Automated systems are also able to supply information on volume, density and the haemoglobin content of reticulocytes. Some of the related parameters are also used in algorithms for identifying abnormal stimulation of bone marrow as reticulocytes haematocrit. The pre-analytical variability of reticulocytes (transportation, storage, biological variability) should be taken into account in sports medicine also. Reticulocytes remain stable for almost 24 hours at 4 degrees C from blood drawing, they are affected by transportation, and biological variability is not high in general. It could be remarked, however, that the intra-individual variability is high when compared with other haematological parameters such as haemoglobin and haematocrit. The intervals of data reported in athletes are very similar to reference intervals characterizing the general population.The reticulocyte count shows some modifications after training and during the competition season. The variability induced by exercise cannot be overlooked since the so-called haematological passport, a personal athlete's document in which haemoglobin and other parameters are registered, may be introduced by sports federations. Exposure to naturally high altitude and 'living high-training low' programmes determined contentious results on reticulocytes. Simulated high altitude induced by intermittent hypobaric hypoxia does not modify reticulocytes, despite an increase in erythropoietin serum concentration. The variability among athletes competing in different sport disciplines is apparently limited. The knowledge of the behaviour of reticulocytes in training and competitions is crucial for defining their role in an antidoping control context. It is important for sport physicians and clinical pathologists to know the reticulocyte variability in the general population and in athletes, the pre-analytical warnings, the different methodologies for counting reticulocytes and the derived parameters automatically available, and, finally, the possible influence of training, competitions, type of sport and altitude.

Reference intervals for serum creatine kinase in athletes

BACKGROUND

The serum concentration of creatine kinase (CK) is used widely as an index of skeletal muscle fibre damage in sport and exercise. Since athletes have higher CK values than non-athletes, comparing the values of athletes to the normal values established in non-athletes is pointless. The purpose of this study was to introduce reference intervals for CK in athletes.

METHOD

CK was assayed in serum samples from 483 male athletes and 245 female athletes, aged 7-44. Samples had been obtained throughout the training and competition period. For comparison, CK was also assayed in a smaller number of non-athletes. Reference intervals (2.5th to 97.5th percentile) were calculated by the non-parametric method.

RESULTS

The reference intervals were 82-1083 U/L (37 degrees C) in male and 47-513 U/L in female athletes. The upper reference limits were twice the limits reported for moderately active non-athletes in the literature or calculated in the non-athletes in this study. The upper limits were up to six times higher than the limits reported for inactive individuals in the literature. When reference intervals were calculated specifically in male football (soccer) players and swimmers, a threefold difference in the upper reference limit was found (1492 vs 523 U/L, respectively), probably resulting from the different training and competition demands of the two sports.

CONCLUSION

Sport training and competition have profound effects on the reference intervals for serum CK. Introducing sport-specific reference intervals may help to avoid misinterpretation of high values and to optimise training.