Total Hemoglobin Mass, Aerobic Capacity, and HBB Gene in Polish Road Cyclists

A Systematic Review and Meta-analysis of the Association Between ACTN3 R577X Genotypes and Performance in Endurance Versus Power Athletes and Non-athletes

BACKGROUND

Previous studies reported differences in genotype frequency of the ACTN3 R577X polymorphisms (rs1815739; RR, RX and XX) in athletes and non-athletic populations. This systematic review with meta-analysis assessed ACTN3 R577X genotype frequencies in power versus endurance athletes and non-athletes.

METHODS

Five electronic databases (PubMed, Web of Science, Scopus, Science Direct, SPORTDiscus) were searched for research articles published until December 31st, 2022. Studies were included if they reported the frequency of the ACTN3 R577X genotypes in power athletes (e.g., weightlifters) and if they included a comparison with endurance athletes (e.g., long-distance runners) or non-athletic controls. A meta-analysis was then performed using either fixed or random-effects models. Pooled odds ratios (OR) were determined. Heterogeneity was detected using I2 and Cochran's Q tests. Publication bias and sensitivity analysis tests were computed.

RESULTS

After screening 476 initial registrations, 25 studies were included in the final analysis (13 different countries; 14,541 participants). In power athletes, the RX genotype was predominant over the two other genotypes: RR versus RX (OR 0.70; 95% CI 0.57-0.85, p = 0.0005), RR versus XX (OR 4.26; 95% CI 3.19-5.69, p < 0.00001), RX versus XX (OR 6.58; 95% CI 5.66-7.67, p < 0.00001). The R allele was higher than the X allele (OR 2.87; 95% CI 2.35-3.50, p < 0.00001) in power athletes. Additionally, the frequency of the RR genotype was higher in power athletes than in non-athletes (OR 1.48; 95% CI 1.25-1.75, p < 0.00001). The RX genotype was similar in both groups (OR 0.84; 95% CI 0.71-1.00, p = 0.06). The XX genotype was lower in power athletes than in controls (OR 0.73; 95% CI 0.64-0.84, p < 0.00001). Furthermore, the R allele frequency was higher in power athletes than in controls (OR 1.28; 95% CI 1.19-1.38, p < 0.00001). Conversely, a higher frequency of X allele was observed in the control group compared to power athletes (OR 0.78; 95% CI 0.73-0.84, p < 0.00001). On the other hand, the frequency of the RR genotype was higher in power athletes than in endurance athletes (OR 1.27; 95% CI 1.09-1.49, p = 0.003). The frequency of the RX genotype was similar in both groups (OR 1.07; 95% CI 0.93-1.24, p = 0.36). In contrast, the frequency of the XX genotype was lower in power athletes than in endurance athletes (OR 0.63; 95% CI 0.52-0.76, p < 0.00001). In addition, the R allele was higher in power athletes than in endurance athletes (OR 1.32; 95% CI 1.11-1.57, p = 0.002). However, the X allele was higher in endurance athletes compared to power athletes (OR 0.76; 95% CI 0.64-0.90, p = 0.002). Finally, the genotypic and allelic frequency of ACTN3 genes were similar in male and female power athletes.

CONCLUSIONS

The pattern of the frequencies of the ACTN3 R577X genotypes in power athletes was RX > RR > XX. However, the RR genotype and R allele were overrepresented in power athletes compared to non-athletes and endurance athletes. These data suggest that the RR genotype and R allele, which is associated with a normal expression of α-actinin-3 in fast-twitch muscle fibers, may offer some benefit in improving performance development in muscle strength and power.

Genomic predictors of physical activity and athletic performance

Physical activity and athletic performance are complex phenotypes influenced by environmental and genetic factors. Recent advances in lifestyle and behavioral genomics led to the discovery of dozens of DNA polymorphisms (variants) associated with physical activity and allowed to use them as genetic instruments in Mendelian randomization studies for identifying the causal links between physical activity and health outcomes. On the other hand, exercise and sports genomics studies are focused on the search for genetic variants associated with athlete status, sports injuries and individual responses to training and supplement use. In this review, the findings of studies investigating genetic markers and their associations with physical activity and athlete status are reported. As of the end of September 2023, a total of 149 variants have been associated with various physical activity traits (of which 42 variants are genome-wide significant) and 253 variants have been linked to athlete status (115 endurance-related, 96 power-related, and 42 strength-related).

Genes and Athletic Performance: The 2023 Update

Phenotypes of athletic performance and exercise capacity are complex traits influenced by both genetic and environmental factors. This update on the panel of genetic markers (DNA polymorphisms) associated with athlete status summarises recent advances in sports genomics research, including findings from candidate gene and genome-wide association (GWAS) studies, meta-analyses, and findings involving larger-scale initiatives such as the UK Biobank. As of the end of May 2023, a total of 251 DNA polymorphisms have been associated with athlete status, of which 128 genetic markers were positively associated with athlete status in at least two studies (41 endurance-related, 45 power-related, and 42 strength-related). The most promising genetic markers include the AMPD1 rs17602729 C, CDKN1A rs236448 A, HFE rs1799945 G, MYBPC3 rs1052373 G, NFIA-AS2 rs1572312 C, PPARA rs4253778 G, and PPARGC1A rs8192678 G alleles for endurance; ACTN3 rs1815739 C, AMPD1 rs17602729 C, CDKN1A rs236448 C, CPNE5 rs3213537 G, GALNTL6 rs558129 T, IGF2 rs680 G, IGSF3 rs699785 A, NOS3 rs2070744 T, and TRHR rs7832552 T alleles for power; and ACTN3 rs1815739 C, AR ≥21 CAG repeats, LRPPRC rs10186876 A, MMS22L rs9320823 T, PHACTR1 rs6905419 C, and PPARG rs1801282 G alleles for strength. It should be appreciated, however, that elite performance still cannot be predicted well using only genetic testing.

HIF-1α and NFIA-AS2 Polymorphisms as Potential Determinants of Total Hemoglobin Mass in Endurance Athletes

ABSTRACT

Malczewska-Lenczowska, J, Orysiak, J, Majorczyk, E, Sitkowski, D, Starczewski, M, and Żmijewski, P. HIF-1α and NFIA-AS2 polymorphisms as potential determinants of total hemoglobin mass in endurance athletes. J Strength Cond Res 36(6): 1596-1604, 2022-The aims of this study were to examine (1) the genotype distribution of rs11549465:C>T of the HIF-1α gene and rs1572312:C>A of the NFIA-AS2 gene; (2) the association between the genes and hematological status in endurance-oriented athletes; and (3) the association between the NFIA-AS2 gene and aerobic capacity in cyclists. Two hundred thirty-eight well-trained athletes (female n = 90, male n = 148) participated in the study. Total hemoglobin mass (tHbmass), blood morphology, intravascular volumes, i.e., erythrocyte volume (EV), blood volume (BV) and plasma volume (PV), and aerobic capacity indices, e.g., peak oxygen uptake (V̇o2peak), and power at anaerobic threshold (PAT) were determined. In both studied genes, the CC genotype was predominant. In the HIF-1α gene, there were no differences in genotype and allele distribution among athletes from different disciplines and between sexes. The distribution of genotypes and alleles of the NFIA-AS2 gene differed significantly in male athletes; the frequency of A allele carriers (CA + AA) was significantly higher in cyclists than in rowers and middle- and long-distance runners. The athletes with CC genotype of NF1A-AS2 had significantly higher relative values of: tHbmass (total female athletes, cyclists), PV, BV (cyclists), and EV (total male athletes, cyclists) and PAT (cyclists) than A allele carriers (CA + AA genotypes). In conclusion, our study indicates that NFIA-AS2 rs1572312:C>A polymorphism was associated with hematological status in endurance athletes, as well as aerobic capacity indices in male cyclists. It suggests that this polymorphism may be a determinant of quantity of hemoglobin and intrtavascular volumes, which in turn can have an impact on aerobic performance.

Advances in sports genomics

Sports genomics is the scientific discipline that focuses on the organization and function of the genome in elite athletes, and aims to develop molecular methods for talent identification, personalized exercise training, nutritional need and prevention of exercise-related diseases. It postulates that both genetic and environmental factors play a key role in athletic performance and related phenotypes. This update on the panel of genetic markers (DNA polymorphisms) associated with athlete status and soft-tissue injuries covers advances in research reported in recent years, including one whole genome sequencing (WGS) and four genome-wide association (GWAS) studies, as well as findings from collaborative projects and meta-analyses. At end of 2020, the total number of DNA polymorphisms associated with athlete status was 220, of which 97 markers have been found significant in at least two studies (35 endurance-related, 24 power-related, and 38 strength-related). Furthermore, 29 genetic markers have been linked to soft-tissue injuries in at least two studies. The most promising genetic markers include HFE rs1799945, MYBPC3 rs1052373, NFIA-AS2 rs1572312, PPARA rs4253778, and PPARGC1A rs8192678 for endurance; ACTN3 rs1815739, AMPD1 rs17602729, CPNE5 rs3213537, CKM rs8111989, and NOS3 rs2070744 for power; LRPPRC rs10186876, MMS22L rs9320823, PHACTR1 rs6905419, and PPARG rs1801282 for strength; and COL1A1 rs1800012, COL5A1 rs12722, COL12A1 rs970547, MMP1 rs1799750, MMP3 rs679620, and TIMP2 rs4789932 for soft-tissue injuries. It should be appreciated, however, that hundreds and even thousands of DNA polymorphisms are needed for the prediction of athletic performance and injury risk.

The association of HFE gene H63D polymorphism with endurance athlete status and aerobic capacity: novel findings and a meta-analysis

PURPOSE

Iron is an important component of the oxygen-binding proteins and may be critical to optimal athletic performance. Previous studies have suggested that the G allele of C/G rare variant (rs1799945), which causes H63D amino acid replacement, in the HFE is associated with elevated iron indexes and may give some advantage in endurance-oriented sports. The aim of the present study was to investigate the association between the HFE H63D polymorphism and elite endurance athlete status in Japanese and Russian populations, aerobic capacity and to perform a meta-analysis using current findings and three previous studies.

METHODS

The study involved 315 international-level endurance athletes (255 Russian and 60 Japanese) and 809 healthy controls (405 Russian and 404 Japanese). Genotyping was performed using micro-array analysis or by PCR. VO2max in 46 male Russian endurance athletes was determined using gas analysis system.

RESULTS

The frequency of the iron-increasing CG/GG genotypes was significantly higher in Russian (38.0 vs 24.9%; OR 1.85, P = 0.0003) and Japanese (13.3 vs 5.0%; OR 2.95, P = 0.011) endurance athletes compared to ethnically matched controls. The meta-analysis using five cohorts (two French, Japanese, Spanish, and Russian; 586 athletes and 1416 controls) showed significant prevalence of the CG/GG genotypes in endurance athletes compared to controls (OR 1.96, 95% CI 1.58-2.45; P = 1.7 × 10-9). Furthermore, the HFE G allele was associated with high V̇O2max in male athletes [CC: 61.8 (6.1), CG/GG: 66.3 (7.8) ml/min/kg; P = 0.036].

CONCLUSIONS

We have shown that the HFE H63D polymorphism is strongly associated with elite endurance athlete status, regardless ethnicities and aerobic capacity in Russian athletes.

Hematological status and endurance performance predictors after low altitude training supported by normobaric hypoxia: a double-blind, placebo controlled study

The benefits of altitude/hypoxic training for sea level performance are still under debate. This study examined the effects of low altitude training supported by normobaric hypoxia on hematological status and endurance performance predictors in elite female cyclists. Twenty-two female cyclists trained for 3 weeks at low altitude (<1100 m) and 2 weeks near sea level. During the first 3 weeks, 15 subjects stayed in hypoxic rooms simulating an altitude of 2200 m (+NH group, n = 8) or 1000 m (placebo group, n = 7), and 7 (control group) stayed in regular rooms. Significant increases in total hemoglobin mass (tHb-mass: p = 0.008, p = 0.025), power at 4 mmol·l^-1 lactate (PAT4: p = 0.004, p = 0.005) (in absolute and relative values, respectively) and maximal power (PF: p = 0.034) (in absolute values) were observed. However, these effects were not associated with normobaric hypoxia. Changes in tHb-mass were not associated with initial concentrations of ferritin or transferrin receptor, whereas changes in relative tHb-mass (r = -0.53, p = 0.012), PF (r = -0.53, p = 0.01) and PAT4 (r = -0.65, p = 0.001) were inversely correlated with initial values. Changes in tHb-mass and PAT4 were positively correlated (r = 0.50, p = 0.017; r = 0.47, p = 0.028). Regardless of normobaric hypoxia application, low altitude training followed by sea-level training might improve hematological status in elite female cyclists, especially with relatively low initial values of tHb-mass, which could translate into enhanced endurance performance.

Individual and Combined Influence of ACE and ACTN3 Genes on Muscle Phenotypes in Polish Athletes

Orysiak, J, Mazur-Różycka, J, Busko, K, Gajewski, J, Szczepanska, B, and Malczewska-Lenczowska, J. Individual and combined influence of ACE and ACTN3 genes on muscle phenotypes in polish athletes. J Strength Cond Res 32(10): 2776-2782, 2018-The aim of this study was to examine the association between angiotensin-converting enzyme (ACE) and α-actinin-3 (ACTN3) genes, independently or in combination, and muscle strength and power in male and female athletes. The study involved 398 young male (n = 266) and female (n = 132) athletes representing various sport disciplines (ice hockey, canoeing, swimming, and volleyball). All were Caucasians. The following measurements were taken: height of jump and mechanical power in countermovement jump (CMJ) and spike jump (SPJ), and muscle strength of 10 muscle groups (flexors and extensors of the elbow, shoulder, hip, knee, and trunk). The insertion-deletion (I/D) polymorphism of ACE and the R577X polymorphism of ACTN3 were typed using polymerase chain reaction (PCR) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), respectively. The genotype distribution of the ACE and ACTN3 genes did not differ significantly between groups of athletes for either sex. There was no association between ACE and ACTN3 genotypes (alone or in combination) and sum of muscle strength, height of jump or mechanical power in both jump tests (CMJ and SPJ) for male and female athletes. These findings do not support an influential role of the ACE and ACTN3 genes in determining power/strength performance of elite athletes.