Haemoglobin Mass in Cyclists during Stage Racing

Abstract

Haemoglobin mass is a main determinant of maximal oxygen uptake. Blood doping aims at increasing this variable. Limits for haematocrit and haemoglobin concentration are used as indicators of blood doping. However, these variables are measures of concentration, do not represent total haemoglobin mass and are altered by vascular volumes shifts. Direct estimation of haemoglobin mass could improve blood tests. It is unknown if physical exercise alters haemoglobin mass. The purpose of this study was to investigate the reaction of haemoglobin mass and other vascular compartments to heavy exercise in athletes. Haemoglobin mass and vascular compartments were evaluated using the optimised CO rebreathing method in 7 elite cyclists during a stage race. Simultaneously, haemoglobin concentration and haematocrit were analysed. Haemoglobin mass (pre-race 958 ± 123 g, end race 948 ± 106 g) and red cell volume did not change significantly over the study period, while plasma volume and blood volume tended to increase. Haematocrit (pre-race 44.1 ± 2.5 %, end race 40.9 ± 1.59 %) and haemoglobin concentration (pre race 15.8 ± 0.9 g/dl, end race 14.7 ± 0.7 g/dl) decreased. During the study, a plasma volume expansion as adaptation to prolonged exercise occurred. Haemoglobin concentration and haematocrit decreased accordingly, whereas haemoglobin mass remained stable. Haemoglobin mass might therefore be a suitable screening tool for blood manipulations.

Key words

exercise - blood doping - carbon monoxide rebreathing

References

• 1 Ashenden M, Varlet-Marie E, Lasne F, Audran M. The effects of microdose recombinant human erythropoietin regimens in athletes.  Haematologica. 2006;  91 1143-1144
• 2 Bassett Jr D R, Howley E T. Limiting factors for maximum oxygen uptake and determinants of endurance performance.  Med Sci Sports Exerc. 2000;  32 70-84
• 3 Bland J M, Altman D G. Measurement error.  BMJ. 1996;  313 744
• 4 Burge C M, Skinner S L. Determination of hemoglobin mass and blood volume with CO: evaluation and application of a method.  J Appl Physiol. 1995;  79 623-631
• 5 Ekblom B, Berglund B. Effect of erythropoietin administration on maximal aerobic power.  Scand Med Sci Sports. 1991;  1 88-93
• 6 Gledhill N. Blood doping and related issues: a brief review.  Med Sci Sports Exerc. 1982;  14 183-189
• 7 Gore C J, Hopkins W G, Burge C M. Errors of measurement for blood volume parameters: a meta-analysis.  J Appl Physiol. 2005;  99 1745-1758
• 8 Gore C J, Parisotto R, Ashenden M J, Stray-Gundersen J, Sharpe K, Hopkins W, Emslie K R, Howe C, Trout G J, Kazlauskas R, Hahn A G. Second-generation blood tests to detect erythropoietin abuse by athletes.  Haematologica. 2003;  88 333-344
• 9 Harris E K. Effects of intra- and interindividual variation on the appropriate use of normal ranges.  Clin Chem. 1974;  20 1535-1542
• 10 Heinicke K, Wolfarth B, Winchenbach P, Biermann B, Schmid A, Huber G, Friedmann B, Schmidt W. Blood volume and hemoglobin mass in elite athletes of different disciplines.  Int J Sports Med. 2001;  22 504-512
• 11 Hopkins W G. Measures of reliability in sports medicine and science.  Sports Med. 2000;  30 1-15
• 12 Katch V L, Sady S S, Freedson P. Biological variability in maximum aerobic power.  Med Sci Sports Exerc. 1982;  14 21-25
• 13 Lasne F, Martin L, Crepin N, de Ceaurriz J. Detection of isoelectric profiles of erythropoietin in urine: differentiation of natural and administered recombinant hormones.  Analyt Biochem. 2002;  311 119-126
• 14 Malcovati L, Pascutto C, Cazzola M. Hematologic passport for athletes competing in endurance sports: a feasibility study.  Haematologica. 2003;  88 570-581
• 15 Myers J, Walsh D, Sullivan M, Froelicher V. Effect of sampling on variability and plateau in oxygen uptake.  J Appl Physiol. 1990;  68 404-410
• 16 Nelson M, Popp H, Sharpe K, Ashenden M. Proof of homologous blood transfusion through quantification of blood group antigens.  Haematologica. 2003;  88 1284-1295
• 17 Odeh R E, Owen D B. Tables for Normal Tolerance Limits, Sampling Plans, and Screening. New York; Marcel Dekker Inc. 1980
• 18 Parisotto R, Wu M, Ashenden M J, Emslie K R, Gore C J, Howe C, Kazlauskas R, Sharpe K, Trout G J, Xie M. Detection of recombinant human erythropoietin abuse in athletes utilizing markers of altered erythropoiesis.  Haematologica. 2001;  86 128-137
• 19 Sottas P E, Robinson N, Giraud S, Taroni F, Kamber M, Mengin P. Statistical classification of abnormal blood profiles in athletes.  Int J Biostat. 2006;  2 1011
• 20 Sawka M N, Convertino V A, Eichner E R, Schnieder S M, Young A J. Blood volume: importance and adaptations to exercise training, environmental stresses, and trauma/sickness.  Med Sci Sports Exerc. 2000;  32 332-348
• 21 Sawka M N, Young A J, Pandolf K B, Dennis R C, Valeri C R. Erythrocyte, plasma, and blood volume of healthy young men.  Med Sci Sports Exerc. 1992;  24 447-453
• 22 Schmidt W, Biermann B, Winchenbach P, Lison S, Boning D. How valid is the determination of hematocrit values to detect blood manipulations?.  Int J Sports Med. 2000;  21 133-138
• 23 Schmidt W, Prommer N. The optimised CO-rebreathing method: a new tool to determine total haemoglobin mass routinely.  Eur J Appl Physiol. 2005;  95 486-495
• 24 Schumacher Y O, Grathwohl D, Barturen J M, Wollenweber M, Heinrich L, Schmid A, Huber G, Keul J. Haemoglobin, haematocrit and red blood cell indices in elite cyclists. Are the control values for blood testing valid?.  Int J Sports Med. 2000;  21 380-385
• 25 Schumacher Y O, Temme J, Bueltermann D, Schmid A, Berg A. The influence of exercise on serum markers of altered erythropoiesis and the indirect detection models of recombinant human erythropoietin abuse in athletes.  Haematologica. 2003;  88 712-714
• 26 Sharpe K, Ashenden M J, Schumacher Y O. A third generation approach to detect erythropoietin abuse in athletes.  Haematologica. 2006;  91 356-363
• 27 Sharpe K, Hopkins W, Emslie K R, Howe C, Trout G J, Kazlauskas R, Ashenden M J, Gore C, Parisotto R, Hahn A. Development of reference ranges in elite athletes for markers of altered erythropoiesis.  Haematologica. 2002;  87 1248-1257
• 28 Sklerov J H, Goldbaum L R. Mechanism of carbon monoxide toxicity. (Part 1).  FASEB Journal. 1999;  13 A155
• 29 UCI .UCI Sporting Safety and Condition Regulations. Lausanne; UCI 1997 Chapter XIII, 13.01.023
• 30 Weight L M, Darge B L, Jacobs P. Athletes' pseudoanaemia.  Eur J Appl Physiol. 1991;  62 358-362
• 31 Williams G Z. Individuality of clinical biochemical patterns in preventive health maintenance.  J Occup Med. 1967;  9 567-570
• 32 Zander R, Schaffartzik W. Haem oxymeter.  Qualitest. 1999;  5 1-8