Haematocrit in Elite Athletes

It is possible to increase haemoglobin (Hb) and haematocrit (Ht) to non-physiological values by injecting recombinant human erythropoietin (rhEPO). Although this treatment may result in a better performance of athletes, it may also cause a health risk. To prevent doping with rhEPO, the Union Cycliste Internationale has decided to exclude male cyclists with Ht > 0.50 and female cyclists with Ht > 0.47 from competition. These cut-off values, however, may result in a non-justified exclusion of clean athletes. To test this hypothesis, we measured the Ht of elite athletes (50 men and 41 women) during a total study period of 43 months. Ht was compared with that in healthy control subjects (134 men and 144 women). No significant differences in Ht were detected between male elite athletes and their references and female elite athletes and their references (P > 0.05). In both populations, however, male subjects were found with Ht > 0.50, 6 controls and 5 elite athletes (4 highlanders and 1 lowlander). In the female subjects 5 controls but not one of the athletes exceeded a Ht > 0.47. „Increased” Ht values among athletes were mainly seen in highlanders. The study shows that it is very difficult to set up a decision value for Ht with regard to doping by erythropoietin.

Key words:

Haematocrit - erythropoietin - elite athlete - highlander - altitude

References

• 1 Antezana A M, Richalet J P, Noriega I, Galarza M, Antezana G. Hormonal changes in normal and polycythemic high-altitude natives.  J Appl Physiol. 1995;  79 795-800
• 2 Bailey D M, Davies B. Physiological implications of altitude training for endurance performance at sea level: a review.  Br J Sports Med. 1997;  31 183-190
• 3 Beard J L, Haas J D, Tufts D, Spielvogel H, Vargas E, Rodriguez C. Iron deficiency anemia and steady-state work performance at high altitude.  J Appl Physiol. 1988;  64 1878-1884
• 4 Gore C J, Hahn A G, Burge C M, Telford R D. V˙O₂max and haemoglobin mass of trained athletes during high intensity training.  Int J Sports Med. 1997;  18 477-482
• 5 Hillman R S. Anemia. In: Fauci AS (ed) Harrison's Principles of Internal Medicine. New York; McGraw-Hill 1998: 334-339
• 6 Martin D T, Ashenden M, Parisotto R, Pyne D, Hahn A G. Blood testing for professional cyclists. What's a fair hematocrit limit?Sportscience News 1997; http://www.sportsci.org/news/news9703/AIS blood.html. 
• 7 Marx J JM, Vergouwen P CJ. Packed-cell volume in elite athletes.  The Lancet. 1998;  352 451
• 8 Normand H, Vargas E, Bordachar J, Benoit O, Raynaud J. Sleep Apneas in High Altitude Residents (3800 m).  Int J Sports Med. 1992;  13 42
• 9 Samaja M, Veicsteinas A, Cerretelli P. Oxygen affinity of blood in altitude Sherpas.  J Appl Physiol. 1979;  47 337-341
• 10 Santolaya R B, Lahiri S, Alfaro R T, Schoene R B. Respiratory adaptation in highest inhabitants and highest Sherpa mountaineers.  Resp Physiol. 1989;  77 253-262
• 11 Schmidt W, Dahners H W, Correa R, Ramirez R, Rojas J, Boning D. Blood gas transport properties in endurance-trained athletes living at different altitudes.  Int J Sports Med. 1990;  11 15-21
• 12 Schmidt W, Spielvogel H, Eckerdt U, Quintela A, Penaloza R. Effects of chronic hypoxia and exercise on plasma erythropoietin in high altitude residents.  J Appl Physiol. 1993;  74 1874-1878
• 13 Seiler S. Tighter control on EPO use bij skiers. Sportscience News 1997; http://www.sportsci.org/news/news9701/EPOfeat.html. 
• 14 U.C.I .Lettre aux groupes sportifs. Lettre à tous les coureurs. Lausanne; UCI 1997: 07-1997
• 15 U.C.I .Protocole d'examen hématologique complémentaire lors d'une valeur d'hématocrite supèrieure à 50 %. Lausanne; Institut Universitaire de Médecine Légale, U.C.I. 1997: 02-1997
• 16 U.C.I .Letter to the trade teams. Sporting safety and conditions regulations. Lausanne; U.C.I. 1997: 16-1997
• 17 U.C.I .Sporting safety and conditions regulations. Lausanne; U.C.I. 1998: 5
• 18 Winslow R M, Chapman K W, Gibson C C, Samaja M, Monge C C, Goldwasser E, Sherpa M, Blume F D, Santolaya R. Different hematologic responses to hypoxia in Sherpas and Quechua Indians.  J Appl Physiol. 1989;  66 1561-1569