Blood Testing in Sport: Hematological Profiling

Abstract

Hemoglobin concentration and percent reticulocytes (%retics) were analyzed in blood samples taken pre-competition, post-competition, and during out of competition testing in elite speed skaters. Percent reticulocytes during screening was not different from the values obtained post-race, and no significant gender difference was found. Mean hemoglobin concentration both in males and females was slightly higher at 1 425 m altitude compared to <750 m altitude (0.23 g/dl increase in males and 0.48 g/dl increase in females; p<0.05 and p<0.01, respectively). Mean %retics at 1 425 m altitude is higher (0.24% in males and 0.27% in females, respectively, p<0.01) compared to blood sampled <750 m altitude. The distribution of percent reticulocytes shows 11 out of 11 500 samples with %reticulocytes below 0.4%. From the 171 samples with a values >2.4% in 52 skaters at least two consecutive samples yielded a percent reticulocytes above 2.4%. In 50 individuals with generally normal values but at least in two consecutive samples values above 2.4% the pattern required additional testing. In conclusion, percent reticulocytes are a robust hematological parameter, including acute exercise.

Key words

sport - blood testing - reticulocytes - hemoglobin concentration - profiles

References

• 1 Ashenden M, Valet-Marie E, Lasne F, Audran M. The effect of microdose recombinant human erythropoietin regimens in athletes.  Haematologica. 2006;  91 1143-1144
• 2 Banfi G. Reticulocytes in sports medicine.  Sports Med. 2008;  38 1-24
• 3 Berglund B. High altitude training. Aspects of haematological adaptation.  Sports Med. 1992;  14 289-303
• 4 Birkeland KI, Stray-Gundersen J, Hemmersbach P, Hallen J, Haug E, Bahr R. Effect of rhEPO administration on serum levels of sTfR and cycling performance.  Med Sci Sports Exerc. 2000;  32 1238-1243
• 5 Gore CJ, Parisotto R, Ashenden MJ, Stray-Gundersen J, Sharpe K, Hopkins W, Emslie KR, Howe C, Trout GJ, Kazlauskas R, Hahn AG. Second generation blood tests to detect erythropoietin abuse by athletes.  Haematologica. 2003;  88 333-343
• 6 Gore CJ, Hahn G, Burge CM, Telford RD. VO2max and hemoglobin mass of trained athletes during high intensity training.  Int J Sports Med. 1997;  18 477-482
• 7 Harriss DJ, Atkinson G. International Journal of Sports Medicine – Ethical Standards in Sport and Exercise Science Research.  Int J Sports Med. 2009;  30 701-702
• 8 ISU . Communication 1520.  http://www.isu.org 2008; 
• 9 ISU . Communication 1546.  http://www.isu.org 2008; 
• 10 Kling G. Using the ADVIA 120 for Sports Events: Calibration Procedures, Internal Report Bayer Corporation.  2000; 
• 11 Kuipers H, Brouwer T, Vanhoutvin S, Dubravcic-Simunjak S, Moran J, Mitchell D, Shobe J, Saikai H, Stray-Gundersen J. Evaluation of blood testing methodology for use in sport.  Croat Sports Med J. 2003;  18 10-14
• 12 Kuipers H, Brouwer T, Dubravcic-Simunjak S, Moran J, Mitchell D, Shobe J, Sakai H, Stray-Gundersen J, Vanhoutvin S. Hemoglobin and hematocrit values after saline infusion and tourniquet.  Int J Sports Med. 2005;  26 405-408
• 13 Lippi G, Guidi G. Laboratory screening for erythropoietin abuse in sport: an emerging challenge.  Clin Chem Lab Med. 2000;  38 13-19
• 14 Lundby C, Achman-Andersen NJ, Thomsen JJ, Norgaard AM, Robach P. Testing for recombinant human erythropoietin in urine: problems associated with current anti-doping testing.  J Appl Physiol. 2008;  105 417-419
• 15 Mørkeberg J, Belhage B, Ashenden M, Bornø A, Sharpe K, Dziegiel MH, Damsgaard R. Screening for autologous blood transfusion.  Int J Sports Med. 2009;  30 285-292
• 16 Parisotto R, Wu M, Ashenden MJ, Emslie KR, Gore CJ, Howe C, Kazlauskas R, Sharpe K, Trout GJ, Xie M, Hahn AG. Detection of recombinant human erythropoietin abuse in athletes utilizing markers of altered erythropoiesis.  Haematologica. 2001;  86 128-137
• 17 Richardson RS, Verstraete D, Johnson SC, Luetkemeier MJ, Stray-Gundersen J. Evidence of a secondary hypervolemia in trained man following actue high intensity exercise.  Int J Sports Med. 1996;  17 243-247
• 18 Robinson N, Magin P, Saugy M. Time and temperature dependant changes in red blood cell analytes used for testing recombinant erythropoietin abuse in sport.  Clin Lab. 2004;  50 317-323
• 19 Russell G, Gore CJ, Ashenden MJ, Parisotto R, Hahn AG. Effects of prolonged low doses of recombinant human erythropoietin during submaximal and maximal exercise.  Eur J Appl Physiol. 2002;  86 442-449
• 20 Schmidt W, Biermann B, Winchenbach P, Lison S, Bönig D. How valid is the determination of hematocrit values to detect blood manipulations?.  Int J Sports Med. 2000;  21 133-138
• 21 Sharpe K, Ashenden MJ, Schumacher YO. A third generation approach to detect erythropoietin abuse in athletes.  Haematologic. 2006;  91 356-363
• 22 Thevis M, Thomas A, Kohler M, Beuck S, Schänzer W. Emerging drugs: mechanism of action, mass spectrometry and doping control analysis.  J Mass Spectom. 2009;  44 442-460
• 23 Van Hove L, Goossens W, Van Duppen V, Verwilghen RL. Reticulocyte count using thiazole orange. A flow cytometry method.  Clin Lab Haematol. 1990;  12 287-299

Correspondence