The Effect of Exercise Performed Before and 24 Hours After Blood Withdrawal on Serum Erythropoietin and Growth Hormone Concentrations in Humans

Abstract

In the present experiment we have studied the effect of exercise performed before and 24 h after withdrawal of 450 ml of blood on the serum erythropoietin and growth hormone (GH) levels, in humans. Twelve male subjects (x ± SD) aged 23.2 ± 2.6 y, with a body mass of 74.8 ± 7.2 kg, height 178.0 ± 7.6 cm, BMI 23.6 ± 2.1 kg × m^-2, V˙O₂max 2937 ± 324 ml × min^-1, participated in this study. The subjects performed twice an incremental exercise test until exhaustion, separated by a period of about 7 - 10 days. The second test was performed 24 h after withdrawal of 450 ml of blood (honorary blood donation). In the control study we found no effect of the incremental exercise on the serum erythropoietin concentration, which amounted to 14.24 ± 7.66 mU × ml^-1 at rest and 14.97 ± 6.07 mU × ml^-1 at the end of the incremental test. Serum GH level in the control study rose considerably from 0.158 ± 0.024 nmol × l^-1 at rest to 1.523 ± 0.336 nmol × l^-1 at the end of exercise and returned to initial value 2 h after the exercise. During the experiment performed 24 h after withdrawal of 450 ml of blood the serum erythropoietin concentration at rest was significantly elevated (p < 0.01) in relation to the control measurement (amounting to 24.85 ± 13.60 mU × ml^-1) and at the end of the incremental exercise a tendency towards further elevation (p = 0.09) in erythropoietin concentration up to 28.32 ± 14.51 mU × m^-1 was observed. Serum GH level during the experiment after blood withdrawal was similar to that in control test and exercise caused a rise in the GH level to 1.056 ± 0.52 nmol × l^-1, significantly less than in control test, but this increment fell to control value 2 h after exercise. The elevated level of erythropoietin 24 h after blood withdrawal was accompanied by a significant increase (p < 0.015) in blood hydrogen ion concentration [H⁺]_b at rest from 48.2 ± 2.8 nmol × l^-1 in the control study to 52.9 ± 4.5 nmol × l^-1 after blood donation. No effect of blood withdrawal on pre-exercise level of plasma lactate concentration, end-tidal O₂ and end-tidal CO₂ was found. We concluded that withdrawal of 450 ml of blood, within 24 hours significantly increased serum erytropoietin concentration and caused non-lactic acidosis. A single bout of maximal incremental exercise, performed before and 24 hours after blood withdrawal, had no effect on serum erythropoietin concentration in humans but the exercise-induced increase in serum GH concentration performed after blood withdrawal tended to be lower than in the control study.

Acidosis - blood donation - fatigue

References

• 1 Bauer C, Kurtz A. Oxygen sensing in the kidney and its relation to erythropoietin production.  Ann Rev Physiol. 1989;  51 845-856
• 2 Bauer C. The oxygen sensor that controls EPO production: facts and fancies.  J Perinat Med. 1995;  23 7-12
• 3 Berglund B, Birgegård G, Hemmingsson P. Serum erythropoietin in cross-country skiers.  Med Sci Sports Exerc. 1988;  20 208-209
• 4 Bodary P F, Pate R R, Wu Q F, McMillan G S. Effects of acute exercise on plasma erythropoietin levels in trained runners.  Med Sci Sports Exerc. 1999;  31 543-546
• 5 Bondurant M C, Koury M J. Anemia induces accumulation of erythropoietin mRNA in the kidney and liver.  Mol Cell Biol. 1986;  6 2731-2733
• 6 Böning D. Altitude and hypoxia training-effects on performance capacity and physiological functions at sea level.  Medicina Sportiva. 2002;  6 7-17
• 7 Braumann R M, Böning D, Trost F. Bohr effect and slope of the oxygen dissociation curve after physical training.  J Appl Physiol. 1982;  52 1524-1529
• 8 Dempsey J A, Wagner P D. Exercise-induced arterial hypoxemia.  J Appl Physiol. 1999;  87 1997-2006
• 9 de Paoli Vitali E, Guglielmini C, Casoni I, Vedovato M, Gilli P, Farinelli A, Salvatorelli G, Conconi F. Serum erythropoietin in cross country skiers.  Int J Sports Med. 1988;  9 99-101
• 10 di Luigi L, Guidetti L, Nordio M, Baldari C, Romanelli F. Acute effect of physical exercise on serum insulin-like growth factor-binding protein 2 and 3 in healthy men: role of exercise-linked growth hormone secretion.  Int J Sports Med. 2001;  22 103-110
• 11 Eckardt K U, Kurtz A, Bauer C. Triggering of erythropoietin production by hypoxia is inhibited by respiratory and metabolic acidosis.  Am J Physiol. 1990;  258 678-683
• 12 Faquin W C, Schneider T J, Goldberg M A. Effect of inflammatory cytokines on hypoxia-induced erythropoietin production.  Blood. 1992;  79 1987-1994
• 13 Gareau R, Caron C, Brisson G R. Exercise duration and serum erythropoietin level.  Horm Metab Res. 1991;  23 355
• 14 Jelkmann W, Pagel H, Wolff M, Fandrey J. Monokines inhibiting erythropoietin production in human hepatoma cultures and in isolated perfused rat kidneys.  Life Sci. 1992;  50 301-308
• 15 Jelkmann W. Erythropoietin: structure, control of production, and function.  Physiol Rev. 1992;  72 449-489
• 16 Klausen T, Breum L, Fogh-Andersen N, Bennett P, Hippe E. The effect of short and long duration exercise on serum erythropoietin concentrations.  Eur J Appl Physiol. 1993;  67 213-217
• 17 Klausen T, Poulsen T D, Fogh-Andersen N, Richalet J P, Nielsen O J, Olsen N V. Diurnal variation of serum erythropoietin at sea level and altitude.  Eur J Appl Physiol. 1996;  72 297-302
• 18 Klausen T. The feed-back regulation of erythropoietin production in healthy humans.  Dan Med Bull. 1998;  45 345-353
• 19 Krafte-Jacobs B, Levetown M L, Bray G L, Ruttimann U E, Pollack M M. Erythropoietin response to critical illness.  Crit Care Med. 1994;  22 821-826
• 20 Mairbäurl H, Schobersberger W, Oelz O, Bärtsch P, Eckardt K U, Bauer C. Unchanged in vivo P₅₀ at high altitude despite decreased erythrocyte age and elevated 2,3-diphosphoglycerate.  J Appl Physiol. 1990;  68 1186-1194
• 21 Milledge J S, Cotes P M. Serum erythropoietin in humans at high altitude and its relation to plasma renin.  J Appl Physiol. 1985;  59 360-364
• 22 Newsholme E A, Leech A R. Biochemistry for the Medical Sciences. John Wiley & Sons Chichester -New York; 1992
• 23 Nguyen U N, Mougin F, Simon-Rigaud M L, Rouillon J D, Marguet P, Regnard J. Influence of exercise duration on serum insuline-like growth factor and its binding proteins in athletes.  Eur J Appl Physiol Occup Physiol. 1998;  78 533-537
• 24 Remacha A F, Ordonez J, Barcelo M J, Garcia-Die F, Arza B, Estruch A. Evaluation of erythropoietin in endurance runners.  Haematologica. 1994;  79 350-352
• 25 Ricci G, Masotti M, de Paoli Vitali E, Vedovato M, Zanotti G. Effects of exercise on haematologic parameters, serum iron, serum ferritin, red cell 2,3-diphosphoglycerate and creatine contents, and serum erythropoietin in long-distance runners during basal training.  Acta Haemat. 1988;  80 95-98
• 26 Rowell L B, Taylor H I, Wang Y, Carlson W S. Saturation of arterial blood with oxygen during maximal exercise.  J Appl Physiol. 1964;  19 284-286
• 27 Sakata S, Shimizu S, Kishi T, Hirai K, Mori I, Ohno Y, Ueda M, Takaki M, Kohzuki H, Okamoto S, Shimamoto I, Yanagi S, Ogoshi K, Sherchand J B. Correlation between erythropoietin and lactate in humans during altitude exposure.  Jap J Physiol. 2000;  50 285-288
• 28 Schmidt W, Spielvogel H, Eckardt K U, Quintela A, Peñaloza R. Effects of chronic hypoxia and exercise on plasma erythropoietin in high-altitude residents.  J Appl Physiol. 1993;  74 1874-1878
• 29 Schmidt W, Dore S, Hilgendorf A, Strauch S, Gareau R, Brisson G R. Effects of exercise during normoxia and hypoxia on the growth hormone-insulin-like growth factor I axis.  Eur J Appl Physiol Occup Physiol. 1995;  71 424-430
• 30 Sliwowski Z, Lorens K, Konturek S J, Bielanski W, Zoladz J A, Majerczak J, Duda K. Leptin, gastrointestinal and stress hormones in response to exercise in fasted or fed subjects and before or after blood donation.  J Physiol Pharmacol. 2001;  52 53-70
• 31 Sohmiya M, Ishikawa K, Kato Y. Stimulation of erythropoietin secretion by continuous subcutaneous infusion of recombinant human GH in anemic patients with chronic renal failure.  Eur J Endocrinol. 1998;  138 302-306
• 32 Sohmiya M, Kato Y. Effect of long-term administration of recombinant human growth hormone (rhGH) on plasma erythropoietin (EPO) and haemoglobin levels in anaemic patients with adult GH deficiency.  Clin Endocrinol (Oxf). 2001;  55 749-754
• 33 Vedovato M, de Paoli Vitali E, Guglielmini C, Casoni I, Ricci G, Masotti M. Erythropoietin in athletes of endurance events.  Nephron. 1988;  48 78-79
• 34 Weight L M, Alexander D, Elliot T, Jacobs P. Erythropoietic adaptations to endurance training.  Eur J Appl Physiol. 1992;  64 444-448
• 35 Zoladz J A, Rademaker A CHJ, Sargeant A J. Non-linear relationship between O₂ uptake and power output at high intensities of exercise in humans.  J Physiol. 1995;  488 211-217