Int J Sports Med 2013; 34(09): 763-769
DOI: 10.1055/s-0033-1333692
Physiology & Biochemistry
© Georg Thieme Verlag KG Stuttgart · New York

The Effects of Injury and Illness on Haemoglobin Mass

C. E. Gough
1   Physiology, Australian Institute of Sport, Canberra, Australia
2   Faculty of Health, University of Canberra, Canberra, Australia
,
K. Sharpe
3   Department of Mathematics and Statistics, University of Melbourne, Melbourne, Australia
,
L. A. Garvican
1   Physiology, Australian Institute of Sport, Canberra, Australia
,
J. M. Anson
4   Faculty of Applied Science, University of Canberra, Canberra, Australia
,
P. U. Saunders
1   Physiology, Australian Institute of Sport, Canberra, Australia
2   Faculty of Health, University of Canberra, Canberra, Australia
,
C. J. Gore
1   Physiology, Australian Institute of Sport, Canberra, Australia
2   Faculty of Health, University of Canberra, Canberra, Australia
5   Exercise Physiology Laboratory, School of Education, Flinders University, Adelaide, Australia
› Author Affiliations
Further Information

Publication History



accepted after revision 20 December 2012

Publication Date:
26 February 2013 (online)

Abstract

This study sought to quantify the effects of reduced training, surgery and changes in body mass on haemoglobin mass (Hbmass) in athletes. Hbmass of 15 athletes (6 males, 9 females) was measured 9±6 (mean±SD) times over 162±198 days, during reduced training following injury or illness. Additionally, body mass (n=15 athletes) and episodes of altitude training (n=2), iron supplementation (n=5), or surgery (n=3) were documented. Training was recorded and compared with pre-injury levels. Analysis used linear mixed models for ln(Hbmass), with Sex, Altitude, Surgery, Iron, Training and log(Body Mass) as fixed effects, and Athlete as a fixed and random effect. Reduced training and surgery led to 2.3% (p=0.02) and 2.7% (p=0.04) decreases in Hbmass, respectively. Altitude and iron increased Hbmass by 2.4% (p=0.03) and 4.2% (p=0.05), respectively. The effect of changes in body mass on Hbmass was not statistically significant (p=0.435).The estimates for the effects of surgery and altitude on Hbmass should be confirmed by future research using a larger sample of athletes. These estimates could be used to inform the judgements of experts examining athlete biological passports, improving their interpretation of Hbmass perturbations, which athletes claim are related to injury, thereby protecting innocent athletes from unfair sanctioning.

 
  • References

  • 1 Alexander A, Garvican LA, Burge CM, Clark SA, Plowman JS, Gore CJ. Standardising analysis of carbon monoxide rebreathing for application in anti-doping. J Sci Med Sport 2011; 14: 100-105
  • 2 Brien AJ, Simon TL. The effects of red blood cell infusion on 10-km race time. J Am Med Assoc 1987; 257: 2761-2765
  • 3 Clark SA, Quod MJ, Clark MA, Martin DT, Saunders PU, Gore CJ. Time course of haemoglobin mass during 21 days live high:train low simulated altitude. Eur J Appl Physiol 2009; 106: 399-406
  • 4 Eastwood A, Bourdon PC, Snowden KR, Gore CJ. Detraining decreases Hbmass of triathletes. Int J Sports Med 2012; 33: 253-257
  • 5 Eastwood A, Sharpe K, Bourdon PC, Woolford SM, Saunders PU, Robertson EY, Clark SA, Gore CJ. Within subject variation in hemoglobin mass in elite athletes. Med Sci Sports Exerc 2011; 44: 725-732
  • 6 Foster C, Florhaug JA, Franklin J, Gottschall L, Hrovatin LA, Parker S, Doleshal P, Dodge C. A new approach to monitoring exercise training. J Strength Cond Res 2001; 15: 109-115
  • 7 Friedmann B, Weller E, Mairbaurl H, Bartsch P. Effects of iron repletion on blood volume and performance capacity in young athletes. Med Sci Sports Exerc 2001; 33: 741-746
  • 8 Garvican LA, Lobigs L, Telford RD, Fallon KE, Gore CJ. Haemoglobin mass in an anaemic female endurance runner before and after iron supplementation. Int J Sports Physiol Perform 2011; 6: 137-140
  • 9 Garvican LA, Martin DT, McDonald W, Gore CJ. Seasonal variation of haemoglobin mass in internationally competitive female road cyclists. Eur J Appl Physiol 2010; 109: 221-231
  • 10 Giraud S, Sottas PE, Robinson N, Saugy M. Blood transfusion in sports. Handb Exp Pharmacol 2010; 295-304
  • 11 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: 333-344
  • 12 Gough CE, Sharpe K, Ashenden M, Anson JM, Saunders PU, Garvican LA, Bonetti DL, Gore CJ, Prommer N. Quality control technique to reduce the variability of longitudinal measurement of hemoglobin mass. Scand J Med Sci Sports 2011; 21: e365-e371
  • 13 Gough CE, Saunders PU, Fowlie J, Savage B, Pyne DB, Anson JM, Wachsmuth N, Prommer N, Gore CJ. Influence of altitude training modality on performance and total haemoglobin mass in elite swimmers. Eur J Appl Physiol 2012; 112: 3275-3285
  • 14 Harriss DJ, Atkinson G. Update – ethical standards in sport and exercise science research. Int J Sports Med 2011; 32: 819-821
  • 15 Kjellberg SR, Rudhe U, Sjostrand T. Increase of the amount of hemoglobin and blood volume in connection with physical training. Acta Physiol Scand 1949; 19: 148-151
  • 16 Morkeberg J, Sharpe K, Belhage B, Damsgaard R, Schmidt W, Prommer N, Gore CJ, Ashenden MJ. Detecting autologous blood transfusions: a comparison of three passport approaches and four blood markers. Scand J Med Sci Sports 2011; 21: 235-243
  • 17 Pinheiro J, Bates D, DebRoy S, Sarkar D. the R core team. nlme: Linear and Nonlinear Mixed Effects Models. In: R Package 3.1-96 ed; 2009;
  • 18 Pottgiesser T, Echteler T, Sottas PE, Umhau M, Schumacher YO. Hemoglobin mass and biological passport for the detection of autologous blood doping. Med Sci Sports Exerc 2012; 44: 835-843
  • 19 Pottgiesser T, Umhau M, Ahlgrim C, Ruthardt S, Roecker K, Schumacher YO. Hb mass measurement suitable to screen for illicit autologous blood transfusions. Med Sci Sports Exerc 2007; 39: 1748-1756
  • 20 Prommer N, Schmidt W. Loss of CO from the intravascular bed and its impact on the optimised CO-rebreathing method. Eur J Appl Physiol 2007; 100: 383-391
  • 21 Prommer N, Sottas PE, Schoch C, Schumacher YO, Schmidt W. Total hemoglobin mass – a new parameter to detect blood doping?. Med Sci Sports Exerc 2008; 40: 2112-2118
  • 22 R Development Core Team . A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2010
  • 23 Robertson EY, Saunders PU, Pyne DB, Aughey RJ, Anson JM, Gore CJ. Reproducibility of performance changes to simulated live high/train low altitude. Med Sci Sports Exerc 2010; 42: 394-401
  • 24 Schumacher YO, Ahlgrim C, Pottgiesser T. Evaluation of anthropometrical reference parameters for hemoglobin mass in endurance athletes. J Sports Med Phys Fitness 2008; 48: 509-514
  • 25 Schumacher YO, Ahlgrim C, Ruthardt S, Pottgiesser T. Hemoglobin mass in an elite endurance athlete before, during, and after injury-related immobility. Clin J Sport Med 2008; 18: 172-173
  • 26 The 2012 Prohibited List: International Standard. 2012. http://www.wada-ama.org/Documents/World_Anti-Doping_Program/WADP-Prohibited-list/2012/WADA_Prohibited_List_2012_EN.pdf. Accessed 23rd February