IntroductionIron deficiency (ID) is one of the most common factors that may reduce sports performance, supplementation forms and doses are still not standardized in athletes. Our aim was to assess the iron status of young male basketball players and to study the effect of iron supplementation in a randomized placebo‐controlled study.HypothesisWe hypothesized that due to the higher iron demand of athletes, the 100 μg/L ferritin cut‐off may be appropriate to determine the non‐anaemic iron deficiency.MethodsDuring a sports cardiology screening, questionnaires, laboratory tests, electrocardiograms, echocardiography exams and cardiopulmonary exercise tests were performed. Athletes with ID (ferritin <100μg/L) were randomized into iron and placebo groups. Ferrous sulfate (containing 100 mg elemental iron (II) and 60 mg ascorbic acid) or placebo (50 mg vitamin C) was administered for 3 months. All exams were repeated after the supplementation period.ResultsWe included 65 (age 15.8±1.7 years) basketball players divided into 4 age groups. Non anemic ID was observed in 60 (92%) athletes. After supplementation, ferritin levels were higher in the iron group (75.5±25.9 vs. 54,9±10.4μg/L, p<0.01). Ferritin > 100μg/L level was achieved only in 15% of the athletes. There were no differences in performance between the groups (VO2 max: 53.6±4.3ml/kg/min vs. 54.4±5.7ml/kg/min, p=0.46; peak lactate: 9.1±2.2mmol/L vs. 9.1±2.6mmol/L, p=0.90).ConclusionsAs a result of the 3‐month iron supplementation, the ferritin levels increased; however, only a small portion of the athletes achieved the target ferritin level, while performance improvement was not detectable.This article is protected by copyright. All rights reserved.
Introduction Iron metabolism determines the oxygen transport of the blood, thereby affecting the exercise capacity and performance. In patients with heart failure iron deficiency is a major risk factor that predicts and influences patient's quality of life. In athletes diagnosing iron deficiency is also extremely important as it determines sport performance. Purpose Our aim is to study the correlation of iron metabolism parameters with exercise capacity in athletes. Methods Cardiopulmonary exercise test (CPET) was performed as part of detailed sports cardiology screening. We studied in athletes the changes of iron metabolism parameters (serum iron, transferrin, total iron-binding capacity (TIBC), ferritin) and correlation with the exercise physiology parameters. Results Our measurements were performed on 105 top athletes: swimmers (n=58,55%; male = 29; junior = 30; 20,4±4,6 y), football players (n=47, 45%; junior = 6; 23,2±5,4 y). Laboratory test verified hemoglobin (male = 153,8±9,4; female = 141,2±7,7 g/L; p<0,001) and hematocrit (male = 0,45±0,03; female = 0,42±0,02 L/L; p<0,001) value in a normal range for all. In women, significantly lower ferritin (67,8±76,2 vs. 98,9±48 μg/L; p<0,05) and higher TIBC (78,1±14,3 vs. 66,5±9,3 μmol/L; p<0,001) were observed. Young male athletes had significantly lower serum iron (16,1±6 vs. 21,2±7,5 μmol/L; p<0,05), ferritin (68±42,7 vs. 109,1±45,5 μg/L; p<0,01) and higher TIBC (76,1±11,0 vs. 64,3±7,4 μmol/L; p<0,001) compared to adults. During CPET male athletes had higher maximal aerobic capacity (52.2±4.4 vs. 55.9±5.5 mL/kg/min; p<0.001) and ventilation (115.8±16.1 vs. 153.2±26 L/min; p<0.001) compared to females. Maximal aerobic capacity and ventilation showed positive correlation with ferritin (p<0,0001). The ferritin cut-off value of iron supplementation was <100 μg/L. Iron supplementation was required in almost half of the athletes (n=49, 47%). Conclusion Diagnosing iron deficiency in athletes, complete iron panel containing ferritin is required. According to our results iron status determines performance, therefore iron deficiency screening and iron supplementation is essential. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): - Supported by the ÚNKP-20-3-I New National Excellence Program of the Ministry for Innovation and Technology from the Source of the National Research, Development and Innovation Fund - The research was financed by the Thematic Excellence Programme (2020-4.1.1.-TKP2020) of the Ministry for Innovation and Technology in Hungary, within the framework of the Therapeutic Development and Bioimaging programmes of the Semmelweis University.
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