The Athlete's Biological Passport (ABP) is a tool for the indirect detection of blood doping. Current guidelines from the World Anti-Doping Agency (WADA) require a delay of 2 hours after any physical exercise and to be seated for 10 minutes prior to any blood sampling to obtain a valid measurement.Since body position prior to and during phlebotomy may influence the outcome, this study compared blood biomarker variations with changes in body position during blood sample collection. Ten successive venous blood samples from 38 subjects of 3 groups (elite cyclists, apnea divers and controls) in three situations (seated, after a 50 m walk, and supine) were collected and analyzed via flow cytometry. While reticulocytes percentage was unchanged in all conditions, haemoglobin concentration and hematocrit were stable after at least 10 min in a seated position. Due to shifts in plasma volume, the measures were significantly higher after changing posture for a short walk, but readjusted to previous levels after only 5 min. Supine position caused generally lower values after 10-30 min. The results support the current guidelines and additionally provide evidence to adjust the waiting time for blood sampling after short changes in posture.
The hematological module of the Athlete Biological Passport (ABP) is used in elite sport for antidoping purposes. Its aim is to better target athletes for testing and to indirectly detect blood doping. The ABP allows to monitor hematological variations in athletes using selected primary blood biomarkers [hemoglobin concentration (Hb) and reticulocyte percentage (Ret%)] with an adaptive Bayesian model to set individual upper and lower limits. If values fall outside the individual limits, an athlete may be further targeted and ultimately sanctioned. Since (Hb) varies with plasma volume (PV) fluctuations, possibly caused by training load changes, we investigated the putative influence of acute and chronic training load changes on the ABP variables. Monthly blood samples were collected over one year in 10 male elite cyclists (25.6 ± 3.4 years, 181 ± 4 cm, 71.3 ± 4.9 kg, 6.7 ± 0.8 W.kg−1 5-min maximal power output) to calculate individual ABP profiles and monitor hematological variables. Total hemoglobin mass (Hbmass) and PV were additionally measured by carbon monoxide rebreathing. Acute and chronic training loads–respectively 5 and 42 days before sampling–were calculated considering duration and intensity (training stress score, TSSTM). (Hb) averaged 14.2 ± 0.0 (mean ± SD) g.dL−1 (range: 13.3–15.5 g·dl−1) over the study with significant changes over time (P = 0.004). Hbmass was 1030 ± 87 g (range: 842–1116 g) with no significant variations over time (P = 0.118), whereas PV was 4309 ± 350 mL (range: 3,688–4,751 mL) with a time-effect observed over the study time (P = 0.014). Higher acute–but not chronic—training loads were associated with significantly decreased (Hb) (P <0.001). Although individual hematological variations were observed, all ABP variables remained within the individually calculated limits. Our results support that acute training load variations significantly affect (Hb), likely due to short-term PV fluctuations, underlining the importance of considering training load when interpreting individual ABP variations for anti-doping purposes.
The haematological module of the athlete biological passport (ABP) monitors longitudinal haematological variations that could be indicative of blood manipulation. This study applied a multi-parametric model previously validated in elite cyclists to compare inferred and actual PV variations, whereas the potential influence of the oral contraceptive pill (OCP) cycle on the ABP blood biomarkers and plasma volume (PV) in 14 physically active women taking OCPs was also investigated. Blood and serum samples were collected each week for 8 weeks, and the ABP haematological variables were determined according to the World Anti-Doping Agency guidelines.Transferrin (sTFN), ferritin (FERR), albumin (ALB), calcium (Ca), creatinine (CRE), total protein (TP) and low-density lipoprotein (LDL) were additionally computed as 'volume-sensitive' variables in a multivariate analysis to determine individual estimations of PV variations. Actual PV variations were indirectly measured using a validated carbon monoxide rebreathing method. We hypothesised ABP markers to be stable during a standard OCP cycle and estimated PV variations similar to measured PV variations. Measured PV variations were in good agreement with the predictions and allowed to explain an atypical passport finding (ATPF). The ABP biomarkers, Hbmass and PV were stable over 8 weeks. Significant differences occurred only between Week 7 and Week 1, with lower levels of haemoglobin concentration ([Hb]), haematocrit (HCT) and red blood cell count (RBC)(À4.4%, p < 0.01; À5.1%, p < 0.01; À5.2%, p < 0.01) and higher levels of PV at week 7 (+9%, p = 0.05). We thus concluded that estimating PV variations may help interpret individual ABP haematological profiles in women.
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