Assessing serum albumin concentration following exercise‐induced fluid shifts in the context of the athlete biological passport

Abstract

Purpose The hydration status of an athlete at the time of a doping control sample collection is an important factor to consider when reviewing athlete biological passports (ABPs). Dehydration results in a reduction of the circulating plasma volume (PV), which may lead to artificially high values of some blood parameters. This study aimed to identify whether serum albumin could serve as a single marker of fluid shifts, which are not currently accounted for in the hematological passport. An additional marker could be used to assist experts when interpreting irregularities in the ABP. Methods Twelve subjects underwent multiple controlled exercise trials designed to induce varying levels of PV shifts. Pre‐exercise blood samples were collected to establish baseline values for individual passports. During exercise interventions, blood samples were collected before the start of exercise and at 10 minute, 1 hour, 2 hours, and 24 hours following exercise. Results Significant increases in hematological parameters – hemoglobin [Hb], hematocrit (HCT), albumin (ALB), and calculated OFF‐score – were identified at varying time points following fluid shift‐inducing exercise. Changes in ALB correlated strongly with changes in [Hb] (r = 0.753) and with estimated PV shifts (r = −0.764). In analyzing ABPs, the resulting increases in Hb did not trigger any atypical findings at 99% specificity. Perspective Monitoring changes in ALB longitudinally may assist experts when reviewing PV shifts in the biological passport.

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“…An increase in the level of albumin may have been caused by dehydration. Researchers have had similar findings analyzing serum albumin in the blood plasma of athletes after intense training [ 92 , 93 ]. An increase in the values of α1- and α2-globulins, which include proteins of the acute phase, can result from stress and inflammatory reactions in the body.…”

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“…Numerous studies have highlighted specific blood variations as the result of pre-analytical factors including circadian modifications [25,48] and prevention strategies such as sodium intake [17], overhydration [31] or posture adjustments [13]. In the same way, a temporary [Hb] increase caused by PV reduction was usually observed following acute exercise [7,26,52,53] without affecting Ret% in most cases [51]. Similarly, acute exposure to extreme environmental conditions, such as heat [18,[54][55][56], cold [57,58] or hypoxia [59], was reported to cause transitory PV shifts.…”