Comparison of the Hematological Profile of Elite Road Cyclists during the 2010 and 2012 GiroBio Ten-Day Stage Races and Relationships with Final Ranking

Lombardi, Giovanni; Lanteri, Patrizia; Fiorella, Pier Luigi; Simonetto, Luigi; Impellizzeri, Franco M.; Bonifazi, Marco; Banfi, Giuseppe; Locatelli, Massimo

doi:10.1371/journal.pone.0063092

Cited by 21 publications

(23 citation statements)

References 25 publications

(31 reference statements)

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“…Three blood collections were performed on the Chinese riders: 1 day before the start of the race (D-1) and on the rest day (D9) and the morning after the race had finished (D15). All blood sampling, handling, and transport, both in Australia and China, were performed in strict accordance with World Anti-Doping Agency (WADA) and UCI rules (44) to ensure consistency and reliability (30). Specifically, all blood tests were performed at rest between 0600 and 0900 without prior exercise and with cyclists seated for at least 10 min before collection with their feet on the floor (1).…”

Section: Methodsmentioning

confidence: 99%

“…To date, there are a number of published studies that document changes in hematological variables such as hemoglobin concentration ([Hb]), hematocrit (Hct), percentage of reticulocytes (%Retics), and more recently, hemoglobin mass (Hbmass) during cycling stage races of 1-3 wk. In the largest cohort currently investigated, Lombardi et al (30) report decreased [Hb] and Hct values during the first half of a 10-day cycling race. Similar findings have been reported by others, albeit in much smaller cohorts (15,31,40).…”

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confidence: 99%

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Stage racing at altitude induces hemodilution despite an increase in hemoglobin mass

Garvican-Lewis

Schumacher

Clark³

et al. 2014

Journal of Applied Physiology

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Plasma volume (PV) can be modulated by altitude exposure (decrease) and periods of intense exercise (increase). Cycle racing at altitude combines both stimuli, although presently no data exist to document which is dominant. Hemoglobin mass (Hbmass), hemoglobin concentration ([Hb]), and percent reticulocytes (%Retics) of altitude (ALT; n = 9) and sea-level (SL; n = 9) residents were measured during a 14-day cycling race, held at 1,146-4120 m, as well as during a simulated tour near sea level (SIM; n = 12). Hbmass was assessed before and on days 9 and 14 of racing. Venous blood was collected on days 0, 3, 6, 10, and 14. PV was calculated from Hbmass and [Hb]. A repeated-measures ANOVA was used to assess the impact of racing at altitude over time, within and between groups. [Hb] decreased significantly in all groups over time (P < 0.0001) with decreases evident on the third day of racing. %Retics increased significantly in SL only (P < 0.0001), with SL values elevated at day 6 compared with prerace (P = 0.02), but were suppressed by the end of the race (P = 0.0002). Hbmass significantly increased in SL after 9 (P = 0.0001) and 14 (P = 0.008) days of racing and was lower at the end of the race than midrace (P = 0.018). PV increased in all groups (P < 0.0001). Multiday cycle racing at altitude induces hemodilution of a similar magnitude to that observed during SL racing and occurs in nonacclimatized SL residents, despite an altitude-induced increase in Hbmass. Osmotic regulatory mechanisms associated with intense exercise appear to supersede acute enhancement of oxygen delivery at altitude.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Stage racing at altitude induces hemodilution despite an increase in hemoglobin mass

Garvican-Lewis

Schumacher

Clark³

et al. 2014

Journal of Applied Physiology

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“…It is unknown how fast plasma volume returns to baseline after the end of an increased training load or multiday competition in high-level athletes, which is well known to be associated with a ~15-20% plasma volume expansion [1][2][3][4] and ~10% [Hb] reduction 1,2,[4][5][6][7][8] in both moderate and highly trained subjects. The time course of plasma volume reduction and its effect on primary anti-doping-related hematological variables such as [Hb] is of high importance for anti-doping purposes and in particular for interpretation of blood profiles in the Athlete Biological Passport (ABP).…”

Section: Introductionmentioning

confidence: 99%

Plasma volume reduction and hematological fluctuations in high‐level athletes after an increased training load

Bejder

Andersen

Goetze

et al. 2017

Scandinavian Med Sci Sports

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The time course of plasma volume (PV) reduction following an increased training load period is unknown and was investigated. The accompanying fluctuations in [Hb] and OFF-hr score were analyzed in the Athlete Biological Passport. Further, whether fluctuations in plasma albumin, soluble transferrin receptors (sTfR), and pro-atrial natriuretic peptide (proANP) concentrations correlate with PV fluctuations was investigated. Eleven high-level competitive cyclists were investigated for 3 weeks. After initial measurements in week 1, training load was increased ~250% in week 2 followed by a reversion to baseline training load in week 3. PV and hematological variables were determined frequently during all weeks. The higher training load in week 2 increased (P<.001) PV 10%, while [Hb] and OFF-hr score decreased ~6% (P<.01) and ~16% (P<.001), respectively. PV and [Hb] returned to baseline within 2 and 4 days after week 2, respectively, while OFF-hr score remained reduced for 6 days. Further, one and three atypical blood profiles of the ABP occurred during weeks 2 and 3, respectively. Individual changes in albumin, sTfR, and proANP only correlated weakly (R <.20) with PV fluctuations. In conclusion, PV and [Hb] fluctuations caused by an elevated training load period were reverted within 2 and 4 days after returning to baseline training load, respectively, while OFF-hr remained altered for 6 days. Furthermore, some atypical blood profiles were induced during and subsequent to the increased training load, demonstrating the importance of knowledge on naturally occurring hematological fluctuations. Finally, concentrations of albumin, sTfR, and proANP could not explain PV fluctuations.

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“…Therefore, a better understanding of hematological responses associated with different sporting disciplines is necessary. Hemodilution, especially due to prolonged exercise, has been well‐described as a confounding factor to the hematological passport . However, ABP results of this phenomenon have not yet been fully described in the context of Ironman triathlons, nor have the extent and duration post‐exercise been established.…”

Section: Discussionmentioning

confidence: 99%

“…8,19 Notably, anecdotal evidence has shown that dramatic decreases in hemoglobin occur during routine biological passport monitoring of long-distance triathletes in the days following competitions. These suspected hemodilution effects in turn affect the values present in the biological passport, 10,16,17 potentially resulting in the presentation of atypical profiles, and must be considered by ABP experts. Thus, the aim of this study was to assess the hematological changes and their relation to the ABP for up to one week following completion of an Ironman triathlon.…”

Section: Introductionmentioning

confidence: 99%

Hematological changes following an Ironman triathlon: An antidoping perspective

Miller¹,

Beharry

Teramoto

et al. 2019

Drug Testing and Analysis

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Understanding and characterizing confounding factors to the Athlete Biological Passport (ABP) is crucial for the reliable interpretation of biological profiles in the antidoping field. The physiological effects on hematological parameters and plasma volume (PV) following competition in a long‐distance triathlon, as seen in the Ironman discipline, have yet to be fully described and are the focus of this study. Complete blood count blood tests were conducted on 19 Ironman triathletes before and after an Ironman triathlon to characterize changes in hematological parameters and the effect on ABP interpretation, as it was hypothesized that changes in the plasma volume may result in the presentation of atypical ABP profiles. Baseline blood samples were collected from the athletes prior to the event, and one sample was collected per day for up to 1 week following the race. Differences were observed between the male and female athletes across multiple parameters. Most importantly to the ABP, decreases in hemoglobin concentration (HGB) and hematocrit (HCT) were identified post‐race, with the largest decreases identified on day +2. The average HGB returned to pre‐race baseline levels on day +5. Beginning 5–6 days after the race, increases in the reticulocyte percentage (Ret%) were identified. Atypical Passport Findings were identified in 32% (6/19) of the ABPs, flagged mainly due to atypical hemoglobin concentration and one instance in which the OFF‐score exceeded the adaptive model limits. These results offer a characterized timeline of hematological changes and expected shifting of plasma volume following an Ironman triathlon providing important data for the reliable interpretation of ABP profiles in this field.

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Comparison of the Hematological Profile of Elite Road Cyclists during the 2010 and 2012 GiroBio Ten-Day Stage Races and Relationships with Final Ranking

Cited by 21 publications

References 25 publications

Stage racing at altitude induces hemodilution despite an increase in hemoglobin mass

Stage racing at altitude induces hemodilution despite an increase in hemoglobin mass

Plasma volume reduction and hematological fluctuations in high‐level athletes after an increased training load

Hematological changes following an Ironman triathlon: An antidoping perspective

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