Hemoglobin Mass and Peak Oxygen Uptake in Untrained and Trained Residents of Moderate Altitude

Böning, Dieter; Rojas, Juan David; Serrato, Mauricio; Ulloa, Catalina; Coy, L.; Mora‐Plazas, Mercedes; Gómez, José Manuel Naranjo; Hütler, Matthias

doi:10.1055/s-2001-18530

Cited by 34 publications

(68 citation statements)

References 35 publications

(59 reference statements)

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“…In the younger groups of acclimatized SI, higher P a O 2 values compared to OI were observed that might be explained by reduced hypoxic ventilatory response with age (Kronenberg and Drage 1973). Our findings confirm previous studies performed on residents living at high altitude showing higher tHb and RCV (Bo¨ning et al 2001;Hurtado 1964;Sanchez et al 1970). RA exhibited an 11% higher tHb when compared to sea level dwellers (SL).…”

Section: Discussionsupporting

confidence: 93%

“…In our study we observed the well-known fact that RA subjects possess elevated [Hb] and Hct compared to SL subjects (Bo¨ning et al 2001;Sanchez et al 1970;Schmidt et al 1993). As a consequence of the higher RCV and the changes in PV mentioned above, [Hb] and Hct values were clearly increased in both groups exposed to intermittent hypoxia and were comparable to those found in RA.…”

Section: Pv Bv [Hb] and Hctsupporting

confidence: 90%

“…In the present study, PV was reduced by 14% in RA compared to SL, but their increased RCV was not sufficient to cause a corresponding compensation that would result in an elevated BV. On one hand these data support the classical view that decreased PV leads to increased [Hb], thereby partly compensating for the decreased arterial oxygen saturation at altitude (Bo¨ning et al 2001). On the other hand, these alterations might be due to differences in genetic ancestry as well as different levels of physical activity in RA and SL.…”

Section: Pv Bv [Hb] and Hctsupporting

confidence: 71%

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Long-term exposure to intermittent hypoxia results in increased hemoglobin mass, reduced plasma volume, and elevated erythropoietin plasma levels in man

et al. 2003

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While it is well established that highlanders have optimized their oxygen transport system, little is known about the acclimatization of those who move between different altitudes. The purpose of this study was to establish whether the acclimatization to long-term intermittent hypoxic exposure in members of the Chilean Army who frequently move from sea level to 3,550 m altitude is correlated with acute acclimatization or chronic adaptation to hypoxia. A group of officers was exposed intermittently to hypoxia for about 22 years (OI, officers at intermittent hypoxia) and a group of soldiers for 6 months (SI, soldiers at intermittent hypoxia). Both groups were compared to residents at altitude (RA) and to soldiers at sea level (SL). When compared to SL, we observed an 11% increase in total hemoglobin mass (tHb) as well as a corresponding increase in red cell volume (RCV), hemoglobin concentration and hematocrit in all three groups at altitude. Plasma volume (PV) and blood volume (BV) decreased at altitude but increased when OI and SI returned to sea level. Moreover, intermittent hypoxic exposure of OI and SI resulted in increased plasma erythropoietin (Epo) levels, which peaked on day 2 at high altitude followed by decreasing levels during the successive days, and reaching pre-altitude values in SI even when staying at altitude. In conclusion, with regard to tHb and RCV, the acclimatization to long-term intermittent hypoxia resembles the adaptation to chronic hypoxia, while PV and BV regulation mimicked acclimatization to acute hypoxia. Remarkably, finely controlled regulation of Epo expression still occurs after up to 22 years of weekly exposure to altitude.

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Section: Discussionsupporting

confidence: 93%

Section: Pv Bv [Hb] and Hctsupporting

confidence: 90%

Section: Pv Bv [Hb] and Hctsupporting

confidence: 71%

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Long-term exposure to intermittent hypoxia results in increased hemoglobin mass, reduced plasma volume, and elevated erythropoietin plasma levels in man

et al. 2003

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“…Additional data (Hb mass, blood volume) are published elsewhere (Böning et al 2001b). Informed consent was obtained from all participants, the study protocol was approved by the ethics committee of the faculty.…”

Section: Methodsmentioning

confidence: 99%

“…From the increase in Hb mass compared to sea level (approximately 12% in UT and 9% in TR, Böning et al 2001b;Robinson et al 2007) one might expect a corresponding increase in b nbi by only 2 mmol l -1 at rest. The effect should be larger because of two effects: extracellular volume and total body water seem to be reduced in highlanders (Ramirez et al 1998) as well as in sojourners (rev.…”

Section: Relation Between Be and [La] Changesmentioning

confidence: 96%

Extracellular pH defense against lactic acid in untrained and trained altitude residents

et al. 2008

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The assumption that buffering at altitude is deteriorated by bicarbonate (bi) reduction was investigated. Extracellular pH defense against lactic acidosis was estimated from changes (Delta) in lactic acid ([La]), [HCO3-], pH and PCO2 in plasma, which equilibrates with interstitial fluid. These quantities were measured in earlobe blood during and after incremental bicycle exercise in 10 untrained (UT) and 11 endurance-trained (TR) highlanders (2,600 m). During exercise the capacity of non-bicarbonate buffers (betanbi=-Delta[La]. DeltapH(-1)-Delta[HCO3-]. DeltapH(-1)) amounted to 40+/-2 (SEM) and 28+/-2 mmol l(-1) in UT and TR, respectively (P<0.01). During recovery beta (nbi) decreased to 20 (UT) and 16 (TR) mmol l(-1) (P<0.001) corresponding to values expected from hemoglobin, dissolved protein and phosphate concentrations related to extracellular fluid (ecf). This was accompanied by a larger decrease of base excess after than during exercise for a given Delta[La]. betabi amounted to 37-41 mmol l(-1) being lower than at sea level. The large exercise betanbi was mainly caused by increasing concentrations of buffers due to temporary shrinking of ecf. Tr has lower betanbi in spite of an increased Hb mass mainly because of an expanded ecf compared to UT. In highlanders betanbi is higher than in lowlanders because of larger Hb mass and reduced ecf and counteracts the decrease in [HCO3-]. The amount of bicarbonate is probably reduced by reduction of the ecf at altitude but this is compensated by lower maximal [La] and more effective hyperventilation resulting in attenuated exercise acidosis at exhaustion.

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Hemoglobin Mass and Aerobic Performance at Moderate Altitude in Elite Athletes

Wehrlin

Marti

Hallén

2016

Advances in Experimental Medicine and Biology

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Fore more than a decade, the live high-train low (LHTL) approach, developed by Levine and Stray-Gundersen, has been widely used by elite endurance athletes. Originally, it was pointed out, that by living at moderate altitude, athletes should benefit from an increased red cell volume (RCV) and hemoglobin mass (Hbmass), while the training at low altitudes should prevent the disadvantage of reduced training intensity at moderate altitude. VO2max is reduced linearly by about 6-8 % per 1000 m increasing altitude in elite athletes from sea level to 3000 m, with corresponding higher relative training intensities for the same absolute work load. With 2 weeks of acclimatization, this initial deficit can be reduced by about one half. It has been debated during the last years whether sea-level training or exposure to moderate altitude increases RCV and Hbmass in elite endurance athletes. Studies which directly measured Hbmass with the optimized CO-rebreathing technique demonstrated that Hbmass in endurance athletes is not influenced by sea-level training. We documented that Hbmass is not increased after 3 years of training in national team cross-country skiers. When athletes are exposed to moderate altitude, new studies support the argument that it is possible to increase Hbmass temporarily by 5-6 %, provided that athletes spend >400 h at altitudes above 2300-2500 m. However, this effect size is smaller than the reported 10-14 % higher Hbmass values of endurance athletes living permanently at 2600 m. It remains to be investigated whether endurance athletes reach these values with a series of LHTL camps.

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Hemoglobin Mass and Peak Oxygen Uptake in Untrained and Trained Residents of Moderate Altitude

Cited by 34 publications

References 35 publications

Long-term exposure to intermittent hypoxia results in increased hemoglobin mass, reduced plasma volume, and elevated erythropoietin plasma levels in man

Long-term exposure to intermittent hypoxia results in increased hemoglobin mass, reduced plasma volume, and elevated erythropoietin plasma levels in man

Extracellular pH defense against lactic acid in untrained and trained altitude residents

Hemoglobin Mass and Aerobic Performance at Moderate Altitude in Elite Athletes

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