The athlete's hematological response to hypoxia: A meta-analysis on the influence of altitude exposure on key biomarkers of erythropoiesis.

Autor: Lobigs LM; School of Human Sciences (Exercise and Sports Science), University of Western Australia, Perth, WA, 6009, Australia.; Aspetar Sports Medicine Hospital, PO Box 29222, Doha, Qatar., Sharpe K; Statistical Consulting Centre, School of Mathematics and Statistics, University of Melbourne, Vic, 3010, Australia., Garvican-Lewis LA; Australian Institute of Sport, Canberra, 2617, Australia.; Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia., Gore CJ; Australian Institute of Sport, Canberra, 2617, Australia., Peeling P; School of Human Sciences (Exercise and Sports Science), University of Western Australia, Perth, WA, 6009, Australia.; Western Australian Institute of Sport, Mt Claremont, WA, 6010, Australia., Dawson B; School of Human Sciences (Exercise and Sports Science), University of Western Australia, Perth, WA, 6009, Australia., Schumacher YO; Aspetar Sports Medicine Hospital, PO Box 29222, Doha, Qatar.
Jazyk: angličtina
Zdroj: American journal of hematology [Am J Hematol] 2018 Jan; Vol. 93 (1), pp. 74-83. Date of Electronic Publication: 2017 Oct 31.
DOI: 10.1002/ajh.24941
Abstrakt: Altitude training is associated with changes in blood markers, which can confound results of the Athlete?s Biological Passport (ABP). This meta-analysis aims to describe the fluctuations during- and post-altitude in key ABP variables; hemoglobin concentration ([Hb]), square-root transformed reticulocyte percentage (sqrt(retic%)) and the OFF-score. Individual de-identified raw data were provided from 17 studies. Separate linear mixed effects analyses were performed for delta values from baseline for [Hb], sqrt(retic%) and OFF-score, by altitude phase (during and post). Mixed models were fitted with the hierarchical structure: study and subject within study as random effects. Delta values as response variables and altitude dose (in kilometer hours; km.hr = altitude (m) / 1000 x hours), sex, age, protocol and baseline values as fixed effects. Allowances were made for potential autocorrelation. Within two days at natural altitude [Hb] rapidly increased. Subsequent delta [Hb] values increased with altitude dose, reaching a plateau of 0.94 g/dL [95%CI (0.69, 1.20)] at ~1000 km.hr. Delta sqrt(retic%) and OFF-score were the first to identify an erythrocyte response, with respective increases and decreases observed within 100 to 200 km.hr. Post-altitude, [Hb] remained elevated for two weeks. Delta sqrt(retic%) declined below baseline, the magnitude of change was dependent on altitude dose. Baseline values were a significant covariate (p<0.05). The response to altitude is complex resulting in a wide range of individual responses, influenced primarily by altitude dose and baseline values. Improved knowledge of the plausible hematological variations during- and post-altitude provides fundamental information for both the ABP expert and sports physician.
(© 2017 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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