Within-subject variation in hemoglobin mass in elite athletes

Annette Eastwood, Ken Sharpe, Pitre C. Bourdon, Sarah M. Woolford, Philo U. Saunders, Eileen Y. Robertson, Sally A. Clark, Christopher J. Gore

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Illicit autologous blood transfusion to improve performance in elite sport is currently undetectable, but the stability of longitudinal profiles of an athlete's hemoglobin mass (Hbmass) might be used to detect such practices. Purpose: Our aim was to quantify within-subject variation of Hbmass in elite athletes, and the effects of potentially confounding factors such as reduced training or altitude exposure. Methods: A total of 130 athletes (43 females and 87 males) were measured for Hbmass an average of six times during a period of approximately 1 yr using carbon monoxide rebreathing. Linear mixed models were used to quantify within-subject variation of Hbmass and its associated analytical and biological components for males and females, as well as the effects of reduced training and moderate altitude exposure in certain athletes. Results: The maximum within-subject coefficient of variation (CV) for Hbmass was 3.4% for males and 4.0% for females. The analytical CV was ∼2.0% for both males and females, and the long-term biological CV, after allowing for analytical variation, was 2.8% for males and 3.5% for females. On average, self-reported reduced training resulted in a 2.8% decrease in Hbmass and altitude exposure increased Hbmass by 1.5% to 2.9%, depending on the duration and type of exposure. Conclusions: The within-subject CV for Hbmass of ∼4% indicates that athletes may experience changes up to ∼20% with a 1-in-1000 probability. Changes of this magnitude for measures taken a few months apart suggest that Hbmass has a limited capacity to detect autologous blood doping. However, changes in Hbmass may be a useful indicator when combined with other measures of blood manipulation.

Original languageEnglish
Pages (from-to)725-732
Number of pages8
JournalMedicine and Science in Sports and Exercise
Volume44
Issue number4
DOIs
Publication statusPublished - Apr 2012
Externally publishedYes

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Athletes
Hemoglobins
Doping in Sports
Autologous Blood Transfusions
Carbon Monoxide
Sports
Linear Models

Cite this

Eastwood, A., Sharpe, K., Bourdon, P. C., Woolford, S. M., Saunders, P. U., Robertson, E. Y., ... Gore, C. J. (2012). Within-subject variation in hemoglobin mass in elite athletes. Medicine and Science in Sports and Exercise, 44(4), 725-732. https://doi.org/10.1249/MSS.0b013e318238ea7f
Eastwood, Annette ; Sharpe, Ken ; Bourdon, Pitre C. ; Woolford, Sarah M. ; Saunders, Philo U. ; Robertson, Eileen Y. ; Clark, Sally A. ; Gore, Christopher J. / Within-subject variation in hemoglobin mass in elite athletes. In: Medicine and Science in Sports and Exercise. 2012 ; Vol. 44, No. 4. pp. 725-732.
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abstract = "Illicit autologous blood transfusion to improve performance in elite sport is currently undetectable, but the stability of longitudinal profiles of an athlete's hemoglobin mass (Hbmass) might be used to detect such practices. Purpose: Our aim was to quantify within-subject variation of Hbmass in elite athletes, and the effects of potentially confounding factors such as reduced training or altitude exposure. Methods: A total of 130 athletes (43 females and 87 males) were measured for Hbmass an average of six times during a period of approximately 1 yr using carbon monoxide rebreathing. Linear mixed models were used to quantify within-subject variation of Hbmass and its associated analytical and biological components for males and females, as well as the effects of reduced training and moderate altitude exposure in certain athletes. Results: The maximum within-subject coefficient of variation (CV) for Hbmass was 3.4{\%} for males and 4.0{\%} for females. The analytical CV was ∼2.0{\%} for both males and females, and the long-term biological CV, after allowing for analytical variation, was 2.8{\%} for males and 3.5{\%} for females. On average, self-reported reduced training resulted in a 2.8{\%} decrease in Hbmass and altitude exposure increased Hbmass by 1.5{\%} to 2.9{\%}, depending on the duration and type of exposure. Conclusions: The within-subject CV for Hbmass of ∼4{\%} indicates that athletes may experience changes up to ∼20{\%} with a 1-in-1000 probability. Changes of this magnitude for measures taken a few months apart suggest that Hbmass has a limited capacity to detect autologous blood doping. However, changes in Hbmass may be a useful indicator when combined with other measures of blood manipulation.",
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Eastwood, A, Sharpe, K, Bourdon, PC, Woolford, SM, Saunders, PU, Robertson, EY, Clark, SA & Gore, CJ 2012, 'Within-subject variation in hemoglobin mass in elite athletes', Medicine and Science in Sports and Exercise, vol. 44, no. 4, pp. 725-732. https://doi.org/10.1249/MSS.0b013e318238ea7f

Within-subject variation in hemoglobin mass in elite athletes. / Eastwood, Annette; Sharpe, Ken; Bourdon, Pitre C.; Woolford, Sarah M.; Saunders, Philo U.; Robertson, Eileen Y.; Clark, Sally A.; Gore, Christopher J.

In: Medicine and Science in Sports and Exercise, Vol. 44, No. 4, 04.2012, p. 725-732.

Research output: Contribution to journalArticle

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T1 - Within-subject variation in hemoglobin mass in elite athletes

AU - Eastwood, Annette

AU - Sharpe, Ken

AU - Bourdon, Pitre C.

AU - Woolford, Sarah M.

AU - Saunders, Philo U.

AU - Robertson, Eileen Y.

AU - Clark, Sally A.

AU - Gore, Christopher J.

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AB - Illicit autologous blood transfusion to improve performance in elite sport is currently undetectable, but the stability of longitudinal profiles of an athlete's hemoglobin mass (Hbmass) might be used to detect such practices. Purpose: Our aim was to quantify within-subject variation of Hbmass in elite athletes, and the effects of potentially confounding factors such as reduced training or altitude exposure. Methods: A total of 130 athletes (43 females and 87 males) were measured for Hbmass an average of six times during a period of approximately 1 yr using carbon monoxide rebreathing. Linear mixed models were used to quantify within-subject variation of Hbmass and its associated analytical and biological components for males and females, as well as the effects of reduced training and moderate altitude exposure in certain athletes. Results: The maximum within-subject coefficient of variation (CV) for Hbmass was 3.4% for males and 4.0% for females. The analytical CV was ∼2.0% for both males and females, and the long-term biological CV, after allowing for analytical variation, was 2.8% for males and 3.5% for females. On average, self-reported reduced training resulted in a 2.8% decrease in Hbmass and altitude exposure increased Hbmass by 1.5% to 2.9%, depending on the duration and type of exposure. Conclusions: The within-subject CV for Hbmass of ∼4% indicates that athletes may experience changes up to ∼20% with a 1-in-1000 probability. Changes of this magnitude for measures taken a few months apart suggest that Hbmass has a limited capacity to detect autologous blood doping. However, changes in Hbmass may be a useful indicator when combined with other measures of blood manipulation.

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Eastwood A, Sharpe K, Bourdon PC, Woolford SM, Saunders PU, Robertson EY et al. Within-subject variation in hemoglobin mass in elite athletes. Medicine and Science in Sports and Exercise. 2012 Apr;44(4):725-732. https://doi.org/10.1249/MSS.0b013e318238ea7f