Altitude exposure in sports: the Athlete Biological Passport standpoint

Sanchís-Gomar, Fabián; Pareja‐Galeano, Helios; Brioche, Thomas; Martínez-Bello, Vladimir E.; Lippi, Giuseppe

doi:10.1002/dta.1539

Cited by 14 publications

(21 citation statements)

References 31 publications

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“…Altitude training has previously been raised as a potential confounding factor for the haematological module of ABP . Here, we present additional data on the influence of simulated live high, train low altitude training on the biomarkers of the ABP, as well as the effects of different forms of iron supplementation used in combination with altitude training.…”

Section: Discussionmentioning

confidence: 92%

“…Altitude training is a popular training tool of athletes looking to enhance their performance at sea level with performance enhancements following altitude training often attributed to an increase in haemoglobin mass (Hbmass) . However, the associated changes in reticulocytes and [Hb] arising from haematological adaptation to hypoxia (both in terms of accelerated erythropoiesis and altered plasma volume) also have the potential to exceed individual threshold limits thus altitude remains one of the biggest confounders to the ABP …”

Section: Introductionmentioning

confidence: 99%

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Influence of combined iron supplementation and simulated hypoxia on the haematological module of the athlete biological passport

Garvican-Lewis

Vuong

Govus

et al. 2017

Drug Testing and Analysis

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The integrity of the athlete biological passport (ABP) is underpinned by understanding normal fluctuations of its biomarkers to environmental or medical conditions, for example, altitude training or iron deficiency. The combined impact of altitude and iron supplementation on the ABP was evaluated in endurance-trained athletes (n = 34) undertaking 3 weeks of simulated live-high: train-low (14 h.d , 3000 m). Athletes received either oral, intravenous (IV) or placebo iron supplementation, commencing 2 weeks prior and continuing throughout hypoxic exposure. Venous blood was sampled twice prior, weekly during, and up to 6 weeks after altitude. Individual ABP thresholds for haemoglobin concentration ([Hb]), reticulocyte percentage (%retic), and OFF score were calculated using the adaptive model and assessed at 99% and 99.9% specificity. Eleven athletes returned values outside of the calculated reference ranges at 99%, with 8 at 99.9%. The percentage of athletes exceeding the thresholds in each group was similar, but IV returned the most individual occurrences. A similar frequency of abnormalities occurred across the 3 biomarkers, with abnormal [Hb] and OFF score values arising mainly during-, and %retic values mainly post- altitude. Removing samples collected during altitude from the model resulted in 10 athletes returning abnormal values at 99% specificity, 2 of whom had not triggered the model previously. In summary, the abnormalities observed in response to iron supplementation and hypoxia were not systematic and mostly in line with expected physiological adaptations. They do not represent a uniform weakness in the ABP. Nevertheless, altitude training and iron supplementation should be carefully considered by experts evaluating abnormal ABP profiles.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Influence of combined iron supplementation and simulated hypoxia on the haematological module of the athlete biological passport

Garvican-Lewis

Vuong

Govus

et al. 2017

Drug Testing and Analysis

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“…The ABP reference limits are initially based on population‐derived values but as data from the athlete are accumulated, this reference range is moved towards the athlete's own values by use of the Bayesian statistical approach . One drawback of the ABP approach is that several possible confounders exist, with one of the most challenging being altitude exposure, which may elicit haematological changes similar to those of blood or rHuEPO doping …”

Section: Introductionmentioning

confidence: 99%

“…Artificial hypoxia (use of hypoxic tents, masks etc.) must also be registered . Originally, it was proposed to incorporate this information in the ABP to generate appropriate reference values .…”

Section: Introductionmentioning

confidence: 99%

Altitude training causes haematological fluctuations with relevance for the Athlete Biological Passport

Bonne

Lundby

et al. 2014

Drug Testing and Analysis

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The impact of altitude training on haematological parameters and the Athlete Biological Passport (ABP) was evaluated in international-level elite athletes. One group of swimmers lived high and trained high (LHTH, n = 10) for three to four weeks at 2130 m or higher whereas a control group (n = 10) completed a three-week training camp at sea-level. Haematological parameters were determined weekly three times before and four times after the training camps. ABP thresholds for haemoglobin concentration ([Hb]), reticulocyte percentage (RET%), OFF score and the abnormal blood profile score (ABPS) were calculated using the Bayesian model. After altitude training, six swimmers exceeded the 99% ABP thresholds: two swimmers exceeded the OFF score thresholds at day +7; one swimmer exceeded the OFF score threshold at day +28; one swimmer exceeded the threshold for RET% at day +14; and one swimmer surpassed the ABPS threshold at day +14. In the control group, no values exceeded the individual ABP reference range. In conclusion, LHTH induces haematological changes in Olympic-level elite athletes which can exceed the individually generated references in the ABP. Training at altitude should be considered a confounding factor for ABP interpretation for up to four weeks after altitude exposure but does not consistently cause abnormal values in the ABP.

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“…(C) Protein precipitation with solvent extraction (protocols detailed in the Methods section).to be of use as universal cancer biomarkers. Nevertheless, this panel of proteins and the SRM LC-MS/MS method presented here will be useful for longitudinal studies of individuals in the context of cancer or anti-doping analysis and of the biological passport[44].…”

mentioning

confidence: 98%

Targeted mass spectrometry analysis of the proteins IGF1, IGF2, IBP2, IBP3 and A2GL by blood protein precipitation

Such-Sanmartín¹,

Bache²,

Callesen³

et al. 2015

Journal of Proteomics

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Altitude exposure in sports: the Athlete Biological Passport standpoint

Cited by 14 publications

References 31 publications

Influence of combined iron supplementation and simulated hypoxia on the haematological module of the athlete biological passport

Influence of combined iron supplementation and simulated hypoxia on the haematological module of the athlete biological passport

Altitude training causes haematological fluctuations with relevance for the Athlete Biological Passport

Targeted mass spectrometry analysis of the proteins IGF1, IGF2, IBP2, IBP3 and A2GL by blood protein precipitation

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