Abstract
Background: Soluble transferrin receptor (sTfr) is a new marker of iron status and erythropoietic activity. It has been included in multivariable blood testing models for the detection of performance enhancing erythropoietin misuse in sport.
Objective: To evaluate the effect of different types and volumes of physical activity on sTfr concentration, variables of iron status (ferritin, transferrin, iron, and protein), and haematological indices.
Methods: Thirty nine subjects were divided into three groups: 1, untrained (n = 12); 2, moderately trained (n = 14); 3, highly trained (n = 13, seven men, six women). Groups 1 and 2 carried out two exercise tests: an incremental running test until exhaustion (test A) and a 45 minute constant speed running test at 70% VO2MAX (test B). Group 3 performed three days (women) or four days (men) of prolonged aerobic cycling exercise. The above variables together with haemoglobin and packed cell volume were analysed in venous blood samples before and after exercise. Changes in blood and plasma volume were estimated.
Results: sTfr levels were slightly increased in trained and untrained subjects immediately after test A. Test B and aerobic exercise had no significant effect on sTfr. Ferritin levels were increased after the laboratory tests for trained and untrained subjects and after prolonged aerobic exercise in male cyclists. Transferrin was increased significantly in trained and untrained subjects after both laboratory tests, but remained unchanged after prolonged exercise. Plasma and blood volumes were decreased after the laboratory tests but increased after aerobic exercise. No differences in the variables were observed between trained and untrained subjects with respect to response to exercise.
Conclusion: The changes in sTfr and the variables of iron status can be mainly attributed to exercise induced changes in volume. Taking these limitations into account, sTfr can be recommended as a marker of iron deficiency in athletes.
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Selected References
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- Ahluwalia N. Diagnostic utility of serum transferrin receptors measurement in assessing iron status. Nutr Rev. 1998 May;56(5 Pt 1):133–141. doi: 10.1111/j.1753-4887.1998.tb01738.x. [DOI] [PubMed] [Google Scholar]
- Audran M., Gareau R., Matecki S., Durand F., Chenard C., Sicart M. T., Marion B., Bressolle F. Effects of erythropoietin administration in training athletes and possible indirect detection in doping control. Med Sci Sports Exerc. 1999 May;31(5):639–645. doi: 10.1097/00005768-199905000-00003. [DOI] [PubMed] [Google Scholar]
- Balaban E. P., Cox J. V., Snell P., Vaughan R. H., Frenkel E. P. The frequency of anemia and iron deficiency in the runner. Med Sci Sports Exerc. 1989 Dec;21(6):643–648. doi: 10.1249/00005768-198912000-00003. [DOI] [PubMed] [Google Scholar]
- Balaban E. P., Snell P., Stray-Gundersen J., Frenkel E. P. The effect of running on serum and red cell ferritin. A longitudinal comparison. Int J Sports Med. 1995 Jul;16(5):278–282. doi: 10.1055/s-2007-973005. [DOI] [PubMed] [Google Scholar]
- Beguin Y. The soluble transferrin receptor: biological aspects and clinical usefulness as quantitative measure of erythropoiesis. Haematologica. 1992 Jan-Feb;77(1):1–10. [PubMed] [Google Scholar]
- Birkeland K. I., Stray-Gundersen J., Hemmersbach P., Hallen J., Haug E., Bahr R. Effect of rhEPO administration on serum levels of sTfR and cycling performance. Med Sci Sports Exerc. 2000 Jul;32(7):1238–1243. doi: 10.1097/00005768-200007000-00009. [DOI] [PubMed] [Google Scholar]
- Cook J. D. The measurement of serum transferrin receptor. Am J Med Sci. 1999 Oct;318(4):269–276. doi: 10.1097/00000441-199910000-00006. [DOI] [PubMed] [Google Scholar]
- Cooper M. J., Zlotkin S. H. Day-to-day variation of transferrin receptor and ferritin in healthy men and women. Am J Clin Nutr. 1996 Nov;64(5):738–742. doi: 10.1093/ajcn/64.5.738. [DOI] [PubMed] [Google Scholar]
- Dill D. B., Costill D. L. Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration. J Appl Physiol. 1974 Aug;37(2):247–248. doi: 10.1152/jappl.1974.37.2.247. [DOI] [PubMed] [Google Scholar]
- Dube V. K., Berg J. "Pediatric dentistry today". J Gt Houst Dent Soc. 1995 Feb;66(7):27–35. [PubMed] [Google Scholar]
- Dufaux B., Hoederath A., Streitberger I., Hollmann W., Assmann G. Serum ferritin, transferrin, haptoglobin, and iron in middle- and long-distance runners, elite rowers, and professional racing cyclists. Int J Sports Med. 1981 Feb;2(1):43–46. doi: 10.1055/s-2008-1034583. [DOI] [PubMed] [Google Scholar]
- Feelders R. A., Kuiper-Kramer E. P., van Eijk H. G. Structure, function and clinical significance of transferrin receptors. Clin Chem Lab Med. 1999 Jan;37(1):1–10. doi: 10.1515/CCLM.1999.001. [DOI] [PubMed] [Google Scholar]
- Flowers C. H., Skikne B. S., Covell A. M., Cook J. D. The clinical measurement of serum transferrin receptor. J Lab Clin Med. 1989 Oct;114(4):368–377. [PubMed] [Google Scholar]
- Gareau R., Audran M., Baynes R. D., Flowers C. H., Duvallet A., Senécal L., Brisson G. R. Erythropoietin abuse in athletes. Nature. 1996 Mar 14;380(6570):113–113. doi: 10.1038/380113a0. [DOI] [PubMed] [Google Scholar]
- Gimenez M., Uffholtz H., Paysant P., Belleville F., Nabet P. Serum iron and transferrin during an exhaustive session of interval training. Eur J Appl Physiol Occup Physiol. 1988;57(2):154–158. doi: 10.1007/BF00640655. [DOI] [PubMed] [Google Scholar]
- Green H. J., Sutton J. R., Coates G., Ali M., Jones S. Response of red cell and plasma volume to prolonged training in humans. J Appl Physiol (1985) 1991 Apr;70(4):1810–1815. doi: 10.1152/jappl.1991.70.4.1810. [DOI] [PubMed] [Google Scholar]
- Haymes E. M., Spillman D. M. Iron status of women distance runners, sprinters, and control women. Int J Sports Med. 1989 Dec;10(6):430–433. doi: 10.1055/s-2007-1024938. [DOI] [PubMed] [Google Scholar]
- Hulthén L., Lindstedt G., Lundberg P. A., Hallberg L. Effect of a mild infection on serum ferritin concentration--clinical and epidemiological implications. Eur J Clin Nutr. 1998 May;52(5):376–379. doi: 10.1038/sj.ejcn.1600573. [DOI] [PubMed] [Google Scholar]
- Kohgo Y., Niitsu Y., Kondo H., Kato J., Tsushima N., Sasaki K., Hirayama M., Numata T., Nishisato T., Urushizaki I. Serum transferrin receptor as a new index of erythropoiesis. Blood. 1987 Dec;70(6):1955–1958. [PubMed] [Google Scholar]
- Konijn A. M., Hershko C. Ferritin synthesis in inflammation. I. Pathogenesis of impaired iron release. Br J Haematol. 1977 Sep;37(1):7–16. [PubMed] [Google Scholar]
- LaManca J. J., Haymes E. M. Effects of iron repletion on VO2max, endurance, and blood lactate in women. Med Sci Sports Exerc. 1993 Dec;25(12):1386–1392. [PubMed] [Google Scholar]
- Lampe J. W., Slavin J. L., Apple F. S. Poor iron status of women runners training for a marathon. Int J Sports Med. 1986 Apr;7(2):111–114. doi: 10.1055/s-2008-1025744. [DOI] [PubMed] [Google Scholar]
- Magnusson B., Hallberg L., Rossander L., Swolin B. Iron metabolism and "sports anemia". II. A hematological comparison of elite runners and control subjects. Acta Med Scand. 1984;216(2):157–164. [PubMed] [Google Scholar]
- Malczewska J., Błach W., Stupnicki R. The effects of physical exercise on the concentrations of ferritin and transferrin receptor in plasma of female judoists. Int J Sports Med. 2000 Apr;21(3):175–179. doi: 10.1055/s-2000-299. [DOI] [PubMed] [Google Scholar]
- Marx J. J., Vergouwen P. C. Packed-cell volume in elite athletes. Lancet. 1998 Aug 8;352(9126):451–451. doi: 10.1016/s0140-6736(98)24032-3. [DOI] [PubMed] [Google Scholar]
- Parisotto R., Gore C. J., Emslie K. R., Ashenden M. J., Brugnara C., Howe C., Martin D. T., Trout G. J., Hahn A. G. A novel method utilising markers of altered erythropoiesis for the detection of recombinant human erythropoietin abuse in athletes. Haematologica. 2000 Jun;85(6):564–572. [PubMed] [Google Scholar]
- Pattini A., Schena F., Guidi G. C. Serum ferritin and serum iron changes after cross-country and roller ski endurance races. Eur J Appl Physiol Occup Physiol. 1990;61(1-2):55–60. doi: 10.1007/BF00236694. [DOI] [PubMed] [Google Scholar]
- Ponka P., Beaumont C., Richardson D. R. Function and regulation of transferrin and ferritin. Semin Hematol. 1998 Jan;35(1):35–54. [PubMed] [Google Scholar]
- Risser W. L., Lee E. J., Poindexter H. B., West M. S., Pivarnik J. M., Risser J. M., Hickson J. F. Iron deficiency in female athletes: its prevalence and impact on performance. Med Sci Sports Exerc. 1988 Apr;20(2):116–121. doi: 10.1249/00005768-198820020-00003. [DOI] [PubMed] [Google Scholar]
- Sawka M. N., Convertino V. A., Eichner E. R., Schnieder S. M., Young A. J. Blood volume: importance and adaptations to exercise training, environmental stresses, and trauma/sickness. Med Sci Sports Exerc. 2000 Feb;32(2):332–348. doi: 10.1097/00005768-200002000-00012. [DOI] [PubMed] [Google Scholar]
- Schmidt W., Biermann B., Winchenbach P., Lison S., Böning D. How valid is the determination of hematocrit values to detect blood manipulations? Int J Sports Med. 2000 Feb;21(2):133–138. doi: 10.1055/s-2000-8871. [DOI] [PubMed] [Google Scholar]
- Schmidt W., Maassen N., Trost F., Böning D. Training induced effects on blood volume, erythrocyte turnover and haemoglobin oxygen binding properties. Eur J Appl Physiol Occup Physiol. 1988;57(4):490–498. doi: 10.1007/BF00417998. [DOI] [PubMed] [Google Scholar]
- Selby G. B., Eichner E. R. Hematocrit and performance: the effect of endurance training on blood volume. Semin Hematol. 1994 Apr;31(2):122–127. [PubMed] [Google Scholar]
- Suominen P., Punnonen K., Rajamäki A., Irjala K. Serum transferrin receptor and transferrin receptor-ferritin index identify healthy subjects with subclinical iron deficits. Blood. 1998 Oct 15;92(8):2934–2939. [PubMed] [Google Scholar]
- Takubo T., Yamane Y., Hino M., Hashimoto S., Koh K. R., Sakamoto C., Kamitani T., Tatsumi N., Hikawa A. The value of serum soluble transferrin receptor (sTfR) determination in hematological malignancies. Haematologia (Budap) 1998;29(3):259–260. [PubMed] [Google Scholar]
- Weight L. M., Alexander D., Jacobs P. Strenuous exercise: analogous to the acute-phase response? Clin Sci (Lond) 1991 Nov;81(5):677–683. doi: 10.1042/cs0810677. [DOI] [PubMed] [Google Scholar]
- Weight L. M., Byrne M. J., Jacobs P. Haemolytic effects of exercise. Clin Sci (Lond) 1991 Aug;81(2):147–152. doi: 10.1042/cs0810147. [DOI] [PubMed] [Google Scholar]
- Yeung G. S., Kjarsgaard J. C., Zlotkin S. H. Disparity of serum transferrin receptor measurements among different assay methods. Eur J Clin Nutr. 1998 Nov;52(11):801–804. doi: 10.1038/sj.ejcn.1600650. [DOI] [PubMed] [Google Scholar]