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Webb KL, Gorman EK, Morkeberg OH, Klassen SA, Regimbal RJ, Wiggins CC, Joyner MJ, Hammer SM, Senefeld JW. The relationship between hemoglobin and [Formula: see text]: A systematic review and meta-analysis. PLoS One 2023; 18:e0292835. [PMID: 37824583 PMCID: PMC10569622 DOI: 10.1371/journal.pone.0292835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 09/29/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVE There is widespread agreement about the key role of hemoglobin for oxygen transport. Both observational and interventional studies have examined the relationship between hemoglobin levels and maximal oxygen uptake ([Formula: see text]) in humans. However, there exists considerable variability in the scientific literature regarding the potential relationship between hemoglobin and [Formula: see text]. Thus, we aimed to provide a comprehensive analysis of the diverse literature and examine the relationship between hemoglobin levels (hemoglobin concentration and mass) and [Formula: see text] (absolute and relative [Formula: see text]) among both observational and interventional studies. METHODS A systematic search was performed on December 6th, 2021. The study procedures and reporting of findings followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Article selection and data abstraction were performed in duplicate by two independent reviewers. Primary outcomes were hemoglobin levels and [Formula: see text] values (absolute and relative). For observational studies, meta-regression models were performed to examine the relationship between hemoglobin levels and [Formula: see text] values. For interventional studies, meta-analysis models were performed to determine the change in [Formula: see text] values (standard paired difference) associated with interventions designed to modify hemoglobin levels or [Formula: see text]. Meta-regression models were then performed to determine the relationship between a change in hemoglobin levels and the change in [Formula: see text] values. RESULTS Data from 384 studies (226 observational studies and 158 interventional studies) were examined. For observational data, there was a positive association between absolute [Formula: see text] and hemoglobin levels (hemoglobin concentration, hemoglobin mass, and hematocrit (P<0.001 for all)). Prespecified subgroup analyses demonstrated no apparent sex-related differences among these relationships. For interventional data, there was a positive association between the change of absolute [Formula: see text] (standard paired difference) and the change in hemoglobin levels (hemoglobin concentration (P<0.0001) and hemoglobin mass (P = 0.006)). CONCLUSION These findings suggest that [Formula: see text] values are closely associated with hemoglobin levels among both observational and interventional studies. Although our findings suggest a lack of sex differences in these relationships, there were limited studies incorporating females or stratifying results by biological sex.
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Affiliation(s)
- Kevin L. Webb
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Ellen K. Gorman
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Olaf H. Morkeberg
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Stephen A. Klassen
- Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | - Riley J. Regimbal
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Chad C. Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Michael J. Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Shane M. Hammer
- Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma, United States of America
| | - Jonathon W. Senefeld
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, United States of America
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois
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Seccato AS, Bello FD, Queiroz ACC, Marins JCB, Miarka B, Carvalho PHBD, Brito CJ. Hyperproteic supplementation attenuates muscle damage after simulated Olympic cross-country mountain biking competition: a randomized case-control study. MOTRIZ: REVISTA DE EDUCACAO FISICA 2019. [DOI: 10.1590/s1980-6574201900020012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | | | | | - Bianca Miarka
- Universidade Federal de Juiz de Fora, Brazil; Universidade Federal do Rio de Janeiro, Brazil
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Balducci P, Saboul D, Trama R. Monitoring heart rates to evaluate pacing on a 75-km MUM. J Sports Med Phys Fitness 2018; 59:1133-1137. [PMID: 30264978 DOI: 10.23736/s0022-4707.18.08861-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND To examine pacing among twelve males on a 75-km mountain ultra marathon (MUM) and to determine whether pacing relates to final performance. METHODS Speed and heart rates (HR) were measured continuously using a HR monitor and a global position system device. An Index of Pacing (IP) was calculated by dividing the average race speed by the speed on the first race segment. In addition, percentage (%) of heart rate reserve (HRres), coefficient of variation (CV) in speed and in percentage of HRres were analyzed throughout the race. RESULTS Performance time was correlated with IP (r=-0.88, P<0.01), % of HRres (r=- 0.72, P<0.05), and CV in % of HRres (r=0.80, P<0.05), but not with CV in speed (r=-0.12, P=0.9). On the entire race, evolution of HR was not dependent on the elevation gain. CONCLUSIONS Tracking HR is a safer way to rate pacing than speed tracking on a hilly course.
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Affiliation(s)
- Pascal Balducci
- Inter-University Laboratory of Human Movement Science, Claude Bernard Lyon 1 University, Villeurbanne, France -
| | - Damien Saboul
- Inter-University Laboratory of Human Movement Science, Claude Bernard Lyon 1 University, Villeurbanne, France.,Be-Studys, Châtelaine, Genève, Switzerland
| | - Robin Trama
- Inter-University Laboratory of Human Movement Science, Claude Bernard Lyon 1 University, Villeurbanne, France
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Cotter JD, Thornton SN, Lee JK, Laursen PB. Are we being drowned in hydration advice? Thirsty for more? EXTREME PHYSIOLOGY & MEDICINE 2014; 3:18. [PMID: 25356197 PMCID: PMC4212586 DOI: 10.1186/2046-7648-3-18] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 10/01/2014] [Indexed: 12/29/2022]
Abstract
Hydration pertains simplistically to body water volume. Functionally, however, hydration is one aspect of fluid regulation that is far more complex, as it involves the homeostatic regulation of total body fluid volume, composition and distribution. Deliberate or pathological alteration of these regulated factors can be disabling or fatal, whereas they are impacted by exercise and by all environmental stressors (e.g. heat, immersion, gravity) both acutely and chronically. For example, dehydration during exercising and environmental heat stress reduces water volume more than electrolyte content, causing hyperosmotic hypohydration. If exercise continues for many hours with access to food and water, composition returns to normal but extracellular volume increases well above baseline (if exercising upright and at low altitude). Repeating bouts of exercise or heat stress does likewise. Dehydration due to physical activity or environmental heat is a routine fluid-regulatory stress. How to gauge such dehydration and - more importantly-what to do about it, are contested heavily within sports medicine and nutrition. Drinking to limit changes in body mass is commonly advocated (to maintain ≤2% reduction), rather than relying on behavioural cues (mainly thirst) because the latter has been deemed too insensitive. This review, as part of the series on moving in extreme environments, critiques the validity, problems and merits of externally versus autonomously controlled fluid-regulatory behaviours, both acutely and chronically. Our contention is that externally advocated hydration policies (especially based on change in body mass with exercise in healthy individuals) have limited merit and are extrapolated and imposed too widely upon society, at the expense of autonomy. More research is warranted to examine whether ad libitum versus avid drinking is beneficial, detrimental or neither in: acute settings; adapting for obligatory dehydration (e.g. elite endurance competition in the heat), and; development of chronic diseases that are associated with an extreme lack of environmental stress.
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Affiliation(s)
- James David Cotter
- Exercise and Environmental Physiology, School of Physical Education, Sport and Exercise Sciences, Division of Sciences, University of Otago, PO Box 56, Dunedin 9054, New Zealand
| | - Simon N Thornton
- Faculté de Médecine, Université de Lorraine, U 1116 -INSERM-UL, 9, Avenue de la forêt de Haye, CS50-184 - 54505 VANDŒUVRE, Les Nancy cedex, France
| | - Jason Kw Lee
- Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore ; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Paul B Laursen
- High Performance Sport New Zealand, Auckland, New Zealand ; Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
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Millet GY, Tomazin K, Verges S, Vincent C, Bonnefoy R, Boisson RC, Gergelé L, Féasson L, Martin V. Neuromuscular consequences of an extreme mountain ultra-marathon. PLoS One 2011; 6:e17059. [PMID: 21364944 PMCID: PMC3043077 DOI: 10.1371/journal.pone.0017059] [Citation(s) in RCA: 170] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Accepted: 01/19/2011] [Indexed: 11/19/2022] Open
Abstract
We investigated the physiological consequences of one of the most extreme exercises realized by humans in race conditions: a 166-km mountain ultra-marathon (MUM) with 9500 m of positive and negative elevation change. For this purpose, (i) the fatigue induced by the MUM and (ii) the recovery processes over two weeks were assessed. Evaluation of neuromuscular function (NMF) and blood markers of muscle damage and inflammation were performed before and immediately following (n = 22), and 2, 5, 9 and 16 days after the MUM (n = 11) in experienced ultra-marathon runners. Large maximal voluntary contraction decreases occurred after MUM (-35% [95% CI: -28 to -42%] and -39% [95% CI: -32 to -46%] for KE and PF, respectively), with alteration of maximal voluntary activation, mainly for KE (-19% [95% CI: -7 to -32%]). Significant modifications in markers of muscle damage and inflammation were observed after the MUM as suggested by the large changes in creatine kinase (from 144 ± 94 to 13,633 ± 12,626 UI L(-1)), myoglobin (from 32 ± 22 to 1,432 ± 1,209 µg L(-1)), and C-Reactive Protein (from <2.0 to 37.7 ± 26.5 mg L(-1)). Moderate to large reductions in maximal compound muscle action potential amplitude, high-frequency doublet force, and low frequency fatigue (index of excitation-contraction coupling alteration) were also observed for both muscle groups. Sixteen days after MUM, NMF had returned to initial values, with most of the recovery process occurring within 9 days of the race. These findings suggest that the large alterations in NMF after an ultra-marathon race are multi-factorial, including failure of excitation-contraction coupling, which has never been described after prolonged running. It is also concluded that as early as two weeks after such an extreme running exercise, maximal force capacities have returned to baseline.
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Hemoglobin and hematocrit are not such good candidates to detect autologous blood doping. Int J Hematol 2009; 89:714-5. [DOI: 10.1007/s12185-009-0330-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2009] [Revised: 04/10/2009] [Accepted: 04/20/2009] [Indexed: 10/20/2022]
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