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EPO, red cells, and serum transferrin receptor in continuous and intermittent hypoxia


Medicine & Science in Sports & Exercise: April 2000 - Volume 32 - Issue 4 - p 800-804
Basic Sciences: Original Investigations: Symposium: The Role Of Skeletal Muscles In Lactate Exchange During Exercise

KOISTINEN, P. O., H. RUSKO, K. IRJALA, A. RAJAMÄKI, K. PENTTINEN, V-P. SARPARANTA, J. KARPAKKA, and J. LEPPÄLUOTO. EPO, red cells, and serum transferrin receptor in continuous and intermittent hypoxia. Med. Sci. Sports Exerc., Vol. 32, No. 4, pp. 800–804, 2000.

Purpose: Erythropoietic response in 10 healthy nonsmoking volunteers exposed to normobaric hypoxia continuously or intermittently 12 h daily for 7 d was evaluated in a randomized cross-over study.

Methods: An oxygen content of 15.4% corresponding to an altitude of 2500 m was created by adding nitrogen into room air in a flat. Venous blood samples for hemoglobin (Hb), hematocrit (Hct), reticulocytes, serum erythropoietin (S-EPO), red cell 2,3-diphosphoglycerate (2,3-DPG), serum ferritin (S-Ferrit), and serum soluble transferrin receptor (S-TransfR) were drawn at 8:00 a.m.

Results: S-EPO was increased from baseline values of 22.9 ± 9.6 and 20.5 ± 10.1 U·L−1 to 40.7 ± 12.9 (P < 0.05) and 35 ± 14.3 U·L−1 (P < 0.05) after the first night in continuous and intermittent hypoxia, respectively, and remained elevated throughout both exposures. Hb and Hct values did not show any significant changes. Red cell 2,3-DPG rose from baseline a value of 5.0 ± 0.8 to 5.9 ± 0.7 mmol·L−1 (P < 0.05) after the first day in continuous hypoxia and from 5.2 ± 0.7 mmol·L−1 to 6.1 ± 0.5 mmol·L−1 on day 3 (P < 0.05) during intermittent hypoxia. The reticulocyte count rose significantly (P < 0.05) after 5 d in both experiments. S-transferrin receptor level rose significantly from 2.2 ± 0.4 and 2.1 ± 0.5 mg·L−1 to 2.6 ± 0.5 mg·L−1 and 2.3 ± 0.6 mg·L−1 on day 5 (P < 0.05), to 2.7 ± 0.5 mg·L−1 and 2.5 ± 0.6 mg·L−1 on day 7 (P < 0.05) under continuous and intermittent hypoxia, respectively.

Conclusions: We suggest that intermittent exposure to moderate normobaric hypoxia 12 h daily for 1 wk induces a similar stimulation of erythropoiesis as continuous exposure.

Health Center Hospital of Oulu, FINLAND; Research Institute for Olympic Sports, Jyväskylä, FINLAND; Department of Clinical Chemistry and Hematology, University of Turku, FINLAND; and Vuokatti Sports and Training Center, FINLAND; Department of Sports Medicine, Deaconess Institute, Oulu, FINLAND; Kainuu Central Hospital, Kajaani, FINLAND; and Department of Physiology, University of Oulu, FINLAND

Submitted for publication August 1997.

Accepted for publication August 1998.

Address for correspondence: Dr. Pentti Koistinen, Health Center Hospital of Oulu, Box 8, SF-90015 Oulu, Finland; E-mail:

© 2000 Lippincott Williams & Wilkins, Inc.