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Intravascular Hemolysis and Mean Red BloodCell Age in Athletes


Medicine & Science in Sports & Exercise: March 2006 - Volume 38 - Issue 3 - p 480-483
doi: 10.1249/01.mss.0000188448.40218.4c
BASIC SCIENCES: Original Investigations

Purpose: Since the observation that mechanical stress causes red blood cell (RBC) destruction, foot-strike hemolysis has been used to explain sports anemia and RBC rejuvenation in athletes. Recently gained knowledge questions the importance of mechanical RBC trauma on RBC hemolysis in athletes.

Methods: Male athletes (N = 90) and untrained male controls (N = 58) were investigated for aerobic performance, hematological parameters, serum erythropoietin concentration (EPO), soluble transferrin receptor concentration (sTFR), and erythrocyte aspartate aminotransferase activity (eAST).

Results: On hard floor running disciplines (HFR, N = 26, short- and long-distance runners, triathletes) showed a lower eAST (P < 0.001) and thus no younger RBC population than not on hard floor running athletes (NHFR, N = 64, cyclists, soccer players, others) or the untrained control group (N = 58). HFR had higher but still normal EPO (P < 0.01) and no higher sTFR.

Conclusion: Because intravascular hemolysis occurs in swimmers, cyclists, and runners, and mean RBC age is not reduced in runners, mechanisms other than foot-strike hemolysis have to be considered as well. Possible reasons are intramuscular destruction, osmotic stress, and membrane lipid peroxidation caused by free radicals released by activated leukocytes. Intravascular hemolysis can even be regarded as physiological means to provide heme and proteins for muscle growth.

Charité-Campus Benjamin Franklin, Institute for Sports Medicine, Berlin, GERMANY

Address for correspondence: Dr. Med. Yohan Robinson, Charité-Campus Benjamin Franklin, Klinik für Unfall- und Wiederherstellungschirurgie, Hindenburgdamm 30, D-12200 Berlin, Germany; E-mail:

Submitted for publication May 2005.

Accepted for publication September 2005.

©2006The American College of Sports Medicine