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Serum Ferritin as a Marker of Potential Biochemical Iron Overload in Athletes

Lippi, Giuseppe MD*; Schena, Federico MD; Franchini, Massimo MD; Salvagno, Gian Luca MD*; Guidi, Gian Cesare MD*

Clinical Journal of Sport Medicine: September 2005 - Volume 15 - Issue 5 - p 356-358
doi: 10.1097/01.jsm.0000179135.92468.f2
Brief Report

Objectives: Beyond hematological manipulation, iron supplementation therapy is commonplace in athletes to counterbalance physiological or pathologic anemia and to prevent physiologic dysfunction. However, misuse of iron therapy, occasionally resulting in iron overload, is not free from metabolic risks.

Design: We planned to measure baseline serum ferritin concentration in sedentary individual and athletes.

Setting: The Institute of Clinical Biochemistry of the Verona University.

Participants: Serum ferritin was measured in 60 male healthy sedentary controls, 80 amateur road cyclists, 42 male professional cross-country skiers, and 88 professional male road cyclists.

Assessment of Risk Factors: The biochemical iron overload was ascertained by measuring baseline serum ferritin concentration as a reliable approach that mirrors the total body iron content.

Main Outcome Measurements: The concentration of serum ferritin in healthy controls was 112 ± 78 ng/mL, whereas that of amateur cyclists, professional skiers, and professional cyclists was 127 ± 76 ng/mL (P = 0.185), 183 ± 130 ng/mL (P = 0.001), and 332 ± 218 ng/mL (P < 0.001), respectively.

Results: Both categories of professional athletes showed significantly increased concentrations of serum ferritin, whereas the concentration of amateur cyclists was comparable to that of healthy sedentary controls.

Conclusions: Professional endurance athletes have serum ferritin concentrations that are 2-fold to 3-fold higher than those of matched sedentary individuals and amateur athletes, exceeding the threshold for the diagnosis of biochemical iron overload and unveiling potential metabolic risks.

From the *Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologico-Biomediche, Università degli Studi di Verona, Verona, Italy; †Centro Interuniversitario di Ricerca in Bioingegneria e Scienze Motorie, Rovereto, Italy; and ‡Servizio di Immunoematologia e Trasfusione, Azienda Ospedaliera di Verona, Verona, Italy.

Received for publication November 2004; accepted June 2005.

Reprints: Giuseppe Lippi, MD, Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologico-Biomediche, Università degli Studi di Verona, Ospedale Policlinico G. B. Rossi, Piazzale Scuro, 10 37134-Verona, Italy (e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.