title: Total hemoglobin mass--a new parameter to detect blood doping?
abstract: OBJECTIVE
  All kinds of blood manipulations aim to increase the total hemoglobin mass (tHb-mass). To establish tHb-mass as an effective screening parameter for detecting blood doping, the knowledge of its normal variation over time is necessary. The aim of the present study, therefore, was to determine the intraindividual variance of tHb-mass in elite athletes during a training year emphasizing off, training, and race seasons at sea level.
  
  
  METHODS
  tHb-mass and hemoglobin concentration ([Hb]) were determined in 24 endurance athletes five times during a year and were compared with a control group (n = 6). An analysis of covariance was used to test the effects of training phases, age, gender, competition level, body mass, and training volume. Three error models, based on 1) a total percentage error of measurement, 2) the combination of a typical percentage error (TE) of analytical origin with an absolute SD of biological origin, and 3) between-subject and within-subject variance components as obtained by an analysis of variance, were tested.
  
  
  RESULTS
  In addition to the expected influence of performance status, the main results were that the effects of training volume (P = 0.20) and training phases (P = 0.81) on tHb-mass were not significant. We found that within-subject variations mainly have an analytical origin (TE approximately 1.4%) and a very small SD (7.5 g) of biological origin.
  
  
  CONCLUSIONS
  tHb-mass shows very low individual oscillations during a training year (<6%), and these oscillations are below the expected changes in tHb-mass due to Herythropoetin (EPO) application or blood infusion (approximately 10%). The high stability of tHb-mass over a period of 1 year suggests that it should be included in an athlete's biological passport and analyzed by recently developed probabilistic inference techniques that define subject-based reference ranges.
authors.affiliation: Department of Sports Medicine and Sports Physiology, University of Bayreuth, Bayreuth, Germany. Nicole.Prommer@uni-bayreuth.de
authors.forename: Nicole
authors.initials: N
authors.lastname: Prommer
authors.forename: Pierre-Edouard
authors.initials: PE
authors.lastname: Sottas
authors.forename: Christian
authors.initials: C
authors.lastname: Schoch
authors.forename: Yorck Olaf
authors.initials: YO
authors.lastname: Schumacher
authors.forename: Walter
authors.initials: W
authors.lastname: Schmidt
mesh_terms: D016022:Case-Control Studies; D004300:Doping in Sports; D004921:Erythropoietin / Q000008:administration & dosage; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D010807:Physical Endurance; D011994:Recombinant Proteins; D012016:Reference Values; D015203:Reproducibility of Results; D013177:Sports; D015813:Substance Abuse Detection / Q000379:methods*
chemical_list: D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin