title: Relationship between changes in haemoglobin mass and maximal oxygen uptake after hypoxic exposure.
abstract: BACKGROUND
  Endurance athletes have been using altitude training for decades to improve near sea-level performance. The predominant mechanism is thought to be accelerated erythropoiesis increasing haemoglobin mass (Hb(mass)) resulting in a greater maximal oxygen uptake (VO₂(max)). Not all studies have shown a proportionate increase in VO₂(max) as a result of increased Hb(mass). The aim of this study was to determine the relationship between the two parameters in a large group of endurance athletes after altitude training.
  
  
  METHODS
  145 elite endurance athletes (94 male and 51 female) who participated in various altitude studies as altitude or control participants were used for the analysis. Participants performed Hb(mass) and VO₂(max) testing before and after intervention.
  
  
  RESULTS
  For the pooled data, the correlation between per cent change in Hb(mass) and per cent change in VO₂(max) was significant (p<0.0001, r(2)=0.15), with a slope (95% CI) of 0.48 (0.30 to 0.67) intercept free to vary and 0.62 (0.46 to 0.77) when constrained through the origin. When separated, the correlations were significant for the altitude and control groups, with the correlation being stronger for the altitude group (slope of 0.57 to 0.72).
  
  
  CONCLUSIONS
  With high statistical power, we conclude that altitude training of endurance athletes will result in an increase in VO₂(max) of more than half the magnitude of the increase in Hb(mass), which supports the use of altitude training by athletes. But race performance is not perfectly related to relative VO₂(max), and other non-haematological factors altered from altitude training, such as running economy and lactate threshold, may also be beneficial to performance.
authors.affiliation: Department of Physiology, Australian Institute of Sport, , Canberra, Australian Capital Territory, Australia.
authors.forename: Philo U
authors.initials: PU
authors.lastname: Saunders
authors.forename: Laura A
authors.initials: LA
authors.lastname: Garvican-Lewis
authors.forename: Walter F
authors.initials: WF
authors.lastname: Schmidt
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Gore
mesh_terms: D000531:Altitude; D054874:Athletic Performance / Q000502:physiology*; D001642:Bicycling / Q000502:physiology; D016022:Case-Control Studies; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D000860:Hypoxia / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology; D005082:Physical Exertion / Q000502:physiology; D012420:Running / Q000502:physiology; D013550:Swimming / Q000502:physiology; D016138:Walking / Q000502:physiology
chemical_list: D006454:Hemoglobins
keywords: Aerobic fitness/Vo2 Max; Altitude; Elite performance; Endurance; Exercise