open access publication

Article, 2024

Yearly intrasubject variability of hematological biomarkers in elite athletes for the Athlete Biological Passport

Drug Testing and Analysis, ISSN 1942-7611, 1942-7603, 10.1002/dta.3645

Contributors

Krumm, Bastien 0000-0002-9132-606X [1] Lundby, Carsten [2] [3] Hansen, Joar [2] Bejder, Jacob 0000-0002-9698-9188 [3] Sørensen, Henrik 0000-0003-0819-106X [3] Equey, Tristan 0000-0001-5369-9642 [4] Saugy, Jonas J 0000-0002-0744-550X [1] Botrè, Francesco M 0000-0001-5296-8126 [1] [5] Faiss, Raphael 0000-0001-6029-9516 (Corresponding author) [1]

Affiliations

  1. [1] University of Lausanne
  2. [NORA names: Switzerland; Europe, Non-EU; OECD];
  3. [2] Section for Health and Exercise Physiology, Inland University of Applied Sciences, Lillehammer, Norway
  4. [NORA names: Norway; Europe, Non-EU; Nordic; OECD];
  5. [3] University of Copenhagen
  6. [NORA names: KU University of Copenhagen; University; Denmark; Europe, EU; Nordic; OECD];
  7. [4] World Anti-Doping Agency
  8. [NORA names: Canada; America, North; OECD];
  9. [5] Federazione Medico Sportiva Italiana
  10. [NORA names: Italy; Europe, EU; OECD]

Abstract

Confounding factors including exercise and environments challenge the interpretation of individual Athlete Biological Passports (ABPs). This study aimed to investigate the natural variability of hematological ABP parameters over 1 year in elite athletes compared with healthy control subjects and the validity of a multiparametric model estimating plasma volume (PV) shifts to correct individual ABP thresholds. Blood samples were collected monthly with full blood counts performed by flow cytometry (Sysmex XN analyzers) in 20 elite xc-skiers (ELITE) and 20 moderately trained controls. Individual ABP profiles were generated through Anti-Doping Administration & Management System Training, a standalone version of the ABP's adaptive model developed by the World Anti-Doping Agency. Additionally, eight serum parameters were computed as volume-sensitive biomarkers to run a multiparametric model to estimate PV. Variability in ELITE compared with controls was significantly higher for the Abnormal Blood Profile Scores (P = 0.003). Among 12 Atypical Passport Findings (ATPF) initially reported, six could be removed after correction of PV shifts with the multiparametric modeling. However, several ATPF were additionally generated (n = 19). Our study outlines a larger intraindividual variability in elite athletes, likely explained by more frequent exposure to extrinsic factors altering hematological biomarkers. PV correction for individual ABP thresholds allowed to explain most of the atypical findings while generating multiple new ATPF occurrences in the elite population. Overall, accounting for PV shifts in elite athletes was shown to be paramount in this study outlining the opportunity to consider PV variations with novel approaches when interpreting individual ABP profiles.

Keywords

ABP adaptive model, ABP profiles, Abnormal Blood Profile Score, Anti-Doping Agency, Athlete Biological Passport, Biological Passport, PV correction, PV shifts, PV variations, World Anti-Doping Agency, XC skiers, adaptive model, agencies, anti-doping, approach, athletes, atypical findings, atypical passport findings, biomarkers, blood, blood count, blood samples, confounding, confounding factors, control, control subjects, correction, count, cytometry, elite XC skiers, elite athletes, elite population, elites, environment, estimate PV, exercise, exposure to extrinsic factors, extrinsic factors, factors, findings, flow, flow cytometry, full blood count, healthy control subjects, hematological biomarkers, interpretation, intraindividual variability, model, multiparametric model, natural variability, occurrence, parameters, passport, plasma, plasma volume, population, profile, profile score, samples, scores, serum, serum parameters, shift, standalone version, study, subjects, system training, threshold, training, validity, variables, variation, version, volume, world, years

Funders

  • World Anti-Doping Agency

Data Provider: Digital Science