Sharpe Ken, Ashenden Michael J, Schumacher Yorck O
Department of Mathematics and Statistics, University of Melbourne, Australia.
Haematologica. 2006 Mar;91(3):356-63. Epub 2006 Feb 17.
Information derived from blood analyses can assist in the detection and/or deterrence of blood doping in sport. We investigated whether comparing an athlete's hematologic values against his or her own historical baseline rather than population-derived thresholds enhanced the ability to detect blood doping.
We developed an approach whereby an athlete's true baseline value could be estimated with just one prior blood test. We also estimated a universal value for within-subject variability for key hematologic parameters using the highest value obtained among four separate cohorts of male athletes including 80 elite rowers, 124 endurance-trained or team-sport subjects, 288 professional football players and 630 athletes competing at national or international level. The (individual) baseline and (universal) variability were then incorporated so as to define expected thresholds for subsequent blood tests. The sensitivity of our approach was obtained by analyzing data from 49 recreational athletes administered either recombinant human erythropoietin (n=37) or placebo (n=12).
We found that removing within-subject variability by comparing new results against an historical baseline heightened the capacity to detect blood doping. It was possible to delineate the longitudinal changes in either hemoglobin (Hb) or the OFF-hr model score (an algorithm using both Hb and percent reticulocytes) caused by recombinant human erythropoietin treatment from the natural biological fluctuations found in subjects treated with placebo.
Our objective data supported the intuitive belief that longitudinal monitoring of athletes' blood profiles will help detect blood doping. This information could be used to instigate target-testing of suspicious athletes, or even warrant the exclusion from competition of athletes with aberrant variations in key hematologic values.
血液分析得出的信息有助于在体育运动中检测和/或防止血液兴奋剂使用。我们研究了将运动员的血液学值与他或她自己的历史基线进行比较，而非与基于总体得出的阈值进行比较，是否能增强检测血液兴奋剂使用的能力。
我们开发了一种方法，仅通过一次先前的血液检测就能估计运动员的真实基线值。我们还利用在四个不同男性运动员队列（包括80名精英赛艇运动员、124名耐力训练或团队运动受试者、288名职业足球运动员以及630名参加国家或国际比赛的运动员）中获得的最高值，估计了关键血液学参数的个体内变异的通用值。然后将（个体）基线和（通用）变异纳入其中，以定义后续血液检测的预期阈值。通过分析49名接受重组人促红细胞生成素（n = 37）或安慰剂（n = 12）治疗的休闲运动员的数据，获得了我们方法的灵敏度。
我们发现，通过将新结果与历史基线进行比较来消除个体内变异，提高了检测血液兴奋剂使用的能力。能够从接受安慰剂治疗的受试者的自然生物波动中区分出重组人促红细胞生成素治疗引起的血红蛋白（Hb）或非服药时间模型评分（一种同时使用Hb和网织红细胞百分比的算法）的纵向变化。
我们的客观数据支持了这样一种直观的观点，即对运动员血液指标进行纵向监测将有助于检测血液兴奋剂使用。这些信息可用于对可疑运动员进行针对性检测，甚至有理由取消关键血液学值异常变化的运动员的比赛资格。
