Newhouse I J, Clement D B
Allan McGavin Sports Medicine Centre, Faculty of Medicine, University of British Columbia, Vancouver.
Sports Med. 1988 Jun;5(6):337-52. doi: 10.2165/00007256-198805060-00001.
As more studies are done on the iron status of athletes, the significance of apparent iron deficiency remains controversial. Do observed changes in iron status in athletes indicate an actual iron deficiency or a physiological response to exercise? Iron replacement would clearly be indicated if an iron deficiency was present but would not be necessary or effective if the observed changes were simply a physiological response. There is agreement that serum ferritin and haemoglobin decrease with some exercise conditions and that some indicators of haemolysis, such as serum haptoglobin and bilirubin, change in response to exercise. Expansion of plasma volume and the shift of iron storage from bone marrow to the liver could support the claim that the apparent reduced iron status parameters occurring with exercise are misleading. Countering this concept are studies in athletes which demonstrate dietary iron intake deficiencies and blood loss in the gastrointestinal and urinary tract. Iron deficiency is common in the general population, particularly in women. Therefore, continued monitoring of iron status in athletes appears justified in the face of present knowledge. Replacement therapy, when iron deficiency is apparent, is recommended.
随着对运动员铁状态的研究越来越多，明显缺铁的意义仍存在争议。运动员铁状态的观察变化是表明实际缺铁还是对运动的生理反应？如果存在缺铁，显然需要进行铁补充，但如果观察到的变化仅仅是生理反应，则没有必要或效果不佳。人们一致认为，血清铁蛋白和血红蛋白会随着某些运动条件而降低，并且一些溶血指标，如血清触珠蛋白和胆红素，会因运动而发生变化。血浆量的增加以及铁储存从骨髓向肝脏的转移，可能支持这样一种观点，即运动时出现的明显降低的铁状态参数具有误导性。与之相反的是，针对运动员的研究表明存在膳食铁摄入不足以及胃肠道和泌尿道失血。缺铁在普通人群中很常见，尤其是女性。因此，鉴于目前的认知，持续监测运动员的铁状态似乎是合理的。当明显缺铁时，建议进行替代疗法。
