College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, 321000, China.
Department of Kinesiology, School of Kinesiology, Louisiana State University, Baton Rouge, LA, 70803, USA.
Sci Rep. 2021 Jan 19;11(1):1844. doi: 10.1038/s41598-021-81473-4.
Sickle cell trait (SCT) is a risk factor of collapse and sudden death in athletes. We conducted a longitudinal study to determine the hematological responses and hydration status in NCAA Division I American football players with SCT. The study took place over 2 years with 6 SCT and 6 position-matched controls (CON) in year 1; and 4 SCT and 4 CON in year 2. In year 2, three of the four SCT players were recruited and re-enrolled with new position-matched controls (total sample data = 10 SCT and 10 CON). Blood samples were taken at three visits: pre-camp, post-camp, and post-season to examine hemoglobin variants, complete blood counts, and chemistry panel 26. Hydration status was assessed by measuring body weight change, urine specific gravity, and urine and sweat electrolyte concentrations during the pre-season training camp. All SCT players were confirmed to have SCT (HbS = 37.9 ± 2.4%) and had greater red cell distribution width (RDW) compared to CON across all visits. Serum uric acid was higher in SCT (7.3 ± 1.0 mg/dL) compared to CON (6.1 ± 0.6 mg/dL; p = 0.001). Furthermore, serum creatine kinase levels were greater in SCT (1617.0 ± 1034.8 IU/L) at pre-camp compared to CON (1037.4 ± 602.8 IU/L; p = 0.03). SCT players exhibited lower pre- and post-practice urine electrolytes and urine specific gravity (SCT pre: 1.019 ± 0.005 vs. CON pre: 1.026 ± 0.008 p < 0.001; SCT post: 1.020 ± 0.005 vs. CON post: 1.030 ± 0.008 p < 0.01), whereas sweat sodium concentrations were higher in SCT players (55.4 ± 13.6 mmol/L) compared to CON (45.5 ± 10.6 mmol/L; p < 0.001). Given the evidence, greater uric acid and CPK levels in SCT players compared to CON may be an early indicator of altered kidney function and muscle damage, which could be added into NCAA guidelines for surveillance among SCT players. Consistent education and reinforcement of the importance of adequate fluid balance during exercise are critical for both SCT and CON players.
镰状细胞特质（SCT）是运动员晕厥和猝死的一个风险因素。我们进行了一项纵向研究，以确定患有 SCT 的美国大学生体育协会（NCAA）一级美式足球运动员的血液学反应和水合状态。这项研究持续了 2 年，在第 1 年有 6 名 SCT 患者和 6 名位置匹配的对照组（CON）；在第 2 年有 4 名 SCT 患者和 4 名 CON。在第 2 年，有 3 名 SCT 患者被招募并重新与新的位置匹配的对照组（总样本数据=10 名 SCT 和 10 名 CON）一起入组。在三个访视点采集血样：训练营前、训练营后和赛季后，以检查血红蛋白变体、全血细胞计数和化学面板 26。在赛季前训练营期间，通过测量体重变化、尿比重以及尿和汗液电解质浓度来评估水合状态。所有 SCT 患者均被确认为 SCT（HbS=37.9±2.4%），与所有访视点的 CON 相比，SCT 的红细胞分布宽度（RDW）更大。SCT 患者的血清尿酸水平高于 CON（7.3±1.0mg/dL 比 6.1±0.6mg/dL；p=0.001）。此外，SCT 患者的血清肌酸激酶水平在训练营前（1617.0±1034.8IU/L）高于 CON（1037.4±602.8IU/L；p=0.03）。SCT 患者的运动前后尿液电解质和尿比重较低（SCT 前：1.019±0.005 比 CON 前：1.026±0.008，p<0.001；SCT 后：1.020±0.005 比 CON 后：1.030±0.008，p<0.01），而 SCT 患者的汗液钠浓度较高（55.4±13.6mmol/L）比 CON（45.5±10.6mmol/L；p<0.001）。鉴于这些证据，与 CON 相比，SCT 患者的尿酸和 CPK 水平较高可能是肾功能和肌肉损伤改变的早期指标，这可能被添加到 NCAA 对 SCT 患者的监测指南中。对于 SCT 和 CON 运动员来说，持续的教育和强化充分的运动期间的液体平衡的重要性至关重要。
