Laboratory Medicine Department, La Paz University Hospital, Madrid, Spain.
Norwegian Porphyria Centre, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway.
Clin Chem Lab Med. 2021 Nov 19;60(4):618-628. doi: 10.1515/cclm-2021-0910. Print 2022 Mar 28.
Within- and between-subject biological variation (BV) estimates have many applications in laboratory medicine. However, robust high-quality BV estimates are lacking for many populations, such as athletes. This study aimed to deliver BV estimates of 29 routine laboratory measurands derived from a Biological Variation Data Critical Appraisal Checklist compliant design in a population of high-endurance athletes.
Eleven samples per subject were drawn from 30 triathletes monthly, during a whole sport season. Serum samples were measured in duplicate for proteins, liver enzymes, lipids and kidney-related measurands on an Advia2400 (Siemens Healthineers). After outlier and homogeneity analysis, within-subject (CV) and between-subject (CV) biological variation estimates were delivered (CV-ANOVA and log-ANOVA, respectively) and a linear mixed model was applied to analyze the effect of exercise and health related variables.
Most CV estimates were similar or only slightly higher in athletes compared to those reported for the general population, whereas two- to three-fold increases were observed for amylase, ALT, AST and ALP. No effect of exercise and health related variables were observed on the CV estimates. For seven measurands, data were not homogeneously distributed and BV estimates were therefore not reported.
The observation of higher CV estimates in athletes than what has been reported for the general population may be related to physiological stress over time caused by the continuous practice of exercise. The BV estimates derived from this study could be applied to athlete populations from disciplines in which they exercise under similar conditions of intensity and duration.
个体内和个体间生物学变异（BV）估计在实验室医学中有许多应用。然而，许多人群，如运动员，缺乏稳健的高质量 BV 估计。本研究旨在提供来自符合生物学变异数据关键评估清单设计的一个高耐力运动员人群的 29 个常规实验室测定值的 BV 估计值。
每月从 30 名三项全能运动员中抽取每个受试者 11 个样本，整个运动赛季进行。在 Advia2400（西门子健康公司）上对血清样本进行两次重复测量，用于测定蛋白质、肝酶、脂质和与肾脏相关的测定值。在进行离群值和同质性分析后，分别提供个体内（CV）和个体间（CV）生物学变异估计值（CV-ANOVA 和对数-ANOVA），并应用线性混合模型分析运动和健康相关变量的影响。
与一般人群相比，运动员的大多数 CV 估计值相似或仅略高，而淀粉酶、ALT、AST 和 ALP 的 CV 估计值则增加了两到三倍。运动和健康相关变量对 CV 估计值没有影响。对于七个测定值，数据分布不均匀，因此未报告 BV 估计值。
与一般人群相比，运动员的 CV 估计值较高可能与由于持续运动而导致的长期生理应激有关。本研究得出的 BV 估计值可应用于在相似强度和持续时间下进行运动的运动项目的运动员人群。
