Reticulocyte count, mean reticulocyte volume, immature reticulocyte fraction, and mean sphered cell volume in elite athletes: reference values and comparison with the general population
-
Giuseppe Banfi
, Clara Mauri , Benedetto Morelli , Nicola Di Gaetano , Ursula Malgeri and Gianluca Melegati
Abstract
Background: The role of measurement of reticulocytes and their parameters is growing in sports medicine. The use of reticulocyte counts in protocols for evaluating and screening for the suspected abuse of hormones that stimulate the bone marrow is an example. Reticulocytes are also important for evaluation of the performance and general health status of athletes, especially for monitoring therapies and diets. The current availability of fully automated haematological systems that can measure reticulocyte numbers and characteristics (volume, density) increases the potential use of these parameters in laboratory and sports medicine. Few studies have considered the application of these parameters in athletes and a lack of specific reference ranges means that their valid clinical use is difficult.
Methods: Using a Coulter LH700 instrument, we measured reticulocyte count (Retics), mean reticulocyte volume (MRV), immature reticulocyte fraction (IRF), and mean sphered cell volume (MSCV) in 106 male professional elite athletes (football and rugby players and skiers). Reference intervals for the athletes were compared with the intervals found for a control group of 73 age-matched males.
Results: We calculated the following reference intervals: 0.30–1.54% for Retics, 93.1–114.8fL for MRV, 0.18–0.39% for IRF, and 76.8–94.5fL for MSCV.
Conclusions: No statistically significant differences were observed for Retics, MRV, IRF, and MSCV between elite athletes and controls. Significant differences were observed for haemoglobin (Hb), erythrocytes, haematocrit (Ht), and mean corpuscular volume. Moreover, no statistical differences were observed among different sports, whereas differences were remarked in football and rugby players between the samples drawn before the start of competitive season and the samples drawn during the season, demonstrating that reticulocyte counts and parameters are useful for monitoring sportsmen.
References
1. Parisotto R, Gore CJ, Emslie KR, Ashenden MJ, Brugnara C, Howe C, et al. A novel method utilising markers of altered erythropoiesis for the detection of recombinant human erythropoietin abuse in athletes. Haematologica 2000; 85:564–72.Search in Google Scholar
2. Parisotto R, Gore CJ, Hahn AG, Ashenden MJ, Olds TS, Martin DT, et al. Reticulocyte parameters as potential discriminators of recombinant human erythropoietin abuse in elite athletes. Int J Sports Med 2000; 21:471–9.10.1055/s-2000-7421Search in Google Scholar
3. Richardson Jones A, Twedt D, Swaim W, Gottfried E. Diurnal change of blood count analytes in normal subjects. Am J Clin Pathol 1996; 106:723–7.10.1093/ajcp/106.6.723Search in Google Scholar
4. Banfi G, Dolci A, Zorzino L, Longhi E, Barberis M. Comparison of 3 automatic systems for reticulocytes counts during an ultraendurance mountain marathon. J Sports Med Phys Fitness 2003; 43:256–7.Search in Google Scholar
5. Buttarello M, Bulian P, Farina G, Temporin V, Toffolo L, Trabuio E, et al. Flow cytometric reticulocyte counting. Parallel evaluation of five fully automated analyzers: an NCCLS-IFCC approach. Am J Clin Pathol 2001; 115:100–11.10.1309/M26B-1YNQ-VNU8-M1CESearch in Google Scholar
6. Ashenden M, Sharpe K, Damsgaard R, Jarvis L. Standardization of reticulocyte values in an antidoping context. Am J Clin Pathol 2004; 121:816–25.10.1309/1FAM1VT3N76GJGXVSearch in Google Scholar
7. d'Onofrio G, Chirillo R, Zini G, Caenaro G, Tommasi M, Micciulli G. Simultaneous measurement of reticulocyte and red cell indices in healthy subjects and patients with microcytic and macrocytic anemia. Blood 1995; 85:818–23.10.1182/blood.V85.3.818.bloodjournal853818Search in Google Scholar
8. Coulter LH700 series training resource guide. Hialeah, FL: Coulter, 2004.Search in Google Scholar
9. Haymes EM. Vitamin and mineral supplementation to athletes. Int J Sport Nutr 1991; 1:146–69.10.1123/ijsn.1.2.146Search in Google Scholar
10. Fourcade C, Javy L, Belaouni H. Reticulocyte analysis provided by Coulter Gen-S: significance and interpretation in regenerative and non-regenerative hematological conditions. Lab Hematol 1999; 5:153–8.Search in Google Scholar
11. Chang CC, Kass L. Clinical significance of IRF determination by automatic reticulocyte counting. Am J Clin Pathol 1997; 108:69–73.10.1093/ajcp/108.1.69Search in Google Scholar
12. Davis B, Bigelow N. Flow cytometric reticulocyte quantification using thiazole orange provides clinically useful reticulocyte maturity index. Arch Pathol Lab Med 1989; 113:684–9.Search in Google Scholar
13. Varlet-Marie E, Audran M, Lejeune M, Bonafux B, Sicart MT, Marti J, et al. Analysis of human reticulocyte genes reveals altered erythropoiesis: potential use to detect recombinant human erythropoietin doping. Haematologica 2004; 89:991–7.Search in Google Scholar
14. Chiron M, Cynober T, Mielot F, Tchernia G, Croisille L. The Gen-S: a fortuitous finding of a routine screening test for hereditary spherocytosis. Hematol Cell Ther 1999; 41:113–6.10.1007/s00282-999-0113-8Search in Google Scholar
15. Jordan J, Kiernan W, Merker HJ, Wenzel M, Beneke R. Red cell membrane skeletal changes in marathon runners. Int J Sports Med 1998; 19:16–9.10.1055/s-2007-971873Search in Google Scholar
16. Santos-Silva A, Rebelo MI, Bayer Castro EM, Belo L, Guerra A, Rego C, et al. Leukocyte activation, erythrocyte damage, lipid profile and oxidative stress imposed by high competition physical exercise in adolescents. Clin Chim Acta 2001; 306:119–26.10.1016/S0009-8981(01)00406-5Search in Google Scholar
17. Banfi G. Ematologia dello sport. Milano: Edi Ermes, 2005:82–90.Search in Google Scholar
18. Telford RD, Sly GJ, Hahn AG, Cunningham RB, Bryant C, Smith JA. Footstrike is the major cause of hemolysis during running. J Appl Physiol 2003; 94:38–42.10.1152/japplphysiol.00631.2001Search in Google Scholar
19. Solberg HE. Approved recommendation (1986) on the theory of reference values. Part 1. The concept of reference values. J Clin Chem Clin Biochem 1987; 25:337–42.10.1016/0009-8981(87)90224-5Search in Google Scholar
20. PetitClerc C, Solberg HE. Approved recommendation (1987) on the theory of reference values. Part 2. Selection of individuals for the production of reference values. J Clin Chem Clin Biochem 1987; 25:639–44.Search in Google Scholar
21. Solberg HE, PetitClerc C. Approved recommendation (1988) on the theory of reference values. Part 3. Preparation of individuals and collection of specimens for the production of reference values. J Clin Chem Clin Biochem 1988; 26:593–8.Search in Google Scholar
22. Banfi G, Dolci A. Preanalytical phase of sport biochemistry and haematology. J Sports Med Phys Fitness 2003; 43:223–30.Search in Google Scholar
23. Fraser CG. Inherent biological variation and reference values. Clin Chem Lab Med 2004; 42:758–64.10.1515/CCLM.2004.128Search in Google Scholar PubMed
24. Ritchie RF, Palomaki G. Selecting clinically relevant populations for reference intervals. Clin Chem Lab Med 2004; 42:702–9.Search in Google Scholar
25. Fernandez T, Domack LB, Montes D, Pineiro R, Landrum E, Vital E. Performance evaluation of the Coulter LH750 hematology analyzer. Lab Hematol 2001; 7:217–28.Search in Google Scholar
26. Banfi G, Dolci A, Schonhuber H, Costantino B. Values of the parameter immature reticulocyte fraction in elite athletes. Clin Lab Haematol 2004; 26:241–2.10.1111/j.1365-2257.2004.00610.xSearch in Google Scholar PubMed
27. Banfi G, Dolci A, Freschi M, Verdini C. Immature reticulocyte fraction (IRF) monitored in elite athletes during a whole season. Clin Lab Haematol 2005; 27:213–4.10.1111/j.1365-2257.2005.00688.xSearch in Google Scholar PubMed
28. Davis BH, Bigelow N, van Howe L. IRF and reticulocytes counts, comparison with Abbott CD4000, Sysmex R3000, thiazole flow cytometry, and manual counts. Lab Hematol 1996; 2:144–6.Search in Google Scholar
29. Van den Bossche J, Devreese K, Malfait R, Van de Vyvere M, Wauters A, Neels H, et al. Reference intervals for a complete blood count determined on different automated haematology analysers: Abx Pentra 120 Retic, Coulter Gen-S, Sysmex SE9500, Abbott Cell Dyn 4000 and Bayer Advia 120. Clin Chem Lab Med 2002; 40:69–73.Search in Google Scholar
30. Kendall RG, Jeffries R, Cavill I, Norfolk DR. Relationship between endogenous erythropoietin levels, reticulocyte count, and reticulocyte RNA distribution. A study of anemic patients with and without renal failure. Ann NY Acad Sci 1994; 718:353–8.10.1111/j.1749-6632.1994.tb55738.xSearch in Google Scholar PubMed
31. Friedmann B, Jost J, Rating T, Weller E, Werle E, Eckardt KU, et al. Effects of iron supplementation on total body hemoglobin during endurance training at moderate altitude. Int J Sports Med 1999; 20:78–85.10.1055/s-2007-971097Search in Google Scholar PubMed
32. Ashenden MJ, Gore CJ, Dobson GP, Boston TT, Parisotto R, Emslie KR, et al. Simulated moderate altitude elevates serum erythropoietin but does not increase reticulocyte production in well-trained runners. Eur J Appl Physiol 2000; 81:428–35.10.1007/s004210050064Search in Google Scholar PubMed
33. Banfi G, Roi GS, Dolci A, Susta D. Behaviour of haematological parameters in athletes performing marathon and ultramarathon in altitude (“skyrunners”). Clin Lab Haematol 2004; 26:373–7.10.1111/j.1365-2257.2004.00642.xSearch in Google Scholar PubMed
34. Fallon KE, Bishop G. Changes in erythropoiesis assessed by reticulocyte parameters during ultralong distance running. Clin J Sport Med 2002; 12:172–8.10.1097/00042752-200205000-00005Search in Google Scholar PubMed
35. Malcovati L, Pascutto C, Cazzola M. Hematologic passport for athletes competing in endurance sports: a feasibility study. Haematologica 2003; 88:570–81.Search in Google Scholar
36. Fiorella PL, Faina M, Briglia S. Il profilo ematologico dell'atleta nelle categorie giovanili: indagine epidemiologica nel ciclismo. In: Proceedings of “La medicina di laboratorio nello sport”, G Banfi editor. Milano: Biomedia Edizioni, 2001:15.Search in Google Scholar
37. Lippi G, Franchini G, Guidi GC. Haematocrit measurement and antidoping policies. Clin Lab Haematol 2002; 24:65–6.10.1046/j.1365-2257.2002.00425.xSearch in Google Scholar PubMed
38. Schumacher YO, Schmid A, Grathwohl D, Bultermann D, Berg A. Hematological indices and iron status in athletes of various sports and performances. Med Sci Sports Exerc 2002; 34:869–75.10.1097/00005768-200205000-00022Search in Google Scholar PubMed
39. Schumacher YO, Jankovits R, Bultermann D, Schmid A, Berg A. Hematological indices in elite cyclists. Scand J Med Sci Sports 2002; 12:301–8.10.1034/j.1600-0838.2002.10112.xSearch in Google Scholar PubMed
40. Buttarello M. Variabilità biologica dei parametri ematologici. Riv Med Lab 2003; 4:88–91.Search in Google Scholar
©2006 by Walter de Gruyter Berlin New York
Articles in the same Issue
- CCLM: Expanding the science worldwide
- Factor V Leiden, prothrombin G20210A substitution and hormone therapy: indications for molecular screening
- Immunochemical quantification of free immunoglobulin light chains from an analytical perspective
- De novo deletion removes a conserved motif in the C-terminus of ABCA4 and results in cone-rod dystrophy
- Molecular detection of squamous cell carcinoma antigen transcripts in peripheral blood of cancer patients
- Influence of human haptoglobin polymorphism on oxidative stress induced by free hemoglobin on red blood cells
- Real-time RT-PCR quantification of PRAME gene expression for monitoring minimal residual disease in acute myeloblastic leukaemia
- Association of high-sensitive C-reactive protein with advanced stage β-cell dysfunction and insulin resistance in patients with type 2 diabetes mellitus
- A longitudinal evaluation of urinary glycosaminoglycan excretion in normoalbuminuric type 1 diabetic patients
- National survey on the execution of the oral glucose tolerance test (OGTT) in a representative cohort of Italian laboratories
- The reduction of cholesteryl linoleate in lipoproteins: an index of clinical severity in β-thalassemia/Hb E
- Alterations in serum glycosaminoglycan profiles in Graves' patients
- Alterations in anti-oxidative defence enzymes in erythrocytes from sporadic amyotrophic lateral sclerosis (SALS) and familial ALS patients
- Sandwich ELISAs for soluble immunoglobulin superfamily receptor translocation-associated 2 (IRTA2)/FcRH5 (CD307) proteins in human sera
- Utilizing ultrafiltration to remove alkaline phosphatase from clinical analyzer water
- Measurement of serum monoclonal components: comparison between densitometry and capillary zone electrophoresis
- Salivary aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase: possible markers in periodontal diseases?
- Reticulocyte count, mean reticulocyte volume, immature reticulocyte fraction, and mean sphered cell volume in elite athletes: reference values and comparison with the general population
- Serum homocysteine levels and paraoxonase 1 activity in preschool aged children in Greece
- The effects of adrenocorticotrophic hormone and cortisol on homocysteine and vitamin B concentrations
- Plasma, salivary and urinary cotinine in non-smoker Italian women exposed and unexposed to environmental tobacco smoking (SEASD study)
- Cut-off values for total serum immunoglobulin E between non-atopic and atopic children in north-west Croatia
- Thyroglobulin assay during thyroxine treatment in low-risk differentiated thyroid cancer management: comparison with recombinant human thyrotropin-stimulated assay and imaging procedures
- Evaluation of serum levels of p53 in hepatocellular carcinoma in Egypt
- Insufficient filling of vacuum tubes as a cause of microhemolysis and elevated serum lactate dehydrogenase levels. Use of a data-mining technique in evaluation of questionable laboratory test results
- Evaluation of three different specimen types (serum, plasma lithium heparin and serum gel separator) for analysis of certain analytes: clinical significance of differences in results and efficiency in use
- Comparative evaluation of a new immunoradiometric assay for corticotropin
- Mast cells in atherosclerosis as a source of the cytokine RANKL
- Falsely increased total serum protein due to dextran interference
Articles in the same Issue
- CCLM: Expanding the science worldwide
- Factor V Leiden, prothrombin G20210A substitution and hormone therapy: indications for molecular screening
- Immunochemical quantification of free immunoglobulin light chains from an analytical perspective
- De novo deletion removes a conserved motif in the C-terminus of ABCA4 and results in cone-rod dystrophy
- Molecular detection of squamous cell carcinoma antigen transcripts in peripheral blood of cancer patients
- Influence of human haptoglobin polymorphism on oxidative stress induced by free hemoglobin on red blood cells
- Real-time RT-PCR quantification of PRAME gene expression for monitoring minimal residual disease in acute myeloblastic leukaemia
- Association of high-sensitive C-reactive protein with advanced stage β-cell dysfunction and insulin resistance in patients with type 2 diabetes mellitus
- A longitudinal evaluation of urinary glycosaminoglycan excretion in normoalbuminuric type 1 diabetic patients
- National survey on the execution of the oral glucose tolerance test (OGTT) in a representative cohort of Italian laboratories
- The reduction of cholesteryl linoleate in lipoproteins: an index of clinical severity in β-thalassemia/Hb E
- Alterations in serum glycosaminoglycan profiles in Graves' patients
- Alterations in anti-oxidative defence enzymes in erythrocytes from sporadic amyotrophic lateral sclerosis (SALS) and familial ALS patients
- Sandwich ELISAs for soluble immunoglobulin superfamily receptor translocation-associated 2 (IRTA2)/FcRH5 (CD307) proteins in human sera
- Utilizing ultrafiltration to remove alkaline phosphatase from clinical analyzer water
- Measurement of serum monoclonal components: comparison between densitometry and capillary zone electrophoresis
- Salivary aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase: possible markers in periodontal diseases?
- Reticulocyte count, mean reticulocyte volume, immature reticulocyte fraction, and mean sphered cell volume in elite athletes: reference values and comparison with the general population
- Serum homocysteine levels and paraoxonase 1 activity in preschool aged children in Greece
- The effects of adrenocorticotrophic hormone and cortisol on homocysteine and vitamin B concentrations
- Plasma, salivary and urinary cotinine in non-smoker Italian women exposed and unexposed to environmental tobacco smoking (SEASD study)
- Cut-off values for total serum immunoglobulin E between non-atopic and atopic children in north-west Croatia
- Thyroglobulin assay during thyroxine treatment in low-risk differentiated thyroid cancer management: comparison with recombinant human thyrotropin-stimulated assay and imaging procedures
- Evaluation of serum levels of p53 in hepatocellular carcinoma in Egypt
- Insufficient filling of vacuum tubes as a cause of microhemolysis and elevated serum lactate dehydrogenase levels. Use of a data-mining technique in evaluation of questionable laboratory test results
- Evaluation of three different specimen types (serum, plasma lithium heparin and serum gel separator) for analysis of certain analytes: clinical significance of differences in results and efficiency in use
- Comparative evaluation of a new immunoradiometric assay for corticotropin
- Mast cells in atherosclerosis as a source of the cytokine RANKL
- Falsely increased total serum protein due to dextran interference