Early hemorheologic aspects of overtraining in elite athletes

A standardized questionnaire has been proposed by the French consensus grou p on overtraining of the Society Francaise de Medecine du Sport (SFMS) and allows the calculation of a 'score' that may help to quantify the early cli nical symptoms of the overtraining syndrome in sportsmen submitted to a hea vy training program. We investigated a possible relationship between this s core and blood rheology in 36 male elite sportsmen (national level in footb all, volleyball and karate; age: 17-33 yr) who underwent a standardized che ck-up including biological measurements and an exercise-test. The overtrain ing score ranged between 0 and 21 items and was correlated with blood visco sity (r = 0.413, p < 0.02). This correlation was explained by a correlation of this score with plasma viscosity (r = 0.512, p < 0.01) and hematocrit ( r = 0.387, p < 0.05). When subjects with a high score (>6) were compared to subjects with a lower score they appeared to have a higher blood viscosity at native (but not corrected) hematocrit (3.18 +/- 0.01 vs. 2.89 +/- 0.05 mPa.s, p < 0.02), explained by higher values in both plasma viscosity (1.39 +/- 0.02 vs. 1.31 +/- 0.02 mPa.s, p < 0.01) and hematocrit (42.8 +/- 0.45 vs. 41.1 +/- 0.44, p < 0.05). By contrast, there was no difference in RBC d eformability and aggregation. Overtrained subjects have also lower levels o f zinc (0.72 +/- 0.024 vs. 0.84 +/- 0.023 mdl, p < 0.01), ferritin (55.1 +/ - 7.3 vs. 92.3 +/- 9.4 ng/ml), and ICF-binding protein 3 (3.4 +/- 0.22 vs. 4.52 +/- 9.4 ng/ml). Neither zinc nor ferritin status were likely to explai n the rheologic alterations since disturbances in zinc or iron are rather a ssociated with abnormalities in erythrocyte deformability or aggregability. Therefore, the early signs of overtraining in elite sportsmen are associat ed with a hemorheologic pattern that suggests some degree of reversal of th e 'autohemodilution' associated with fitness in athletes.