Erythropoietin concentration and arterial haemoglobin saturation with supramaximal exercise

The aim of this study was to determine if the hypoxaemic stimulus generated by intense exercise results in the physiological response of increased erythropoietin production. Twenty athletes exercised for 3 min at 109 +/- 2.8% (mean +/- s) maximal oxygen consumption. Estimated oxyhaemoglobin saturation was measured by reflective probe pulse oximetry (Nellcor N200) and was validated against arterial oxyhaemoglobin saturation by CO-oximetry in eight athletes. Serum erythropoietin concentrations-as measured using the INCSTAR Epo-Trac radioimmunoassay-increased significantly by 28 +/- 9% at 24 h post-exercise in 11 participants, who also had an arterial oxyhaemoglobin saturation < or = 91% (P < 0.05). Decreased ferritin levels and increased reticulocyte counts were observed at 96 h post-exercise. However, no significant changes in erythropoietin levels were observed in nine non-desaturating athletes and eight non-exercise controls. Good agreement was shown between arterial oxyhaemoglobin saturation and percent estimated oxyhaemoglobin saturation (limits of agreement = -3.9 to 3.7%). In conclusion, short supramaximal exercise can induce both hypoxaemia and increased erythropoietin levels in well-trained individuals. The decline of arterial hypoxaemia levels below 91% during exercise appears to be necessary for the exercise-induced elevation of serum erythropoietin levels. Furthermore, reflective probe pulse oximetry was found to be a valid predictor of percent arterial oxyhaemoglobin saturation during supramaximal exercise when percent estimated oxyhaemoglobin saturation > or = 86%.