Is plasma viscosity a predictor of overtraining in athletes?

There is a lack of consensus about the biological diagnosis of the overtraining syndrome (OTS). Recently, efforts have been made to standardize its clinical diagnosis (e.g., standardized questionnaires like that of the French consensus group on overtraining of the Société Française de Médecine du Sport-SFMS). We previously reported that the early signs of overtraining (= "overreaching") in elite sportsmen are associated with a hemorheologic pattern (raised hematocrit and plasma viscosity etap) that suggests some degree of reversal of the "autohemodilution" which characterizes fitness, and that the feeling of heavy legs in overtrained athletes is related to higher etap and higher red cell aggregation. We thus investigated on a sample of 48 athletes (age 24 +/- 1 yr), referred for possible diagnosis of overtraining to what extent plasma viscosity is a predictor of OTS. From those 48 athletes 10 had a value of etap in the highest quartile (etap > 1.44 pPa.s) and 8 of them had a diagnosis of overreaching, while in the 38 whose etap was < 1.44 mPa.s there were 20 cases of overreachings. Overt cases of OTS were found in 1 subject of the highest quintile and two in the lowest. Thus the predictive value of etap for early stages (overreaching) or chronicized stages (overtraining syndrome) is as follows: (a) prediction of overreaching: sensitivity 28.57%; specificity 90%; positive predictive value 80%; negative predictive value 47.37%; (b) prediction of chronicized overtraining: sensitivity 2.70%; specificity 18.18%; positive predictive value; 10.00%; negative predictive value 5.26%. These results show that etap is a rather specific, although poorly sensitive predictor of overreaching but has no interest in the diagnosis of the overtraining syndrome itself.