Reticulocyte Count and Exercise Performance in Elite Athletes: A Retrospective Study

Athletes engaged in dynamic sports experience a shortened red blood cell (RBC) lifespan and accelerated turnover due to RBC destruction. This accelerated RBC turnover might have a positive impact on exercise performance by increasing the number of young red blood cells with a high oxygen-carrying ca...

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Main Authors: Kohei Ashikaga, Marco Alfonso Perrone, Antonio Gianfelici, Davide Ortolina, Simone Crotta, Alessandro Spinelli, Sara Monosilio, Giuseppe Di Gioia, Viviana Maestrini, Maria Rosaria Squeo, Antonio Pelliccia
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Language:English
Published: MDPI AG 2025-05-01
Series:Sports
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Online Access:https://www.mdpi.com/2075-4663/13/6/169
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author Kohei Ashikaga
Marco Alfonso Perrone
Antonio Gianfelici
Davide Ortolina
Simone Crotta
Alessandro Spinelli
Sara Monosilio
Giuseppe Di Gioia
Viviana Maestrini
Maria Rosaria Squeo
Antonio Pelliccia
author_facet Kohei Ashikaga
Marco Alfonso Perrone
Antonio Gianfelici
Davide Ortolina
Simone Crotta
Alessandro Spinelli
Sara Monosilio
Giuseppe Di Gioia
Viviana Maestrini
Maria Rosaria Squeo
Antonio Pelliccia
author_sort Kohei Ashikaga
collection DOAJ
description Athletes engaged in dynamic sports experience a shortened red blood cell (RBC) lifespan and accelerated turnover due to RBC destruction. This accelerated RBC turnover might have a positive impact on exercise performance by increasing the number of young red blood cells with a high oxygen-carrying capacity. However, accelerated turnover might also be a result of intravascular haemolysis caused by RBC destruction during exercise, impairing RBC function and oxygen transport. Therefore, we aimed to evaluate the relationship between reticulocyte count as an indicator of short-term RBC profile changes and exercise capacity. We retrospectively evaluated elite Italian athletes engaged in endurance or mixed sports disciplines selected for the 2023 European Games or 2024 Olympic Games. Athletes underwent blood tests, echocardiography, and cardiopulmonary exercise tests. We assessed the relationship between reticulocytes and the peak value of VO<sub>2</sub> (peak VO<sub>2</sub>) and anaerobic threshold (AT). In addition, the effects of age, sex, haemoglobin concentration, stroke volume, peak heart rate, and reticulocytes on peak VO<sub>2</sub> and AT were assessed using multiple linear regression. Of the 105 athletes, reticulocyte count (0.059 ± 0.024 × 10<sup>12</sup>/L) negatively correlated with peak VO<sub>2</sub> (45.5 ± 9.1 mL/min/kg) (<i>p</i> = 0.022) and AT (27.6 ± 7.9 mL/min/kg) (<i>p</i> = 0.040). Using multivariate linear regression analysis, reticulocytes were independent predictors of peak VO<sub>2</sub> and AT (95% confidence interval: −192.3 to −45.9; <i>p</i> = 0.001; 95% confidence interval: −143.4 to −13.8: <i>p</i> = 0.018, respectively). Our findings indicated a negative relationship between reticulocyte count and peak VO<sub>2</sub> or AT. The life span of reticulocytes was close to the period of transient decline in RBC function that occurred after high-intensity exercise; therefore, the changes in reticulocytes might be related to the decline in exercise performance owing to this decline in RBC function.
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spelling doaj-art-778cd52fdedd48039ad92c7242f2da7d2025-08-20T03:29:52ZengMDPI AGSports2075-46632025-05-0113616910.3390/sports13060169Reticulocyte Count and Exercise Performance in Elite Athletes: A Retrospective StudyKohei Ashikaga0Marco Alfonso Perrone1Antonio Gianfelici2Davide Ortolina3Simone Crotta4Alessandro Spinelli5Sara Monosilio6Giuseppe Di Gioia7Viviana Maestrini8Maria Rosaria Squeo9Antonio Pelliccia10Institute of Sports Medicine and Science, National Italian Olympic Committee, CONI, 00197 Rome, ItalyInstitute of Sports Medicine and Science, National Italian Olympic Committee, CONI, 00197 Rome, ItalyInstitute of Sports Medicine and Science, National Italian Olympic Committee, CONI, 00197 Rome, ItalyInstitute of Sports Medicine and Science, National Italian Olympic Committee, CONI, 00197 Rome, ItalyInstitute of Sports Medicine and Science, National Italian Olympic Committee, CONI, 00197 Rome, ItalyInstitute of Sports Medicine and Science, National Italian Olympic Committee, CONI, 00197 Rome, ItalyInstitute of Sports Medicine and Science, National Italian Olympic Committee, CONI, 00197 Rome, ItalyInstitute of Sports Medicine and Science, National Italian Olympic Committee, CONI, 00197 Rome, ItalyInstitute of Sports Medicine and Science, National Italian Olympic Committee, CONI, 00197 Rome, ItalyInstitute of Sports Medicine and Science, National Italian Olympic Committee, CONI, 00197 Rome, ItalyInstitute of Sports Medicine and Science, National Italian Olympic Committee, CONI, 00197 Rome, ItalyAthletes engaged in dynamic sports experience a shortened red blood cell (RBC) lifespan and accelerated turnover due to RBC destruction. This accelerated RBC turnover might have a positive impact on exercise performance by increasing the number of young red blood cells with a high oxygen-carrying capacity. However, accelerated turnover might also be a result of intravascular haemolysis caused by RBC destruction during exercise, impairing RBC function and oxygen transport. Therefore, we aimed to evaluate the relationship between reticulocyte count as an indicator of short-term RBC profile changes and exercise capacity. We retrospectively evaluated elite Italian athletes engaged in endurance or mixed sports disciplines selected for the 2023 European Games or 2024 Olympic Games. Athletes underwent blood tests, echocardiography, and cardiopulmonary exercise tests. We assessed the relationship between reticulocytes and the peak value of VO<sub>2</sub> (peak VO<sub>2</sub>) and anaerobic threshold (AT). In addition, the effects of age, sex, haemoglobin concentration, stroke volume, peak heart rate, and reticulocytes on peak VO<sub>2</sub> and AT were assessed using multiple linear regression. Of the 105 athletes, reticulocyte count (0.059 ± 0.024 × 10<sup>12</sup>/L) negatively correlated with peak VO<sub>2</sub> (45.5 ± 9.1 mL/min/kg) (<i>p</i> = 0.022) and AT (27.6 ± 7.9 mL/min/kg) (<i>p</i> = 0.040). Using multivariate linear regression analysis, reticulocytes were independent predictors of peak VO<sub>2</sub> and AT (95% confidence interval: −192.3 to −45.9; <i>p</i> = 0.001; 95% confidence interval: −143.4 to −13.8: <i>p</i> = 0.018, respectively). Our findings indicated a negative relationship between reticulocyte count and peak VO<sub>2</sub> or AT. The life span of reticulocytes was close to the period of transient decline in RBC function that occurred after high-intensity exercise; therefore, the changes in reticulocytes might be related to the decline in exercise performance owing to this decline in RBC function.https://www.mdpi.com/2075-4663/13/6/169reticulocytesexercise performanceelite athletesoxygen uptake
spellingShingle Kohei Ashikaga
Marco Alfonso Perrone
Antonio Gianfelici
Davide Ortolina
Simone Crotta
Alessandro Spinelli
Sara Monosilio
Giuseppe Di Gioia
Viviana Maestrini
Maria Rosaria Squeo
Antonio Pelliccia
Reticulocyte Count and Exercise Performance in Elite Athletes: A Retrospective Study
Sports
reticulocytes
exercise performance
elite athletes
oxygen uptake
title Reticulocyte Count and Exercise Performance in Elite Athletes: A Retrospective Study
title_full Reticulocyte Count and Exercise Performance in Elite Athletes: A Retrospective Study
title_fullStr Reticulocyte Count and Exercise Performance in Elite Athletes: A Retrospective Study
title_full_unstemmed Reticulocyte Count and Exercise Performance in Elite Athletes: A Retrospective Study
title_short Reticulocyte Count and Exercise Performance in Elite Athletes: A Retrospective Study
title_sort reticulocyte count and exercise performance in elite athletes a retrospective study
topic reticulocytes
exercise performance
elite athletes
oxygen uptake
url https://www.mdpi.com/2075-4663/13/6/169
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