ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 11 of 59
JMBS 2020, 5(5): 90–104
Clinical Medicine

The Role of an Innovative Liposomal Form of Iron Pyrophosphate in the Correction of Oxygen Transfer Disorders in Representatives of Olympic Cyclic Sports

Gunina L. M. 1, Danylchenko S. I. 2, Nosach E. V. 3, Golovashchenko R. V. 4, Butskaya L. V. 5, Sergienko Yu. P. 4, Lavrent'ev A. N. 4

Today, sports anemia occurs in elite sports quite often, although it is not a disease (does not apply to ICD-10), but only a pathological condition. Sports anemia is characterized by changes in the red link of the blood, and it is associated with a decrease in the content of erythrocytes and / or hemoglobin. However, this condition leads to a significant decrease in physical performance, and, consequently, the effectiveness of the competitive activity of representatives, first of all, of cyclic sports. Athletes are more sensitive to the effects of anemia and iron deficiency than people who are not constantly exposed to intense physical activity, since performance depends on the maximum oxygen consumption and utilization of active muscles. Sports anemia is often iron deficient, as well as B12 and folate deficient. Therefore, the assessment of various factors accompanying the development of anemia and the development of technologies for the correction of this pathological condition is an important task of sports laboratory diagnostics, as well as pharmacology and nutritional science of sports. Material and methods. We conducted a randomized, double-blind, placebo-controlled study to assess the safety and effectiveness of the effect of a course use of the Santeferra dietary supplement containing liposomal ferric iron in the form of pyrophosphate, vitamins B9, B12 and ascorbic acid on the results of training activities of representatives of cyclic sports with predominantly an aerobic energy supply mechanism. In the course of a dynamic study, which lasted 60 days, the parameters of hematological homeostasis and accumulation, metabolism and transport of iron (content of serum iron, transferrin, ferritin, folic acid, iron binding capacity of serum, saturation of transferrin with iron), as well as the level of serum erythropoietin and the severity of oxidative stress were assessed directly in the membranes of erythrocytes. In parallel, we determined the indicators of aerobic endurance: the absolute and relative values of the maximum oxygen consumption and the PWC170 value. Results and discussion. We found out that in the study sample of 67 athletes who specialized in sports with aerobic energy supply (running disciplines of athletics, rowing and canoeing, triathlon, cross-country skiing), 19 (28.35%) had manifestations of sports anemia, and 23 (34.32%) had latent iron deficiency, which also negatively effect on their physical performance. The course application of Santefrerra, 1 capsule per day for 60 days, helped to normalize the accumulation, transport and metabolism of iron, as well as to significantly reduce the manifestations of oxidative stress that occurs under the influence of prolonged physical exertion. In athletes with anemia and latent iron deficiency, practically no changes in the content of erythropoietin in the blood serum were found. At the end of the course of taking a dietary supplement, the indicators of the relative maximum oxygen consumption in the athletes of the main group increased by 11.5% (P <0.05) and the results of the PWC170 test by 11.4% (P <0.05) which displays predominantly aerobic endurance. In the placebo-control groups, we noted no positive dynamics in indicators of the red link of hematological homeostasis and the accumulation, metabolism and transport of iron, as well as the parameters of the prooxidant-antioxidant balance directly in the erythrocyte membranes during the 60-day observation period. Indicators of aerobic endurance also remained unchanged. Conclusion. Thus, the course using Santeferra is not accompanied by the development of side effects and is effective for the treatment of iron deficiencies in athletes

Keywords: sports anemia, latent iron deficiency, liposomal form of iron, physical performance

Full text: PDF (Ukr) 415K

  1. Dmitriev Alexander, Gunina Larisa. Sports nutrition: science and practice of implementation in the aspect of improving performance and maintaining the health of athletes. IOC Consensus. Nauka v olimpijskom sporte. 2018; 2: 70‒80. [Russian]
  2. Dmitriev AV, Gunina LM. Sports Nutrition. M: Sport; 2020. 639 s. [Russian]
  3. Gunina LM, Dmitriev AV, Vinnichuk YUD, Vysochina NL, Sentyabrev NN. Biomedical support of hockey players training. 2nd ed, rev and suppl. Ed. LM Gunina. M: Izdatel’stvo «Sport»; 2019. 360 s. [Russian]
  4. Volkov NI, Oleinikov VI. Bioenergy sports. M: Sovetskij sport; 2011. 159 s. [Russian]
  5. Makarova GA. Pharmacological support of sports activities: real effectiveness and sports issues. M: Sovetskij sport; 2013. 231 s. [Russian]
  6. Portal S, Epstein M, Dubnov G. [Iron deficiency and anemia in female athletes – causes and risks]. Harefuah. 2003; 142(10): 698-703, 717. PMID: 14565071
  7. Makarova GA, Kolesnikova N.V, Skibiczkij VV, Baranovskaya IB. Diagnostic potential of blood picture in athletes. M: Izdatel’stvo «Sport» «Chelovek»; 2020. 256 s. [Russian]
  8. Gunina LM. Oxidative stress and adaptation: metabolic aspects of the influence of physical activity. Nauka v olimpijskom sporte. 2013; (4): 19-25. [Russian]
  9. Gunina LM, Vinnichuk YUD, Golovashchenko RV. Correction of sports anemia as a factor limiting physical performance with cefaransin. Materialy` konferenczii «Resursy` konkurentosposobnosti sportsmenov: teoriya i praktika realizaczii». Krasnodar, Kubanskij gosudarstvenny`j universitet fizicheskoj kul`tury`, sporta i turizma. 2015. s. 71-3. [Russian]
  10. Diaz V, Lombardi G, Ricci C, Jacobs RA, Montalvo Z, Lundby C, et al. Reticulocyte and haemoglobin profiles in elite triathletes over four consecutive seasons. Int J Lab Hematol. 2011; 33(6): 638-44.
  11. Mørkeberg JS, Belhage B, Damsgaard R. Changes in blood values in elite cyclist. Int J Sports Med. 2009; 30(2): 130-8.
  12. Mercer KW, Densmore JJ. Hematologic disorders in the athlete. Clinics in Sports Medicine. 2005; 24(3): 599-621.
  13. Bärtsch P, Mairbäurl H, Friedmann B. [Pseudo-anemia caused by sports]. Ther Umsch. 1998; 55(4): 251-5.PMID: 9610226
  14. Shaskey DJ, Green GA. Sport haematology. Sports Med. 2000; 29(1): 27-38.
  15. Vinnichuk YUD, Gunina LM. Diagnosis of disorders of iron metabolism and erythrocyte characteristics in athletes during physical exertion. Laboratorna diagnostika. 2016; 4: 17-22. [Russian]
  16. Malczewska-Lenczowska J, Orysiak J, Szczepańska B, Turowski D, Burkhard-Jagodzińska K, Gajewski J. Reticulocyte and erythrocyte hypochromia markers in detection of irondeficiency in adolescent female athletes. Biol Sport. 2017; 34(2): 111-8.
  17. Newhouse IJ, Clement DB, Taunton JE, McKenzie DC. The effects of prelatent/latentirondeficiency on physical work capacity. Med Sci Sports Exerc. 1989; 21(3): 263-8. PMID: 2733574
  18. Radjen S, Radjen G, Zivotić-Vanović M, Radaković S, Vasiljević N, Stojanović D. [Effect of iron supplementation on maximal oxygen uptake in female athletes]. Vojnosanit Pregl. 2011; 68(2): 130-5.
  19. Tsubanova NA, Chernyavsky ES. Innovative technologies in the pharmacological correction of iron deficiency states. Mizhnarodnij endokrinologi`chnij zhurnal. 2019; 15(1): 86-95. [Russian]
  20. Bompo TO. Periodizing training for peak performers high – performance sports conditions. Modern training for ultimate athletics development. Eds by Bill Foran. Human Kinetics Publishers, 2001. p. 261-82.
  21. Garthe I, Maughan RJ. Athletes and Supplements: Prevalence and Perspectives. Int J Sport Nutr Exerc Metab. 2018; 28(2): 126-38.–0429
  22. Maughan RJ, Burke LM, Dvorak J, Larson-Meyer DE, Peeling P, Phillips SM, et al. IOC Consensus Statement: Dietary Supplements and the High-Performance Athlete. Br J Sports Med. 2018 Apr; 52(7): 439-55. PMID: 29540367
  23. Goddard Andrew F, James Martin W, McIntyre Alistair S, Scott Brian B, British Society of Gastroenterology. Guidelines for the management of iron deficiency anaemia. Gut. 2011; 60(10): 1309-16.
  24. Durmanov ND, Filimonov AS. Diagnostics and correction of disorders of iron metabolism in elite sports. Metodicheskie rekomendaczii dlya vrachej klubov. M: 2010. 84 s. [Russian]
  25. Tolkien Z, Stecher L, Mander AP, Pereira DI, Powell JJ. Ferrous sulfate supplementation causes significant gastrointestinal side-effects in adults: a systematic review and meta-analysis. PLoS One. 2015; 10(2): e0117383.
  26. Polka OO, Omelchenko EM, Kachko GO, Pedan LR. Folin acid in prophylactic medicine. Dovkillya ta zdorov'ya. 2017; (2): 22-6. [Ukrainian]
  27. Ebara S. Nutritional role of folate. Congenit Anom (Kyoto). 2017; 57(5): 138-41.
  28. Henry CJ, Nemkov T, Casás-Selves M, Bilousova G, Zaberezhnyy V, Higa KC, et al. Folate dietary insufficiency and folicacid supplementation similarly impair metabolism and compromise hematopoiesis. Haematologica. 2017; 102(12): 1985-94.
  29. Poulios A, Georgakouli K, Draganidis D, Deli CK, Tsimeas PD, Chatzinikolaou A, et al. Protein-Based Supplementation to Enhance Recovery in Team Sports: What is the Evidence? J Sports Sci Med. 2019; 18(3): 523-36. PMID: 31427875
  30. Koskenkorva-Frank TS, Weiss G, Koppenol WH, Burckhardt S. The complex interplay of iron metabolism, reactive oxygen species, and reactive nitrogen species: insights into the potential of various iron therapies to induce oxidative and nitrosative stress. Free Radic Biol Med. 2013; 65: 1174-94.
  31. Camera DM, Smiles WJ, Hawley JA. Exercise-induced skeletal muscle signaling pathways and human athletic performance. Free Radic Biol Med. 2016; 98: 131-43.
  32. Miyamoto S, Kuwata G, Imai M, Nagao A, Terao J. Protective effect of phytic acid hydrolysis products on iron-induced lipid peroxidation of liposomal membranes. Lipids. 2000; 35(12): 1411-13.
  33. Gorchakova NA, Gudivok YAS, Gunina LM., Devyatkina TA, Ilyin VN. Sports pharmacology. Ed by SA Oleinik, LM Gunina, RD Seyfully. K: Olimpijskaya literatura; 2010. s. 49-65. [Russian]
  34. Gunina LM, Vinnichuk YUD, Nosach EV. Biochemical markers of exercise fatigue: guidelines. K: Olimpijskaya literatura; 2013. 35 s. [Russian]
  35. Semko GA. Structural and functional changes in membranes and outer membrane layers of erythrocytes during hyperepidermopoiesis. Ukrayinskij biokhimichnij zhurnal. 1998; 70: 113-8. [Russian]
  36. Bankovа VV, Prishchepova NF, Avratinsky OI. A method for assessing pathological changes in the plasma membrane in children with various diseases. Patologicheskaya fiziologiya i eksperimental`naya terapiya. 1987; (3): 78-81. [Russian]
  37. Shvets NI, Davydov VV. Age features of changes in the glutathione system in the rat heart under immobilization stress. Ukrayinskij biokhimichnij zhurnal. 2008; 80(6): 74-8. [Russian]
  38. Goddard AF, McIntyreb AS, ScottBB. Guidelines for the management of iron deficiency anaemia. Gut. 2001; 48(2): 283-4.
  39. Platonov VN. The system of training athletes in Olympic sports. General theory and practical applications. Textbook for a highly qualified coach. K: Olimpijskaya literatura; 2004. s. 693-4. [Russian]
  40. Selyanov VN Preparation of runners for mid-range. M: SportAkademPress; 2001. 104 s. [Russian]
  41. Karpman BL, Belotserkovsky ZB, Gudkov IL. Research of physical fitness at an athlete. M: Fizkultura i sport; 1974. 95 s. [Russian]
  42. Lang TA, Sesik M. How to describe statistics in medicine: a guide for authors, editors, and reviewers. M: Prakticheskaya mediczina; 2011. 480 s. [Russian]
  43. Sinclair LM, Hinton PS. Prevalence of iron deficiency with and without anemia in recreationally active men and women. J Am Diet Assoc. 2005; 105(6): 975-8.
  44. Coates Alexandra, MountjoyMargo, Burr Jamie. Incidence of Iron Deficiency and Iron Deficient Anemia in Elite Runners and Triathletes. Clin J Sport Med. 2017; 27(5): 493-8.
  45. Mettler S, Zimmermann MB.Iron excess in recreational marathon runners. Eur J Clin Nutr. 2010; 64(5): 490-4.
  46. Reinke S, Taylor WR, Duda GN, von Haehling S, Reinke P, Volk HD, et al. Absolute and functional iron deficiency in professional athletes during training and recovery. Int J Cardiol. 2012; 156(2): 186-91.
  47. Hoffmann JJ, Nabbe KC, van den Broek NM. Effect of age and gender on reference intervals of red blood cell distribution width (RDW) and mean red cell volume (MCV). Clin Chem Lab Med. 2015; 53(12): 2015-9.
  48. Haymes EM, Lamanca JJ. Iron Loss in Runners During Exercise Implications and Recommendations. Sports Medicine. 1989; 7(5): 277-85.
  49. Zourdos MC, Sanchez-Gonzalez MA, Mahoney SE. A brief review: the implications of iron supplementation for marathon runners on health and performance. J Strength Cond Res. 2015; 29(2): 559-65.
  50. Elsayed ME, Sharif MU, Stack AG. Transferrin Saturation: A Body Iron Biomarker. Adv Clin Chem. 2016; 75: 71-97.
  51. Eichner ER. Sports anemia, iron supplements, and blood doping. Med Sci Sports Exerc.1992; 24(9 Suppl): S315-8. PMID: 1406203.
  52. Evans WJ. Physical function in men and women with cancer. Effects of anemia and conditioning. Oncology (Williston Park). 2002; 16(9): 109-15. PMID: 12380960
  53. Jelkmann W. Use of recombinant human erythropoietin as an antianemic and performance enhancing drug. Curr Pharm Biotechnol. 2000; 1(1): 11-31.
  54. Burden RJ, Morton K, Richards T, Whyte GP, Pedlar CR. Is iron treatment beneficial in, iron-deficient but non-anaemic (IDNA) endurance athletes? A systematic review and meta-analysis. Br J Sports Med. 2015; 49(21): 1389-97.