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      The effects of altitude/hypoxic training on oxygen delivery capacity of the blood and aerobic exercise capacity in elite athletes – a meta-analysis

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          Abstract

          [Purpose]

          This study was designed as a meta-analysis of randomized controlled trials comparing effectiveness of altitude/hypoxic training (experimental) versus sea-level training (control) on oxygen delivery capacity of the blood and aerobic exercise capacity of elite athletes in Korea.

          [Methods]

          Databases (Research Information Service System, Korean studies Information Service System, National Assembly Library) were for randomized controlled trials comparing altitude/hypoxic training versus sea-level training in elite athletes. Studies published in Korea up to December 2015 were eligible for inclusion. Oxygen delivery capacity of the blood was quantified by red blood cell (RBC), hemoglobin (Hb), hematocrit (Hct), erythropoietin (EPO); and aerobic exercise capacity was quantified by maximal oxygen consumption (VO 2max). RBC, Hb, Hct, VO 2max represented heterogeneity and compared post-intervention between altitude/hypoxic training and sea-level training in elite athletes by a random effect model meta-analysis. EPO represented homogeneity and meta-analysis performed by a fixed effect model. Eight independent studies with 156 elite athletes (experimental: n = 82, control: n = 74) were included in the metaanalysis.

          [Results]

          RBC (4.499×10 5 cell/ul, 95 % CI: 2.469 to 6.529), Hb (5.447 g/dl, 95 % CI: 3.028 to 7.866), Hct (3.639 %, 95 % CI: 1.687 to 5.591), EPO (0.711 mU/mL, 95% CI: 0.282 to 1.140), VO 2max (1.637 ml/kg/min, 95% CI: 0.599 to 1.400) showed significantly greater increase following altitude/hypoxic training, as compared with sea-level training.

          [Conclusion]

          For elite athletes in Korea, altitude/ hypoxic training appears more effective than sea-level training for improvement of oxygen delivery capacity of the blood and aerobic exercise capacity.

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          Most cited references49

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          HIF-1: mediator of physiological and pathophysiological responses to hypoxia.

          All organisms can sense O(2) concentration and respond to hypoxia with adaptive changes in gene expression. The large body size of mammals necessitates the development of multiple complex physiological systems to ensure adequate O(2) delivery to all cells under normal conditions. The transcriptional regulator hypoxia-inducible factor 1 (HIF-1) is an essential mediator of O(2) homeostasis. HIF-1 is required for the establishment of key physiological systems during development and their subsequent utilization in fetal and postnatal life. HIF-1 also appears to play a key role in the pathophysiology of cancer, cardiovascular disease, and chronic lung disease, which represent the major causes of mortality among industrialized societies. Genetic or pharmacological modulation of HIF-1 activity in vivo may represent a novel therapeutic approach to these disorders.
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            Systematic Reviews and Meta-Analysis

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              Molecular adaptations in human skeletal muscle to endurance training under simulated hypoxic conditions.

              This study was performed to explore changes in gene expression as a consequence of exercise training at two levels of intensity under normoxic and normobaric hypoxic conditions (corresponding to an altitude of 3,850 m). Four groups of human subjects trained five times a week for a total of 6 wk on a bicycle ergometer. Muscle biopsies were taken, and performance tests were carried out before and after the training period. Similar increases in maximal O(2) uptake (8.3-13.1%) and maximal power output (11.4-20.8%) were found in all groups. RT-PCR revealed elevated mRNA concentrations of the alpha-subunit of hypoxia-inducible factor 1 (HIF-1) after both high- (+82.4%) and low (+78.4%)-intensity training under hypoxic conditions. The mRNA of HIF-1alpha(736), a splice variant of HIF-1alpha newly detected in human skeletal muscle, was shown to be changed in a similar pattern as HIF-1alpha. Increased mRNA contents of myoglobin (+72.2%) and vascular endothelial growth factor (+52.4%) were evoked only after high-intensity training in hypoxia. Augmented mRNA levels of oxidative enzymes, phosphofructokinase, and heat shock protein 70 were found after high-intensity training under both hypoxic and normoxic conditions. Our findings suggest that HIF-1 is specifically involved in the regulation of muscle adaptations after hypoxia training. Fine-tuning of the training response is recognized at the molecular level, and with less sensitivity also at the structural level, but not at global functional responses like maximal O(2) uptake or maximal power output.
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                Author and article information

                Journal
                J Exerc Nutrition Biochem
                J Exerc Nutrition Biochem
                JENB
                Journal of Exercise Nutrition & Biochemistry
                한국운동영양학회
                2233-6834
                2233-6842
                31 March 2016
                31 March 2016
                : 20
                : 1
                : 15-22
                Affiliations
                [1 ]Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul Republic of Korea,
                [2 ]Department of Physical Education, Korea University, Seoul Republic of Korea,
                [3 ]Department of Physical Education, Hanyang University, Seoul Republic of Korea,
                [4 ]Department of Physical Education, Konkuk University, Seoul Republic of Korea,
                Author notes
                *Kiwon Lim Department of Physical Education, Konkuk University, Seoul, Republic of Korea Tel : + 82-2-450-3827 Email: exercise@ 123456konkuk.ac.kr
                Article
                JENB_2016_v20n1_15
                10.20463/jenb.2016.03.20.1.3
                4899894
                27298808
                c9c0e250-da3a-4a05-9335-c5bea49de099
                ©2016 The Korean Society for Exercise Nutrition

                ©2016 Hunyoung Park et al.; Licensee Journal of Exercise Nutrition and Biochemistry. This is an open accessarticle distributed under the terms of the creative commons attribution license ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the orginal work is properly cited.

                History
                : 16 February 2016
                : 02 March 2016
                : 03 March 2016
                Funding
                Funded by: National Research Foundation of Korea
                Award ID: NRF-2015M3C1B1019372
                Categories
                Original Article

                altitude/hypoxic training,oxygen delivery capacity of the blood,aerobic exercise capacity,meta-analysis,heterogeneity,fixed and random effect model

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