Changes in blood parameters after intramuscular testosterone ester injections - Implications for anti-doping
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Changes in blood parameters after intramuscular testosterone ester injections - Implications for anti-doping. / Solheim, Sara Amalie; Mørkeberg, Jakob; Dehnes, Yvette; Hullstein, Ingunn; Juul, Anders; Upners, Emmie N; Nordsborg, Nikolai Baastrup.
In: Drug Testing and Analysis, Vol. 12, No. 8, 2020, p. 1019-1030.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Changes in blood parameters after intramuscular testosterone ester injections - Implications for anti-doping
AU - Solheim, Sara Amalie
AU - Mørkeberg, Jakob
AU - Dehnes, Yvette
AU - Hullstein, Ingunn
AU - Juul, Anders
AU - Upners, Emmie N
AU - Nordsborg, Nikolai Baastrup
N1 - This article is protected by copyright. All rights reserved.
PY - 2020
Y1 - 2020
N2 - Testosterone treatment stimulates red blood cell production and alters iron homeostasis. Thus, we investigated whether the 'hematological module' of the Athlete Biological Passport (ABP) used by the World Anti-Doping Agency (WADA) can be used to indicate misuse of testosterone. Nineteen eugonadal men received intramuscular injections of either 250 mg Sustanon®, a blend of four testosterone esters, or placebo on Day 0 and 21 in a randomized, placebo-controlled double-blind design. Urine samples and blood samples for the assessment of steroidal and hematological biomarkers of the ABP were collected twice pre-treatment, at least 5 days apart, and on days 1, 3, 5, 10 and 14 post-injections. The steroidal profile was flagged suspicious in all Sustanon®-treated subjects, while the hematological profile was flagged suspicious in 6 out of 9 subjects. When considering both sensitivity and specificity, RET% appeared as the best marker of the hematological module for implying testosterone ester misuse. Atypical blood passport samples were used to select time points for further isotope-ratio mass spectrometry (IRMS) analysis of testosterone and its metabolites in simultaneously collected urine. The RET% and OFF-Score could, in addition to the T/E ratio, help identify suspicious samples for more targeted IRMS testing. The present results demonstrate that unexpected fluctuations in RET% can be indicative of testosterone doping if samples are collected 3-10 days after injection. From an anti-doping perspective, the hematological and steroidal modules of the ABP should complement each other when planning targeted follow-up testing and substantiating likely misuse of testosterone.
AB - Testosterone treatment stimulates red blood cell production and alters iron homeostasis. Thus, we investigated whether the 'hematological module' of the Athlete Biological Passport (ABP) used by the World Anti-Doping Agency (WADA) can be used to indicate misuse of testosterone. Nineteen eugonadal men received intramuscular injections of either 250 mg Sustanon®, a blend of four testosterone esters, or placebo on Day 0 and 21 in a randomized, placebo-controlled double-blind design. Urine samples and blood samples for the assessment of steroidal and hematological biomarkers of the ABP were collected twice pre-treatment, at least 5 days apart, and on days 1, 3, 5, 10 and 14 post-injections. The steroidal profile was flagged suspicious in all Sustanon®-treated subjects, while the hematological profile was flagged suspicious in 6 out of 9 subjects. When considering both sensitivity and specificity, RET% appeared as the best marker of the hematological module for implying testosterone ester misuse. Atypical blood passport samples were used to select time points for further isotope-ratio mass spectrometry (IRMS) analysis of testosterone and its metabolites in simultaneously collected urine. The RET% and OFF-Score could, in addition to the T/E ratio, help identify suspicious samples for more targeted IRMS testing. The present results demonstrate that unexpected fluctuations in RET% can be indicative of testosterone doping if samples are collected 3-10 days after injection. From an anti-doping perspective, the hematological and steroidal modules of the ABP should complement each other when planning targeted follow-up testing and substantiating likely misuse of testosterone.
KW - Faculty of Science
KW - Doping in sports
KW - Testosterone
KW - Athlete biological passport
KW - Haematological profile
KW - Steroid profile
U2 - 10.1002/dta.2803
DO - 10.1002/dta.2803
M3 - Journal article
C2 - 32307878
VL - 12
SP - 1019
EP - 1030
JO - Drug Testing and Analysis
JF - Drug Testing and Analysis
SN - 1942-7603
IS - 8
ER -
ID: 240984590