Hand strike-induced hemolysis and adaptations in iron metabolism in basque ball players

Introduction: Basque ball players (BBPs) make repeated hand strikes to the ball which involves continuous mechanical trauma. Objective: The aim of this work is to describe the hematological variations and changes in iron metabolism occurring in BBPs as a result of acute and continuous practice of this special sport native to Northern Spain. Methods: 40 healthy male subjects volunteered to participate in this study: 11 subjects who exercise moderately (control group) but do not play Basque ball sport and 29 professional BBPs were studied in two situations: before a match (BM group) and after a match (AM group). The following hematological parameters were determined: red blood cell count (RBC), hemoglobin and hematocrit; MCV, MCH and MCHC. The following variables were measured in serum: iron, ferritin, transferrin, transferrin saturation, proteins, and lactate dehydrogenase (LDH). Proteins and hemoglobin were determined in urine. Results:The BM group showed lower hematocrit, MCV, hemoglobin and serum transferrin levels, and higher LDH than controls. The AM group showed higher RBC, hemoglobin, serum proteins, iron, transferrin and LDH levels, lower plasma volume, and higher urine hemoglobin and protein levels than the BM group. Conclusions: Basque ball playing induces hemolysis and increases the plasma capability to quench free iron, but its clinical consequences on iron metabolism do not seem to be enough to take an iron intake proportional to the caloric intake. In order to prevent, in the long term, the development of anemia in these peculiar sportsmen, it would be useful that medical teams observe urine blood losses and oxidative stress in these BBPs.