{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T13:31:45Z","timestamp":1764855105643,"version":"3.46.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction or background<\/jats:title>\n                    <jats:p>Altitude training is a well-established strategy for improving athletic performance, particularly in endurance sports. Hypoxic exposure induces physiological adaptations through oxygen sensing and erythropoietic mechanisms. However, the comparative effects of aerobic and anaerobic training on hematological and biochemical markers under different altitude conditions have not yet been adequately investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sources of data<\/jats:title>\n                    <jats:p>This prospective cohort study included 24 trained male athletes (aged 19\u201323) who were randomly assigned to aerobic or anaerobic training groups (n\u2009=\u200912 per group). Training was conducted at simulated altitudes of 0\u00a0m, 1700\u00a0m, 2450\u00a0m, and 3200\u00a0m for 8 weeks. Biomarkers such as hypoxia-induced factor 1-alpha (HIF-1\u03b1), hemoglobin, erythropoietin (EPO), iron, hepcidin, and nitric oxide (NO) were measured using ELISA and standard biochemical methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Areas of agreement<\/jats:title>\n                    <jats:p>Consistent with previous literature, both aerobic and anaerobic training resulted in altitude-induced increases in hemoglobin levels. Aerobic training was associated with earlier activation of hypoxia-related markers such as HIF-1\u03b1 and NO, supporting the role of moderate altitude exposure in stimulating adaptive molecular responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Areas of controversy<\/jats:title>\n                    <jats:p>While EPO is generally expected to increase with altitude exposure, this study found a decrease in EPO levels across altitudes in the aerobic group, while a significant increase was observed only at 3200\u00a0m in the anaerobic group. Interpretation of hepcidin dynamics also differs between training modalities, highlighting the complexity of iron regulation under hypoxic stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Growing points<\/jats:title>\n                    <jats:p>This study highlights the different timing and magnitude of biomarker responses to aerobic and anaerobic training at various altitudes. It suggests that aerobic exercise triggers earlier molecular responses, while anaerobic training elicits delayed or blunted adaptations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Areas timely for developing research<\/jats:title>\n                    <jats:p>Further research is needed to optimize altitude training protocols tailored to specific exercise modalities and targeted physiological adaptations. Future studies could examine gender differences, longer training durations, and additional markers of oxidative stress and inflammation to expand on these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bmb\/ldaf021","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T12:25:14Z","timestamp":1763382314000},"source":"Crossref","is-referenced-by-count":0,"title":["Determination of the role of aerobic and anaerobic training at different altitude on hypoxia-induced factor 1, hemoglobin, iron, erythropoietin, hepcidin, and nitric oxide"],"prefix":"10.1093","volume":"156","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7089-1628","authenticated-orcid":false,"given":"U\u011fur","family":"\u00d6nt\u00fcrk","sequence":"first","affiliation":[{"name":"Physical Education and Sports Teacher, Hasan Ali Y\u00fccel Secondary School , Abdurrahman Gazi District, Van, 65100 ,","place":["T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4883-3995","authenticated-orcid":false,"given":"Vedat","family":"\u00c7inar","sequence":"additional","affiliation":[{"name":"Faculty of Sports Sciences, F\u0131rat University, \u00dcniversite District, 23119 Elaz\u0131\u011f , 23119 ,","place":["T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4062-0752","authenticated-orcid":false,"given":"M\u00fccahit","family":"Sarikaya","sequence":"additional","affiliation":[{"name":"Faculty of Sports Sciences, Van Yuzuncu Yil University , Zeve District, 65100 Van ,","place":["T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9202-4944","authenticated-orcid":false,"given":"Hamit Hakan","family":"Alp","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Clinical Biochemistry, Van Yuzuncu Yil University, Zeve District , 65100 Van ,","place":["T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2500-1117","authenticated-orcid":false,"given":"Taner","family":"Akbulut","sequence":"additional","affiliation":[{"name":"Faculty of Sports Sciences, F\u0131rat University, \u00dcniversite District, 23119 Elaz\u0131\u011f , 23119 ,","place":["T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1885-2677","authenticated-orcid":false,"given":"Diego","family":"Chaverri","sequence":"additional","affiliation":[{"name":"National Institute of Physical Education of Catalonia Barcelona Sports Sciences Research Group, National Institute of Physical Education of Catalonia, University of Barcelona , 08038 Barcelona ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6643-7665","authenticated-orcid":false,"given":"Salih","family":"\u00d6ner","sequence":"additional","affiliation":[{"name":"Faculty of Sports Sciences, Van Yuzuncu Yil University , Zeve District, 65100 Van ,","place":["T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2156-6236","authenticated-orcid":false,"given":"\u0130sa","family":"Aydemir","sequence":"additional","affiliation":[{"name":"Faculty of Sports Sciences, Hakkari University , Merzan District, 30000 Hakkari ,","place":["T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7769-8975","authenticated-orcid":false,"given":"K\u0131van\u00e7","family":"Buru","sequence":"additional","affiliation":[{"name":"Ka\u011f\u0131zman Vocational School, Management and Organization, Sports Management, Kafkas University , \u015eahindere District, 36000 Kars ,","place":["T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7144-7403","authenticated-orcid":false,"given":"Gian Mario","family":"Migliaccio","sequence":"additional","affiliation":[{"name":"Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University of Rome , Via di Val Cannuta 247, Rome, 00166 ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"2025120408295415600_ref1","volume-title":"The Physiology of High-Altitude Exposure","author":"Cymerman","year":"1996"},{"key":"2025120408295415600_ref2","doi-asserted-by":"publisher","first-page":"100113","DOI":"10.1016\/j.crphys.2023.100113","article-title":"Physiological and performance effects of live high train low altitude training for elite endurance athletes: A narrative review","volume":"6","author":"Bonato","year":"2023","journal-title":"Curr Res Physiol"},{"key":"2025120408295415600_ref3","volume-title":"Physiology of Exercise for Physical Education and Athletics","author":"DeVries","year":"1974"},{"key":"2025120408295415600_ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2165\/00007256-200838010-00001","article-title":"Physiological responses to exercise at altitude: An update","volume":"38","author":"Mazzeo","year":"2008","journal-title":"Sports Med"},{"key":"2025120408295415600_ref5","doi-asserted-by":"publisher","first-page":"134","DOI":"10.4330\/wjc.v9.i2.134","article-title":"Aerobic vs anaerobic exercise training effects on the cardiovascular system","volume":"9","author":"Patel","year":"2017","journal-title":"World J Cardiol"},{"key":"2025120408295415600_ref6","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1002\/j.2040-4603.2012.tb00407.x","article-title":"Bioenergetics of exercising humans","volume":"2","author":"Brooks","year":"2012","journal-title":"Compr Physiol"},{"key":"2025120408295415600_ref7","doi-asserted-by":"publisher","first-page":"34","DOI":"10.4324\/9781003148418-4","volume-title":"Aerobic and Anaerobic Training. Science and Soccer","author":"Anderson","year":"2023"},{"key":"2025120408295415600_ref8","doi-asserted-by":"publisher","first-page":"3547","DOI":"10.3892\/mmr.2018.9375","article-title":"PI3K\/Akt and HIF-1 signaling pathway in hypoxia-ischemia","volume":"18","author":"Zhang","year":"2018","journal-title":"Mol Med Rep"},{"key":"2025120408295415600_ref9","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1113\/EP085318","article-title":"Skeletal muscle hypoxia-inducible factor-1 and exercise","volume":"101","author":"Lindholm","year":"2016","journal-title":"Exp Physiol"},{"key":"2025120408295415600_ref10","doi-asserted-by":"publisher","first-page":"864532","DOI":"10.3389\/fspor.2022.864532","article-title":"Altitude and erythropoietin: Comparative evaluation of their impact on key parameters of the athlete biological passport: A review","volume":"4","author":"Saugy","year":"2022","journal-title":"Front Sports Act Living"},{"key":"2025120408295415600_ref11","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1016\/j.freeradbiomed.2011.12.028","article-title":"Nitric oxide in adaptation to altitude","volume":"52","author":"Beall","year":"2012","journal-title":"Free Radic Biol Med"},{"key":"2025120408295415600_ref12","doi-asserted-by":"publisher","first-page":"125","DOI":"10.3389\/fphys.2018.00125","article-title":"Erythrocytes and vascular function: Oxygen and nitric oxide","volume":"9","author":"Helms","year":"2018","journal-title":"Front Physiol"},{"key":"2025120408295415600_ref13","doi-asserted-by":"publisher","first-page":"2296","DOI":"10.3390\/healthcare10112296","article-title":"Training in hypoxia at alternating high altitudes is a factor favoring the increase in sports performance","volume":"10","author":"Dragos","year":"2022","journal-title":"Healthcare"},{"key":"2025120408295415600_ref14","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1007\/978-3-031-35092-4_4","volume-title":"High Altitude Medicine: A Case-Based Approach","author":"Sinclair De Fr\u00edas","year":"2023"},{"key":"2025120408295415600_ref15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2019\/7315714","article-title":"Comparison of the effectiveness of high-intensity interval training in hypoxia and normoxia in healthy male volunteers: A pilot study","volume":"2019","author":"Zebrowska","year":"2019","journal-title":"Biomed Res Int"},{"key":"2025120408295415600_ref16","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1016\/j.metabol.2010.01.002","article-title":"Effect of 2 weeks of sprint interval training on health-related outcomes in sedentary overweight\/obese men","volume":"59","author":"Whyte","year":"2010","journal-title":"Metabolism"},{"key":"2025120408295415600_ref17","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1113\/jphysiol.2009.181743","article-title":"A practical model of low-volume high-intensity interval training induces mitochondrial biogenesis in human skeletal muscle: Potential mechanisms","volume":"588","author":"Little","year":"2010","journal-title":"J Physiol"},{"key":"2025120408295415600_ref18","doi-asserted-by":"publisher","first-page":"e119","DOI":"10.1016\/j.scispo.2012.11.006","article-title":"Effects of high-intensity interval training on aerobic and anaerobic indices: Comparison of physically active and inactive men","volume":"28","author":"Siahkouhian","year":"2013","journal-title":"Science & Sports"},{"key":"2025120408295415600_ref19","doi-asserted-by":"publisher","first-page":"3061","DOI":"10.1007\/s00421-011-2285-5","article-title":"Effects of high-intensity interval training on pulmonary function","volume":"112","author":"Dunham","year":"2012","journal-title":"Eur J Appl Physiol"},{"key":"2025120408295415600_ref20","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1111\/cpf.12131","article-title":"Exhaled nitric oxide after high-intensity exercise at 2800 m altitude","volume":"35","author":"Stang","year":"2015","journal-title":"Clin Physiol Funct Imaging"},{"key":"2025120408295415600_ref21","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1089\/ham.2015.0033","article-title":"Altitude adaptation: A glimpse through various lenses","volume":"16","author":"Simonson","year":"2015","journal-title":"High Alt Med Biol"},{"key":"2025120408295415600_ref22","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1152\/jappl.1994.77.2.684","article-title":"Higher exercise performance and lower VO2max in Tibetan than Han residents at 4,700 m altitude","volume":"77","author":"Ge","year":"1985","journal-title":"J Appl Physiol"},{"key":"2025120408295415600_ref23","doi-asserted-by":"publisher","first-page":"8655","DOI":"10.1073\/pnas.0701985104","article-title":"Two routes to functional adaptation: Tibetan and Andean high-altitude natives","volume":"104","author":"Beall","year":"2007","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2025120408295415600_ref24","doi-asserted-by":"publisher","first-page":"i31","DOI":"10.1136\/bjsports-2013-092840","article-title":"Altitude training and haemoglobin mass from the optimised carbon monoxide rebreathing method determined by a meta-analysis","volume":"47","author":"Gore","year":"2013","journal-title":"Br J Sports Med"},{"key":"2025120408295415600_ref25","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1159\/000243791","article-title":"The role of hepcidin in iron metabolism","volume":"122","author":"Nemeth","year":"2009","journal-title":"Acta Haematol"},{"key":"2025120408295415600_ref26","doi-asserted-by":"crossref","volume-title":"Altitude Acclimatization Guide","author":"Muza","DOI":"10.21236\/ADA423388"},{"key":"2025120408295415600_ref27","doi-asserted-by":"publisher","first-page":"249","DOI":"10.2165\/00007256-200131040-00002","article-title":"Current trends in altitude training","volume":"31","author":"Wilber","year":"2001","journal-title":"Sports Med"},{"key":"2025120408295415600_ref28","doi-asserted-by":"publisher","first-page":"e19338","DOI":"10.7717\/peerj.19338","article-title":"The acute effects of simulated hypoxic training at different altitudes on oxidative stress and muscle damage in elite long-distance runners","volume":"13","author":"Sarikaya","year":"2025","journal-title":"PeerJ"},{"key":"2025120408295415600_ref29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1600-0838.2008.00827.x","article-title":"General introduction to altitude adaptation and mountain sickness","volume":"18","author":"Bartsch","year":"2008","journal-title":"Scand J Med Sci Sports"},{"key":"2025120408295415600_ref30","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1113\/jphysiol.2009.180489","article-title":"Nitric oxide contributes to the augmented vasodilatation during hypoxic exercise","volume":"588","author":"Casey","year":"2010","journal-title":"J Physiol"}],"container-title":["British Medical Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bmb\/article-pdf\/156\/1\/ldaf021\/65738416\/ldaf021.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bmb\/article-pdf\/156\/1\/ldaf021\/65738416\/ldaf021.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T13:29:57Z","timestamp":1764854997000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bmb\/article\/doi\/10.1093\/bmb\/ldaf021\/8365013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,22]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,9,22]]}},"URL":"https:\/\/doi.org\/10.1093\/bmb\/ldaf021","relation":{},"ISSN":["0007-1420","1471-8391"],"issn-type":[{"value":"0007-1420","type":"print"},{"value":"1471-8391","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,12]]},"published":{"date-parts":[[2025,9,22]]},"article-number":"ldaf021"}}