Audran et al used the ratio of the serum soluble transferrin receptor to serum protein concentration to detect an athlete who is using recombinant erythropoietin (EPO) as a doping agent.


Advantages of ratio:

(1) Serum protein controls for hemoconcentration.

(2) Serum ferritin levels may be affected by concomitant iron therapy.



(1) soluble transferrin receptor (STfr) in mg/L

(2) serum protein in g/L


ratio of the soluble transferrin receptor to serum protein =

= (concentration of STfr) / (serum protein) * 1000



• The normal ratio is usually < 100.

• Doping with recombinant erythropoietin results in an elevation of the ratio.


Criteria of Audran et al for EPO doping

(1) hematocrit increased (in the absence of dehydration)

(2) soluble transferrin receptor concentration > 10 mg/L

(3) ratio of STfr to serum protein > 153.


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