Sex- and Age-Specific Trajectories of Hemoglobin and Aerobic Power in Competitive Youth Athletes

Maximal aerobic power (V̇O2peak) in youth depends on hemoglobin (Hb)—mediated oxygen transport. While sex- and age-specific patterns are established in untrained cohorts, further research is needed in competitive adolescent athletes. We studied 124 young athletes matched by age and sex (62 boys, 62 girls; 10–16 years). Hb was measured from fasting blood samples, and V̇O2peak was determined via cardiopulmonary exercise testing (CPET). Boys showed higher Hb than girls (14.43 ± 0.85 g/dL vs. 13.6 ± 0.74 g/dL; p < 0.001) and a significant age-related increase (B = 0.29, p < 0.001), whereas girls remained stable. V̇O2peak was also higher in boys (50.03 ± 6.18 mL/min/kg, p < 0.001). Regression analysis identified Hb as a strong predictor of V̇O2peak (β = 0.40, p < 0.001). These findings demonstrate that classical developmental Hb trajectories persist in highly trained youth and confirm Hb as a key determinant of aerobic power. Monitoring hematological status, particularly in female athletes, is essential for optimizing performance and development.