Introduction
Food and sports supplements are used by athletes all over the world, and correct and optimal consumption improves performance and prevents sports injuries. In this regard, creatine and ginseng supplements can be effective in physiological indicators and sports performance. On the other hand, the characteristics of physical fitness indicate having the necessary ability to perform skills correctly and achieve success in athletes in dynamic disciplines, such as fencing. Therefore, considering that no research has been done on the use of these supplements on blood indicators in fencers. The present study compared the effect of creatine and ginseng supplements on blood ammonia, HDL, LDL, and homocysteine indices of the male players of the Iranian Epee fencing team.

Materials and Methods
In the present study, 14 male players of the Epee national fencing team were divided into two creatine supplement groups (7 people) and a ginseng supplement group (7 people). During the research, the subjects in three groups performed their normal exercises with the team, and on the day before the measurement, after a certain activity in a sitting position, a specialist took 2 ml of blood from the arm vein of the subjects. In order to measure the level of homocysteine, HDL, and LDL in the blood, immediately after four minutes after the time of the subject’s pedaling on the bicycle, the level of homocysteine, HDL, and LDL in their blood was measured with the Scout lactometer device made in Germany  (mg/dL). The statistically significant difference was determined at the level of P ≥ 0.05 and the ANCOVA was used to determine the differences between groups and the data were analyzed by SPSS software, version 25. 

Results
The Shapiro-Wilk test was used to check the normal distribution of the variables. The results of this test for all variables showed the normality of the data (P>0.05). Also, to check the assumption of homogeneity of variances, Levene’s test was used, and the homogeneity of the variances of the groups’ scores was confirmed (P>0.05). Therefore, according to the above assumptions, ANCOVA was used to investigate the effect of exercises on the variables. The results showed that after six weeks, there was a significant difference between the creatine and ginseng groups in the blood indices of ammonia, LDL, HDL, and homocysteine (P ≥ 0.05). The average levels of ammonia, LDL, HDL, and homocysteine were creatine supplement group 2.56±0.83, 1.16±0.33, 7.45±0.48, and 8.89±0.18 mg/dL and 2.05±0.29, 1.46±0.78, 8.11±0.27, and 7.63±0.45 in the ginseng group, respectively.

Discussion
The results showed that there was a significant difference in the average blood ammonia, HDL, LDL, and homocysteine levels between the creatine supplement group and the ginseng supplement group. The results showed that the ginseng supplement was more effective in reducing blood ammonia and homocysteine ​​and in increasing HDL compared to the creatine supplement, and the creatine supplement was more effective in reducing LDL compared to the ginseng supplement.
Regarding blood ammonia, the results of Attarzadeh et al.’s study (2018) showed that ginseng supplementation causes a significant decrease in ammonia concentration, which is similar to the results of this study [19]. Ammonia is formed in the kidneys as a result of the activity of phosphate-dependent and non-phosphate-dependent glutaminase enzymes, and all the produced NH3 appears in primary ducts as NH4 +ammonium ions. Since there is no ammonium secretion mechanism in the urinary collecting ducts, and there is not much permeability to it, a small percentage of ammonia in the interstitial water is released into the ducts through non-ionic diffusion. Also, if the pH of urine increases due to the injection of bicarbonate or acetazolamide, ammonium is decomposed and ammonia is released into the blood. In this regard, it has been reported that long-term intense exercise will increase plasma ammonium levels. Also, the increase observed in professional athletes is less.
It can be concluded ginseng supplement is more effective in changes in blood ammonia, homocysteine, and HDL than creatine supplement.

Ethical Considerations

Compliance with ethical guidelines
This article was approved by the Ethics Committee of Islamic Azad University, Shahrood Branch (Code: IR.IAU.SHAHROOD.REC.1400.073).

Funding
This article is taken from Ahmad Yaghoobi's PhD thesis. The present research has no financial sponsor.

Authors' contributions
All authors participated in the design, execution, and writing of all parts of this research.

Conflicts of interest
According to the authors, this article has no conflict of interest.

Acknowledgements
This article is extracted from the doctoral dissertation by Ahmed Yaqoubi. We hereby thank the Fencing Federation of the Islamic Republic of Iran and all those who helped us in conducting this research.

 

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