Baseline Inflammatory Markers as Predictors of Running-Related Injuries: A One-Year Prospective 4HAIE Cohort Study

Area of Science:

• Sports Medicine
• Biochemistry
• Exercise Physiology

Background:

• Running-related injuries (RRIs) are common, with inflammatory processes potentially influencing susceptibility.
• The predictive value of baseline inflammatory biomarkers for RRI occurrence in healthy individuals is not well-established.

Purpose of the Study:

• To investigate if baseline biochemical markers of inflammation predict RRI occurrence in healthy individuals over a one-year period.
• To assess the role of inflammatory markers alongside training, physiological, and injury history in RRI prediction.

Main Methods:

• Prospective study following 1315 healthy individuals (runners and controls) for 12 months with injury surveillance.
• Baseline blood samples analyzed for inflammatory markers; multivariable logistic regression used for analysis.
• Adjusted for age, sex, peak oxygen consumption, running distance, body fat, and prior musculoskeletal trauma.

Main Results:

• Baseline tumor necrosis factor alpha (TNF-α) was a significant predictor of RRI (OR per 1 pg/mL: 1.25).
• History of musculoskeletal trauma, weekly running distance, and age also predicted RRI.
• Interleukin-1 receptor antagonist (IL-1RA) showed a modest protective association (OR per 10 pg/mL: 0.99).
• The predictive model had limited discriminatory ability (AUC = 0.66).

Conclusions:

• Baseline TNF-α and IL-1RA are associated with RRI occurrence, suggesting inflammation contributes to injury susceptibility.
• These inflammatory markers are insufficient as standalone screening tools for individual RRI prediction.
• Inflammatory phenotype is one component of multifactorial RRI risk, informing potential prevention strategies.