Biomarkers of Physiological Responses to Periods of Intensified, Non-Resistance-Based Exercise Training in Well-Trained Male Athletes: A Systematic Review and Meta-Analysis

• Published in: Sports medicine (Auckland) 2018-11, Vol.48 (11), p.2517-2548
• Main Authors: Greenham, Grace, Buckley, Jonathan D., Garrett, Joel, Eston, Roger, Norton, Kevin
• Format: Article
• Language: English
• Subjects: Athletes; Athletic Performance - physiology; Biomarkers - analysis; Creatine Kinase - analysis; Exercise; Glutamine - analysis; Humans; Hydrocortisone - analysis; Lymphocyte Count; Male; Medicine; Medicine & Public Health; Neutrophils; Sports Medicine; Systematic Review; Testosterone - analysis; Urea - analysis
• ISSN: 0112-1642; 1179-2035
• DOI: 10.1007/s40279-018-0969-2

Background Intensified training is important for inducing adaptations to improve athletic performance, but detrimental performance effects can occur if prescribed inappropriately. Monitoring biomarker responses to training may inform changes in training load to optimize performance. Objective This systematic review and meta-analysis aimed to identify biomarkers associated with altered exercise performance following intensified training. Methods Embase, MEDLINE, CINAHL, Scopus and SPORTDiscus were searched up until September 2017. Included articles were peer reviewed and reported on biomarkers collected at rest in well-trained male athletes before and after periods of intensified training. Results The full text of 161 articles was reviewed, with 59 included (708 participants) and 42 (550 participants) meta-analysed. In total, 118 biomarkers were evaluated, with most being cellular communication and immunity markers ( n  = 54). Studies most frequently measured cortisol ( n  = 34), creatine kinase ( n  = 25) and testosterone ( n  = 20). Many studies reported decreased immune cell counts following intensified training, irrespective of performance. Moreover, reduced performance was associated with a decrease in neutrophils ( d  = − 0.57; 95% confidence interval (CI) − 1.07 to − 0.07) and glutamine ( d  = − 0.37; 95% CI − 0.43 to − 0.31) and an increase in urea concentration ( d  = 0.80; 95% CI 0.30 to 1.30). In contrast, increased performance was associated with an increased testosterone:cortisol ratio ( d  = 0.89; 95% CI 0.54 to 1.24). All remaining biomarkers showed no consistent patterns of change with performance. Conclusions Many biomarkers were altered with intensified training but not in a manner related to changes in exercise performance. Neutrophils, glutamine, urea and the testosterone:cortisol ratio exhibited some evidence of directional changes that corresponded with performance changes therefore indicating potential to track performance. Additional investigations of the potential for these markers to track altered performance are warranted.