A diagnosis model between biomarkers and overuse injuries in well-trained wrestlers.

This study aimed to investigate the association between biomarkers and overuse injuries in well-trained wrestlers. Seventy-six well-trained wrestlers in a national team completed two blood sample collections, two clinical overuse injuries diagnoses, and a questionnaire survey at a 2-week interval. Multivariate logistic regression analysis and receiver operating characteristic curve were used to screen for related factors and construct the prediction probability model of overuse injuries. Using a restricted cubic spline further clarifies the relationship between biomarker levels and the risk of overuse injuries. Creatine kinase(CK), cortisol, rheumatoid factor, testosterone in men, and C-reactive protein (CRP) levels in the overuse injuries group were significantly different compared from those in the non-overuse injuries group. The diagnostic efficiency of the prediction probability model was more valuable than any single variable (The area under the curve=0.96,Specificity=0.91,Sensitivity=0.89,high accuracy). A J-shaped relationship was noted between biomarkers (cortisol,CRP,and CK) and the risk of overuse injuries (cutoff point:17.95μg·dL-1 ,4.72mg·L-1 ,and 344U·L-1 ; p for nonlinearity: <0.001, 0.025, and 0.043, respectively). In conclusions, a predictive model based on biomarkers (cortisol,CRP,and CK) predicted the overuse injuries risk of well-trained wrestlers. High levels of these three biomarkers were associated with a higher risk of overuse injuries, and a J-shaped relationship was observed between them.