A systematic review of the integration of molecular biomarkers and anthropometric parameters for monitoring fatigue and inflammation in athletes
DOI:
https://doi.org/10.47197/retos.v71.117162Keywords:
parámetros antropométricos, biomarcadores, fatiga, inflamación, atletasAbstract
Introduction: Fatigue and inflammation are key physiological processes that modulate both recovery and performance outcomes in athletes. Nevertheless, existing monitoring strategies are not typically designed to incorporate molecular and anthropometric markers, which limits their specificity and application in sports settings.
Objective: To critically appraise recent evidence on the integration of molecular biomarkers and anthropometric parameters for the assessment of inflammation and fatigue in athletes.
Methodology: According to PRISMA 2020 guidelines, systematic searching was conducted in the Web of Science, ScienceDirect, and PubMed databases. A total of 47 included studies from peer-reviewed, English-language articles with human athletes and reporting both molecular and anthropometric data.
Results: The review documented associations between body composition and biomarkers of muscle fatigue, inflammation, endocrine control, immune defense, and metabolism. Significant signaling cascades such as nuclear factor kappa B, phosphoinositide-3-kinase/protein kinase B, and the hypothalamic–pituitary–adrenal axis were commonly involved. Greater muscle mass supports better recovery, whereas higher fat mass increases inflammation and metabolic risk.
Discussion: Combining these biomarkers with anthropometric values increases precision in physiological assessment and reduces misclassification risks, particularly in highly trained subjects. This review promoted a two-stranded monitoring strategy—encompassing molecular and morphological measures—to support personalized training, nutrition, and recovery planning.
Conclusions: The combination of multiple biomarkers and anthropometric analysis presents a promising paradigm for individualized monitoring with significant implications for precision training and recovery protocols in sport science.
References
Agostinis-Sobrinho, C., Vicente, S. E. d. C. F., Norkiene, S., Rauckienė-Michaelsson, A., Kievisienė, J., Dubey, V. P., Razbadauskas, A., Lopes, L., & Santos, R. (2022). Is the leptin/adiponectin ratio a better diagnostic biomarker for insulin resistance than leptin or adiponectin alone in adoles-cents? Children, 9(8), 1193. https://doi.org/10.3390/children9081193
Alves, J., Barrientos, G., Toro, V., Sánchez, E., Muñoz, D., & Maynar, M. (2021). Changes in anthropo-metric and performance parameters in high-level endurance athletes during a sports season. International Journal of Environmental Research and Public Health, 18(2782), 1–11. https://doi.org/10.3390/ijerph18052782
Ashwell, M., & Gibson, S. (2016). Waist to height ratio as an indicator of early health risk. BMJ Open, 6(3), e010159. https://doi.org/10.1136/bmjopen-2015-010159
Baird, M. F., Graham, S. M., Baker, J. S., & Bickerstaff, G. F. (2012). Creatine-kinase- and exercise-related muscle damage: Implications for muscle performance and recovery. Journal of Nutri-tion and Metabolism, 2012, 960363. https://doi.org/10.1155/2012/960363
Banfi, G., Colombini, A., Lombardi, G., & Lubkowska, A. (2012). Metabolic markers in sports medicine. Advances in Clinical Chemistry, 56, 1–54. https://doi.org/10.1016/B978-0-12-394317-0.00015-7
Bessa, A. L., Oliveira, V. N., Agostini, G. G., Oliveira, R. J., Oliveira, A. C., White, G. E., Wells, G. D., Teixei-ra, D. N., & Espindola, F. S. (2016). Exercise intensity and recovery: Biomarkers of injury, in-flammation, and oxidative stress. Journal of Strength and Conditioning Research, 30(2), 311–319. https://doi.org/10.1519/JSC.0b013e31828f1ee9
Buchheit, M. (2014). Monitoring training status with HR measures: Do all roads lead to Rome? Fron-tiers in Physiology, 5, 73. https://doi.org/10.3389/fphys.2014.00073
Cao, W., He, Y., Fu, R., Chen, Y., Yu, J., & He, Z. (2025). A review of carbohydrate supplementation ap-proaches and strategies for optimizing performance in elite long-distance endurance. Nutri-ents, 17(5), 918. https://doi.org/10.3390/nu17050918
Chuang, W. C., Chu, C. H., Yao, C. S., Wei, M.C., Hsieh, I.L., & Liao, C.M. (2025). The value of growth dif-ferentiation factor 15 as a biomarker for peripheral artery disease in diabetes patients. Dia-betology & Metabolic Syndrome, 17, 31. https://doi.org/10.1186/s13098-025-01588-w
de Assis, G. G., & Murawska-Ciałowicz, E. (2023). Exercise and weight management: The role of lep-tin—A systematic review and update of clinical data from 2000–2022. Journal of Clinical Medi-cine, 12(13), 4490. https://doi.org/10.3390/jcm12134490
de Lima e Silva, L. ., Rodrigues dos Santos, D. ., Rolim Lopes Silva, Y. ., Alonso Valente dos Santos, L. ., Spineti, J. ., Pereira Salustiano Mallen , G. C., Gomes de Souza Vale, R. ., & de Alkmim Moreira Nunes, R. . (2024). Biomarker response in professional football athletes after matches: a sys-tematic review. Retos, 59, 435-443. https://doi.org/10.47197/retos.v59.107323
Docherty, S., Harley, R., McAuley, J. J., Crowe, L.A.N., Pedret, C., Kirwan, P.D., Siebert, S., & Millar, N.L. (2022). The effect of exercise on cytokines: Implications for musculoskeletal health—A narra-tive review. BMC Sports Science, Medicine and Rehabilitation, 14, 5. https://doi.org/10.1186/s13102-022-00397-2
Friedman, J. M. (2011). Leptin and the regulation of body weight. Keio Journal of Medicine, 60(1), 1–9. https://doi.org/10.2302/kjm.60.1
Frühbeck, G., Catalán, V., Rodríguez, A., Ramírez, B., Becerril, S., Salvador, J., Colina, I., & Gómez-Ambrosi, J. (2019). Adiponectin-leptin ratio is a functional biomarker of adipose tissue inflam-mation. Nutrients, 11(2), 454. https://doi.org/10.3390/nu11020454
Gleeson, M., Bishop, N. C., Stensel, D. J., Lindley, M. R., Mastana, S. S., & Nimmo, M. A. (2011). The anti-inflammatory effects of exercise: Mechanisms and implications for the prevention and treat-ment of disease. Nature Reviews Immunology, 11(9), 607–615. https://doi.org/10.1038/nri3041
Halson, S. L. (2014). Monitoring training load to understand fatigue in athletes. Sports Medicine, 44(Suppl 2), S139–S147. https://doi.org/10.1007/s40279-014-0253-z
Haller, N., Behringer, M., Reichel, T., Wahl, P., Simon, P., Krüger, K., Zimmer, P., & Stöggl, T. (2023). Blood-based biomarkers for managing workload in athletes: Considerations and recommenda-tions for evidence-based use of established biomarkers. Sports Medicine, 53, 1315–1333. https://doi.org/10.1007/s40279-023-01836-x
Herawati, L., Sari, G. M., Argarini, R., Irwadi, I., Wibowo, S., Wiriawan, O., Syaifudin, A., Pamungkas, Y., Handrito, R. P., Adi, S., Rahayuni, K., Azmy, U., & Safii, N. S. (2025). Profile of oxidative stress, inflammation, and muscle damage in professional athletes and recreational basketball players . Retos, 65, 235-245. https://doi.org/10.47197/retos.v65.111599
Jaspers, A., Brink, M. S., Probst, S. G. M., Frencken, W. G. P., & Helsen, W. F. (2017). Relationships be-tween training load indicators and training outcomes in professional soccer. Sports Medicine, 47, 533–544. https://doi.org/10.1007/s40279-016-0591-0
Karvinen, S., Sievänen, T., Karppinen, J. E., Hautasaari, P., Bart, G., Samoylenko, A., Vainio, S. J., Ahti-ainen, J. P., Laakkonen, E. K., & Kujala, U. M. (2020). MicroRNAs in extracellular vesicles in sweat change in response to endurance exercise. Frontiers in Physiology, 11, Article 676. https://doi.org/10.3389/fphys.2020.00676
Lee, E. C., Fragala, M. S., Kavouras, S. A., Queen, R. M., Pryor, J. L., & Casa, D. J. (2017). Biomarkers in sports and exercise: Tracking health, performance, and recovery in athletes. Journal of Strength and Conditioning Research, 31(10), 2920–2937. https://doi.org/10.1519/JSC.0000000000002122
Li, J., Hu, X., Xie, Z., Li, J., Huang, C., & Huang, Y. (2024). Overview of growth differentiation factor 15 (GDF15) in metabolic diseases. Biomedicine & Pharmacotherapy, 176, 116809. https://doi.org/10.1016/j.biopha.2024.116809
Lima, G. B., Figueiredo, N., Kattah, F. M., Oliveira, E. S., Horst, M. A., Dâmaso, A. R., Oyama, L. M., Whit-ton, R. G. M., de Souza, G. I. M. H., Lima, G. C., Mota, J. F., Campos, R. M. S., & Corgosinho, F. C. (2024). Serum fatty acids and inflammatory patterns in severe obesity: A preliminary investiga-tion in women. Biomedicines, 12(10), 2248. https://doi.org/10.3390/biomedicines12102248
Mallardo, M., D’Alleva, M., Lazzer, S., Giovanelli, N., Graniero, F., Billat, V., Fiori, F., Marinoni, M., Par-pinel, M., Daniele, A., & Nigro, E. (2023). Improvement of adiponectin in relation to physical performance and body composition in young obese males subjected to twenty-four weeks of training programs. Heliyon, 9(5), e15790. https://doi.org/10.1016/j.heliyon.2023.e15790
Mallardo, M., Tommasini, E., Missaglia, S., Pecci, C., Rampinini, E., Bosio, A., Morelli, A., Daniele, A., Nigro, E., & Tavian, D. (2024). Effects of exhaustive exercise on adiponectin and high-molecular-weight oligomer levels in male amateur athletes. Biomedicines, 12(8), 1743. https://doi.org/10.3390/biomedicines12081743
McFadden, B. A., Walker, A. J., Arent, M. A., Bozzini, B. N., Sanders, D. J., Cintineo, H. P., Bello, M. L., & Arent, S. M. (2020). Biomarkers correlate with body composition and performance changes throughout the season in women’s Division I collegiate soccer players. Frontiers in Sports and Active Living, 2, 74. https://doi.org/10.3389/fspor.2020.00074
Meeusen, R., Duclos, M., Foster, C., Fry, A., Gleeson, M., Nieman, D., Raglin, J., Rietjens, G., Steinacker, J., & Urhausen, A. (2013). Prevention, diagnosis, and treatment of the overtraining syndrome: Joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. Medicine & Science in Sports & Exercise, 45(1), 186–205. https://doi.org/10.1249/MSS.0b013e318279a10a
Miller, G. D., Teramoto, M., Smeal, S. J., Cushman, D., & Eichner, D. (2019). Assessing serum albumin concentration following exercise-induced fluid shifts in the context of the athlete biological passport. Drug Testing and Analysis, 11(6), 782–791. https://doi.org/10.1002/dta.2571
Miloski, B., de Freitas, V. H., Nakamura, F. Y., de A Nogueira, F. C., & Bara-Filho, M. G. (2016). Seasonal training load distribution of professional futsal players: Effects on physical fitness, muscle damage and hormonal status. Journal of Strength and Conditioning Research, 30(6), 1525–1533. https://doi.org/10.1519/JSC.0000000000001270
Nana, A., Slater, G. J., Stewart, A. D., & Burke, L. M. (2015). Methodology review: Using dual energy X-ray absorptiometry (DXA) for the assessment of body composition in athletes and active peo-ple. International Journal of Sport Nutrition and Exercise Metabolism, 25(2), 198–215. https://doi.org/10.1123/ijsnem.2013-0228
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., ... & Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Peake, J. M., Neubauer, O., Della Gatta, P. A., & Nosaka, K. (2017). Muscle damage and inflammation during recovery from exercise. Journal of Applied Physiology, 122(3), 559–570. https://doi.org/10.1152/japplphysiol.00971.2016
Pérez-Pérez, A., Sánchez-Jiménez, F., Vilariño-García, T., & Sánchez-Margalet, V. (2020). Role of leptin in inflammation and vice versa. International Journal of Molecular Sciences, 21(16), 5887. https://doi.org/10.3390/ijms21165887
Plews, D. J., Laursen, P. B., Kilding, A. E., & Buchheit, M. (2012). Heart rate variability in elite triath-letes: Is variation in variability the key to effective training? A case comparison. European Journal of Applied Physiology, 112(11), 3729–3741. https://doi.org/10.1007/s00421-012-2354-4
Podgórski, T., Kryściak, J., Pluta, B., Adrian, J., Marynowicz, J., Krzykała, M., Konefal, M., Chmura, P., Chmura, J., & Andrzejewski, M. (2021). A practical approach to monitoring biomarkers of in-flammation and muscle damage in youth soccer players during a 6-month training cycle. Jour-nal of Human Kinetics, 80, 185–197. https://doi.org/10.2478/hukin-2021-0041
Saita, Y., Hattori, K., Hokari, A., Ohyama, T., Inoue, J., Nishimura, T., Nemoto, S., & Aoyagi, S. (2023). Plasma myoglobin indicates muscle damage associated with acceleration/deceleration during football. Journal of Sports Medicine and Physical Fitness, 63(12), 1337–1342. https://doi.org/10.23736/S0022-4707.23.15203-0
Saw, A. E., Main, L. C., & Gastin, P. B. (2016). Monitoring the athlete training response: Subjective self-reported measures trump commonly used objective measures: A systematic review. British Journal of Sports Medicine, 50(5), 281–291. https://doi.org/10.1136/bjsports-2015-094758
Senkus, K. E., Crowe-White, K. M., Bolland, A. C., Locher, J.L., & Ard, J.D. (2022). Changes in adiponec-tin:leptin ratio among older adults with obesity following a 12-month exercise and diet inter-vention. Nutrition & Diabetes, 12, 30. https://doi.org/10.1038/s41387-022-00207-1
Slimani, M., Ghouili, H., Dhahbi, W., Farhani, Z., Ben Aissa, M., Souaifi, M., Guelmami, N., Dergaa, I., & Ben Ezzeddine, L. (2025). Position-specific biomarker responses to match vs. VAMEVAL test modalities in elite female soccer players: A comparative analysis study. Cogent Social Sciences, 11(1), 2447399. https://doi.org/10.1080/23311886.2024.2447399
Soler-López, A., Moreno-Villanueva, A., Gómez-Carmona, C. D., & Pino-Ortega, J. (2024). The role of biomarkers in monitoring chronic fatigue among male professional team athletes: A systematic review. Sensors, 24(21), 6862. https://doi.org/10.3390/s24216862
Souglis, A., Bogdanis, G. C., Chryssanthopoulos, C., Apostolidis, N., & Geladas, N. D. (2018). Time course of oxidative stress, inflammation, and muscle damage markers for 5 days after a soccer match: Effects of sex and playing position. Journal of Strength and Conditioning Research, 32(7), 2045–2054. https://doi.org/10.1519/JSC.0000000000002436
Tarabeih, N., Kalinkovich, A., Ashkenazi, S., Cherny, S. S., Shalata, A., & Livshits, G. (2024). Relation-ships between circulating biomarkers and body composition parameters in patients with meta-bolic syndrome: A community-based study. International Journal of Molecular Sciences, 25(2), 881. https://doi.org/10.3390/ijms25020881
Tylutka, A., Morawin, B., Torz, N., Osmolska, J., Łuszczki, K., Jarmużek, P., &Lacny, A.Z. (2024). Associa-tion of adipose tissue inflammation and physical fitness in older adults. Immunity & Ageing, 21, 64. https://doi.org/10.1186/s12979-024-00468-7
Uchiyama, E., Kinoshita, N., & Okuyama, K. (2023). Tracking body composition change with weight loss by BIA and DXA in female adolescent runners: A validation study. Exercise, Sport, and Move-ment, 1(2), e00003. https://doi.org/10.1249/ESM.0000000000000003
Wahl, Y., Achtzehn, S., Schäfer Olstad, D., Mester, J., & Wahl, P. (2021). Training load measures and biomarker responses during a 7-day training camp in young cyclists: A pilot study. Medicina (Kaunas), 57(7), 673. https://doi.org/10.3390/medicina57070673
Wang, L., Zhao, J., Schank, M., Hill, A. C., Banik, P., Zhang, Y., Wu, X. Y., Lightner, J. W., Ning, S., El Gaz-zar, M., Moorman, J. P., & Yao, Z. Q. (2024). Circulating GDF-15: A biomarker for metabolic dysregulation and aging in people living with HIV. Frontiers in Aging, 5, 1414866. https://doi.org/10.3389/fragi.2024.1414866
Wang, M., Yang, Y., Min, J., Song, Y., Tu, J., Mukasa, D., Ye, C., Xu, C., Heflin, N., McCune, J. S., Hsiai, T. K., Li, Z., & Gao, W. (2022). A wearable electrochemical biosensor for the monitoring of metabo-lites and nutrients. Nature Biomedical Engineering, 6(11), 1225–1235. https://doi.org/10.1038/s41551-022-00916-z
Yoshitake, R., Ogata, H., & Omi, N. (2024). Blood glucose levels during decathlon competition: An ob-servational study in timing of intake and competing time. Metabolites, 14(1), 47. https://doi.org/10.3390/metabo14010047
Zouhal, H., Saeidi, A., Salhi, A., Li, H., Essop, M. F., Laher, I., Rhibi, F., Amani-Shalamzari, S., & Ben Ab-derrahman, A. (2020). Exercise training and fasting: Current insights. Open Access Journal of Sports Medicine, 11, 1–28. https://doi.org/10.2147/OAJSM.S224919
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Ramdan Pelana, Sri Agung Fitri Kusuma

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and ensure the magazine the right to be the first publication of the work as licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of authorship of the work and the initial publication in this magazine.
- Authors can establish separate additional agreements for non-exclusive distribution of the version of the work published in the journal (eg, to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Is allowed and authors are encouraged to disseminate their work electronically (eg, in institutional repositories or on their own website) prior to and during the submission process, as it can lead to productive exchanges, as well as to a subpoena more Early and more of published work (See The Effect of Open Access) (in English).
This journal provides immediate open access to its content (BOAI, http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess) on the principle that making research freely available to the public supports a greater global exchange of knowledge. The authors may download the papers from the journal website, or will be provided with the PDF version of the article via e-mail.