# Can Non-Conventional Blood Biomarkers Improve Running Performance Prediction? A Proof of Concept

**Authors:** Matija Dvorski, Marija Rakovac, Tomislav Kelava, Nataša Kovačić, Darja Flegar, Sara Aničić, Ivo Krešić, Ljiljana Ćulibrk, Filip Koražija, Damjan Dimnjaković, Alan Šućur

PMC · DOI: 10.3390/life16020320 · 2026-02-12

## TL;DR

This study explores if blood biomarkers like decorin can improve predictions of running performance beyond traditional measures like VO2max.

## Contribution

The study introduces the potential of non-conventional blood biomarkers to enhance performance prediction in runners.

## Key findings

- The Cooper test caused significant changes in decorin, hypoxanthine, and BDNF.
- Higher post-test decorin and hypoxanthine were linked to faster Cooper test performance.
- Adding decorin to conventional predictors slightly reduced 10 km race time prediction error.

## Abstract

Conventional measures such as maximal oxygen uptake (V˙O2max), although widely regarded as the gold standard, do not fully capture endurance performance. Therefore, this study investigated whether a 2.4 km Cooper test elicits measurable changes in blood-based biomarkers (decorin, hypoxanthine, N-terminal pro-B-type natriuretic peptide (NT-proBNP), brain-derived neurotrophic factor (BDNF)) and whether integrating these markers may improve performance prediction in a heterogeneous sample of runners. In this cross-sectional observational proof-of-concept study, thirty-three participants completed the 2.4 km Cooper test, with venous blood samples collected at baseline and post-test. Non-parametric statistical tests were used to assess biomarker changes (α = 0.05), with exploratory correlations evaluated using Spearman’s ρ. To examine whether blood-based biomarkers provide information beyond conventional field-based predictors, Ridge regression with leave-one-out cross-validation (LOOCV) was applied to predict 10 km race time in a subsample of 24 participants who completed a 10 km race two weeks later. The Cooper test elicited significant post-test changes in decorin, hypoxanthine, and BDNF (all p < 0.001). Higher post-test decorin (ρ = −0.44, p = 0.010) and hypoxanthine (ρ = −0.37, p = 0.034) were associated with faster Cooper test performance. In Ridge regression analysis, adding post-test decorin to conventional predictors resulted in a minor reduction of 10 km race time prediction error. This study suggests that decorin may provide complementary information to a conventional field-based test in heterogeneous recreational runners. Post-test decorin marginally contributed to 10 km race performance prediction beyond established predictors, though external validation and comparison with directly measured V˙O2max are needed before practical application can be recommended.

## Linked entities

- **Proteins:** dcn.S (decorin S homeolog)
- **Chemicals:** hypoxanthine (PubChem CID 135398638)

## Full-text entities

- **Genes:** DCN (decorin) [NCBI Gene 1634] {aka CSCD, DSPG2, PG40, PGII, PGS2, SLRR1B}, GH1 (growth hormone 1) [NCBI Gene 2688] {aka GH, GH-N, GHB5, GHN, IGHD1A, IGHD1B}, CMPK1 (cytidine/uridine monophosphate kinase 1) [NCBI Gene 51727] {aka CK, CMK, CMPK, UMK, UMP-CMPK, UMPK}, TRBV20OR9-2 (T cell receptor beta variable 20/OR9-2 (non-functional)) [NCBI Gene 6962] {aka CDR3, TCRBV20S2, TCRBV2O, TCRBV2S2O}, MSTN (myostatin) [NCBI Gene 2660] {aka GDF8, MSLHP}, BDNF (brain derived neurotrophic factor) [NCBI Gene 627] {aka ANON2, BULN2}
- **Diseases:** muscle hypertrophy (MESH:C536106), systemic (MESH:D015619), neuroinflammation (MESH:D000090862), injury to (MESH:D014947), Lactate (MESH:D007775), inflammation (MESH:D007249), muscle damage (MESH:D009133), fatigue (MESH:D005221)
- **Chemicals:** purine nucleotide (MESH:D011685), Cooper (-), caffeine (MESH:D002110), alcohol (MESH:D000438), ATP (MESH:D000255), purine (MESH:C030985), EDTA (MESH:D004492), cortisol (MESH:D006854), lactate (MESH:D019344), oxygen (MESH:D010100), Hypoxanthine (MESH:D019271), salt (MESH:D012492), Xanthine (MESH:D019820), testosterone (MESH:D013739)
- **Species:** Homo sapiens (human, species) [taxon 9606], Nicotiana tabacum (American tobacco, species) [taxon 4097]

## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12941692/full.md

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Source: https://tomesphere.com/paper/PMC12941692