From the Departments of Clinical and Health Psychology (B.M.A., R.M.B., Z.M.H., C.C.M.), Neurology (R.M.B., S.T.D., M.S.J., J.R.C.), and Community Health and Family Medicine (J.R.C.), and University Athletic Association (J.R.C.), University of Florida, Gainesville; and Banyan Biomarkers, Inc. (A.G.W.), Alachua, FL.
Neurology. 2018 Dec 4;91(23):e2109-e2122. doi: 10.1212/WNL.0000000000006613. Epub 2018 Nov 7.
To describe variability in concussion biomarker concentrations collected from serum in a sample of healthy collegiate athletes, as well as report reliability metrics in a subsample of female athletes.
In this observational cohort study, β-amyloid peptide 42 (Aβ), total tau, S100 calcium binding protein B (S100B), ubiquitin carboxy-terminal hydrolyzing enzyme L1 (UCH-L1), glial fibrillary acidic protein, microtubule associated protein 2, and 2',3'-cyclic-nucleotide 3'-phosphodiesterase (CNPase) serum concentrations were measured in 415 (61% male, 40% white, aged 19.0 ± 1.2 years) nonconcussed collegiate athletes without recent exposure to head impacts. Standardized normative distributions are reported for each biomarker. We evaluated main effects (analyses of variance) of sex and race, reporting demographic-specific normative metrics when appropriate. In a subset of 31 female participants, test-retest reliability (Pearson ) and reliable change indices (80%, 90%, and 95% confidence intervals) across a 6- to 12-month interval are reported for Aβ, total tau, S100B, and UCH-L1.
Males exhibited higher UCH-L1 ( < 0.001, Cohen = 0.75) and S100B ( < 0.001, = 0.56) than females, while females had higher CNPase ( < 0.001, = 0.43). Regarding race, black participants had higher baseline levels of UCH-L1 ( < 0.001, = 0.61) and S100B ( < 0.001, = 1.1) than white participants. Conversely, white participants had higher baseline levels of Aβ ( = 0.005, = 0.28) and CNPase ( < 0.001, = 0.46). Test-retest reliability was generally poor, ranging from -0.02 to 0.40, and Aβ significantly increased from time 1 to time 2.
Healthy collegiate athletes express concussion-related serum biomarkers in variable concentrations. Accounting for demographic factors such as sex and race is essential. Evidence suggested poor reliability for serum biomarkers; however, understanding how other factors influence biomarker expression, as well as knowledge of reliable change metrics, may improve clinical interpretation and future study designs.
描述健康大学生运动员血清中脑震荡生物标志物浓度的变异性，并报告女性运动员亚组的可靠性指标。
在这项观察性队列研究中，测量了 415 名（61%为男性，40%为白人，年龄 19.0±1.2 岁）无近期头部撞击史的无脑震荡大学生运动员的β-淀粉样肽 42（Aβ）、总 tau、S100 钙结合蛋白 B（S100B）、泛素羧基末端水解酶 L1（UCH-L1）、神经胶质纤维酸性蛋白、微管相关蛋白 2 和 2',3'-环核苷酸 3'-磷酸二酯酶（CNPase）的血清浓度。为每个生物标志物报告了标准化的正态分布。我们评估了性别和种族的主要效应（方差分析），并在适当情况下报告了特定于人口统计学的正态指标。在 31 名女性参与者的亚组中，报告了 Aβ、总 tau、S100B 和 UCH-L1 在 6 至 12 个月间隔内的测试-重测可靠性（Pearson）和可靠变化指数（80%、90%和 95%置信区间）。
男性的 UCH-L1（<0.001，=0.75）和 S100B（<0.001，=0.56）水平高于女性，而女性的 CNPase（<0.001，=0.43）水平高于男性。关于种族，黑人参与者的 UCH-L1（<0.001，=0.61）和 S100B（<0.001，=1.1）的基线水平高于白人参与者。相反，白人参与者的 Aβ（=0.005，=0.28）和 CNPase（<0.001，=0.46）的基线水平较高。测试-重测可靠性通常较差，范围为-0.02 至 0.40，并且 Aβ 从第 1 次测量到第 2 次测量显著增加。
健康的大学生运动员以不同的浓度表达与脑震荡相关的血清生物标志物。考虑到性别和种族等人口统计学因素至关重要。证据表明，血清生物标志物的可靠性较差；但是，了解其他因素如何影响生物标志物的表达以及可靠变化指标的知识，可能会改善临床解释和未来的研究设计。
