{
  "abstract": "Objective To evaluate whether biomarkers of systemic inflammation and alterations in redox homeostasis, which we refer to as oxidative stress, associate with musculoskeletal injury (MSKI) during US Army Basic Combat Training (BCT) and to characterise longitudinal changes in these biomarkers throughout BCT.Methods This prospective observational study included 206 Army trainees (51% female) undergoing BCT. Blood samples were collected and analysed for high-sensitivity C reactive protein (hsCRP), free oxygen radical test (FORT), free oxygen radical defence (FORD) and Oxidative Stress Index (OSI=FORT/FORD). Injuries were identified using the International Classification of Diseases, Tenth Revision (ICD-10) codes. Mixed-effects logistic regression models assessed associations between biomarker levels and injury diagnosis over three timeframes (0–7 days before draw, 1–7 days following draw and 8–14 days following draw). Models included both chronic (between-person) and acute (within-person) biomarker components.Results Inflammation and oxidative stress biomarker associations with MSKI were strongest in the 0–7 days before and 0–7 days after injury diagnosis. Acute elevation in hsCRP (OR=1.41, 95% CI 1.03 to 1.93, p=0.034) was associated with 41% higher odds of injury diagnosis within the next 7 days. Chronically high hsCRP and OSI were also associated with increased MSKI risk (OR 2.27, 95% CI 1.22 to 4.19, p=0.01 and OR=1.72, 95% CI 1.01 to 2.92, p=0.046, respectively).Conclusion Elevated hsCRP and OSI were temporally associated with MSKI diagnoses during BCT, with the strongest associations in the week surrounding diagnosis. These associative findings may reflect heightened physiological stress and early injury-related tissue stress and repair responses.",
  "authors": [
    {
      "affiliations": [
        "Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA"
      ],
      "name": "Grace Guerin"
    },
    {
      "affiliations": [
        "US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA"
      ],
      "name": "Brittany N Bozzini"
    },
    {
      "affiliations": [
        "US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA"
      ],
      "name": "Marinaliz Reynoso"
    },
    {
      "affiliations": [
        "US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA"
      ],
      "name": "Katelyn Guerriere Aaron"
    },
    {
      "affiliations": [
        "US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA"
      ],
      "name": "Nicholas Zurinaga"
    },
    {
      "affiliations": [
        "Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA"
      ],
      "name": "Kathryn M Taylor"
    },
    {
      "affiliations": [
        "US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA",
        "Oak Ridge Associated Universities, Oak Ridge, Tennessee, USA"
      ],
      "name": "Ian Hussian"
    },
    {
      "affiliations": [
        "US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA"
      ],
      "name": "Kristin J Heaton"
    },
    {
      "affiliations": [
        "US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA"
      ],
      "name": "Jeffery S Staab"
    },
    {
      "affiliations": [
        "Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA"
      ],
      "name": "Stephen A Foulis"
    },
    {
      "affiliations": [
        "United Kingdom Sports Institute, University of Bath, Bath, UK",
        "Orreco Limited, Galway, County Galway, Ireland"
      ],
      "name": "Nathan A Lewis"
    },
    {
      "affiliations": [
        "Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA",
        "Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"
      ],
      "name": "Mary L Bouxsein"
    },
    {
      "affiliations": [
        "St Mary’s University Faculty of Sport Allied Health and Performance Sciences, Twickenham, UK",
        "Institute of Sport, Exercise and Health Sciences, University College London, London, UK"
      ],
      "name": "Charles Pedlar"
    },
    {
      "affiliations": [
        "US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA"
      ],
      "name": "Julie M Hughes"
    },
    {
      "affiliations": [
        "US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA",
        "TRIA Orthopedic Center, Bloomington, Indiana, USA"
      ],
      "name": "Kristin L Popp"
    }
  ],
  "title": "Inflammation and alterations in redox homeostasis precede and persist following musculoskeletal injury in US army trainees",
  "uid": "4e5f6983-ec39-5671-830e-e19e0172bb84"
}