12 (1B) Kynurenine pathway and inflammation biomarkers, concussion history, and hormonal contraception use in female athletes
Year: 2025
Type: conference-paper
Abstract: Purpose Prior evidence suggests that kynurenine pathway (KP) metabolites and peripheral inflammatory markers are associated with concussion history. Hormonal contraceptives (HC) also affect these markers; however, prior work in female athletes has not accounted for HC use. We tested the hypotheses that HC use moderates associations of KP metabolites (kynurenic acid (KynA), quinolinic acid (QuinA), and their ratio (KynA/QuinA) and inflammatory markers (interleukin (IL)-6, IL-1 receptor antagonist (RA), c-reactive protein (CRP)) with the number of prior concussions.Methods Collegiate female athletes (N=77; 39 using HC) enrolled in a larger cross-sectional study. Semi-structured interviews retrospectively determined number of prior concussions (at least 6 months before study enrollment) consistent with the 1993 American Congress of Rehabilitation Medicine definition. Linear models examined relationships of number of prior concussions, HC use, and the HC-by-prior concussions interaction on log transformed serum concentrations of KP metabolites and inflammatory markers, controlling for years of contact sport exposure.Results QuinA increased with increased number of concussions (Beta[B](standard error)=0.067(0.021), 95% confidence interval(CI)=[0.026, 0.11], t=3.22 p=0.0019). HC use was associated with higher levels of CRP (B=1.96(0.31), 95% CI=[1.34, 2.57], t=6.35 p=1.7E-8), IL6 (B=0.61(0.18), 95% CI=[0.25,0.97], t=3.41 p=0.0011), and QuinA (B=0.13(0.054), 95% CI=[0.025, 0.24], t=2.43 p=0.018), and lower KynA (B=-0.23(0.081), 95% CI=[-0.39, -0.071], t=-2.87 p=0.0054) and KynA/QuinA (B=-0.36(0.080), 95% CI=[-0.52, -0.20], t=-4.53 p=2.3E-5). No significant interactions were found.Conclusions Results indicate increased QuinA with concussion history and associations of biomarkers with HC use. Future work should investigate HC associations with biomarkers in the acute/subacute timeframes and include HC formulation information.
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,839
OpenAlex ID: W4410951561