Abstract
To date, sport-related concussion diagnosis and management is primarily based on subjective clinical tests in the absence of validated biomarkers. A major obstacle to clinical validation and application is a lack of studies exploring potential biomarkers in non-injured populations. This cross-sectional study examined the associations between saliva telomere length (TL) and multiple confounding variables in a healthy university athlete population. One hundred eighty-three (108 male and 75 female) uninjured varsity athletes were recruited to the study and provided saliva samples at either pre- or mid-season, for TL analysis. Multiple linear regression was used to determine the associations between saliva TL and history of concussion, sport contact type, time in season (pre vs. mid-season collection), age, and sex. Results showed no significant associations between TL and history of concussion, age, or sport contact type. However, TL from samples collected mid-season were longer than those collected pre-season [β = 231.4, 95% CI (61.9, 401.0), p = 0.008], and males had longer TL than females [β = 284.8, 95% CI (111.5, 458.2), p = 0.001] when adjusting for all other variables in the model. These findings population suggest that multiple variables may influence TL. Future studies should consider these confounders when evaluating saliva TL as a plausible fluid biomarker for SRC.
Highlights
Mild traumatic brain injury is a prevalent health concern, affecting almost 34 million people worldwide and an estimated 350,000 Canadians annually (Arciniegas et al, 2005; Brain, 2007; Prins et al, 2013; Gardner and Yaffe, 2015)
We sought to examine a fluid biomarker of interest, saliva telomere length (TL), in an uninjured varsity athlete population to explore the effects of multiple common confounders
When controlling for all variables, we found saliva sampled from athletes participating in sport mid-season had longer TL than saliva sampled from athletes participating in sport pre-season
Summary
Mild traumatic brain injury (mTBI) is a prevalent health concern, affecting almost 34 million people worldwide and an estimated 350,000 Canadians annually (Arciniegas et al, 2005; Brain, 2007; Prins et al, 2013; Gardner and Yaffe, 2015). The third leading cause of mTBI is sports and recreation (Canadian Institute for Health Information, 2006), with up to 15% of athletes reporting one or more sport-related concussions (SRC) in their season (Harmon et al, 2013). The international consensus statement on concussion in sport recommends assessment of acute SRC with the sport concussion assessment tool-5 (SCAT5) (McCrory et al, 2016). Telomere Length in Healthy Athletes such as imaging and fluid biomarkers, hold promise but are still in their infancy of diagnostic accuracy for SRC. To better understand the utility of fluid biomarkers for diagnosis and prognosis, exploration of the biomarker of interest requires extensive investigation in a non-injured population. We sought to examine a fluid biomarker of interest, saliva telomere length (TL), in an uninjured varsity athlete population to explore the effects of multiple common confounders. Damage to the central nervous system (CNS) may be reflected in saliva TL (derived from buccal cell DNA), as brain damage and a compromised blood-brain barrier induces an increased immune response and systemic oxidative stress to cells in the periphery (Friedrich et al, 2000; Hehar and Mychasiuk, 2016; Aaron Dadas, 2018; Demanelis et al, 2020)
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