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

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

doi:10.3390/life16020320

Open AccessArticle

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

by

Matija Dvorski

¹

,

Marija Rakovac

^2,*

,

Tomislav Kelava

^3,4,

Nataša Kovačić

^3,5,

Darja Flegar

^3,4,

Sara Aničić

^3,4,

Ivo Krešić

^3,6

,

Ljiljana Ćulibrk

⁷,

Filip Koražija

⁸,

Damjan Dimnjaković

⁹

and

Alan Šućur

^3,4

¹

Department of Environmental and Occupational Health and Sports Medicine, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia

²

Department of Kinesiological Anthropology and Methodology, Faculty of Kinesiology, University of Zagreb, 10110 Zagreb, Croatia

³

Laboratory for Molecular Immunology, Croatian Institute for Brain Research, University of Zagreb, 10000 Zagreb, Croatia

⁴

Department of Physiology and Immunology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia

⁵

Department of Anatomy, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia

⁶

Department of Physiology, School of Medicine, University of Mostar, 88000 Mostar, Bosnia and Herzegovina

⁷

Athletic Club Agram, 10000 Zagreb, Croatia

⁸

Running Club and Academy Trčaona, 10000 Zagreb, Croatia

⁹

Department of Orthopaedic Surgery, University Hospital Centre Zagreb, 10000 Zagreb, Croatia

^*

Author to whom correspondence should be addressed.

Life 2026, 16(2), 320; https://doi.org/10.3390/life16020320

Submission received: 22 January 2026 / Revised: 10 February 2026 / Accepted: 10 February 2026 / Published: 12 February 2026

(This article belongs to the Special Issue Advances and Applications of Sport Physiology: 2nd Edition)

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Abstract

Conventional measures such as maximal oxygen uptake (

\dot{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

\dot{V}

O₂max are needed before practical application can be recommended.

Keywords: blood-based biomarkers; brain-derived neurotrophic factor; cardiorespiratory fitness; decorin; hypoxanthine; prediction model; running performance; N-terminal pro-B-type natriuretic peptide

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MDPI and ACS Style

Dvorski, M.; Rakovac, M.; Kelava, T.; Kovačić, N.; Flegar, D.; Aničić, S.; Krešić, I.; Ćulibrk, L.; Koražija, F.; Dimnjaković, D.; et al. Can Non-Conventional Blood Biomarkers Improve Running Performance Prediction? A Proof of Concept. Life 2026, 16, 320. https://doi.org/10.3390/life16020320

AMA Style

Dvorski M, Rakovac M, Kelava T, Kovačić N, Flegar D, Aničić S, Krešić I, Ćulibrk L, Koražija F, Dimnjaković D, et al. Can Non-Conventional Blood Biomarkers Improve Running Performance Prediction? A Proof of Concept. Life. 2026; 16(2):320. https://doi.org/10.3390/life16020320

Chicago/Turabian Style

Dvorski, Matija, Marija Rakovac, Tomislav Kelava, Nataša Kovačić, Darja Flegar, Sara Aničić, Ivo Krešić, Ljiljana Ćulibrk, Filip Koražija, Damjan Dimnjaković, and et al. 2026. "Can Non-Conventional Blood Biomarkers Improve Running Performance Prediction? A Proof of Concept" Life 16, no. 2: 320. https://doi.org/10.3390/life16020320

APA Style

Dvorski, M., Rakovac, M., Kelava, T., Kovačić, N., Flegar, D., Aničić, S., Krešić, I., Ćulibrk, L., Koražija, F., Dimnjaković, D., & Šućur, A. (2026). Can Non-Conventional Blood Biomarkers Improve Running Performance Prediction? A Proof of Concept. Life, 16(2), 320. https://doi.org/10.3390/life16020320

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

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