To investigate acute changes in biochemical markers of bone and cartilage turnover in response to moderate intensity exercise with and without joint impact in healthy human subjects.
A randomized, cross-over, exploratory, clinical study was conducted. Twenty healthy subjects with no history of joint trauma completed 30 min interventions of standardized moderate intensity cycling and running as well as a resting intervention 1 week apart. Blood samples were taken immediately before, four times after exercise and again the next day. Urine was sampled, before, after and the next day. On the day of rest, samples were taken at timepoints similar to the days of exercise. Markers of type I (CTX-I), II (C2M, CTX-II) and VI (C6M) collagen degradation, cartilage oligomeric matrix protein (COMP) and procollagen C-2 (PRO-C2) was measured. Trial registration number: NCT04542655, 02 September 2020, retrospectively registered.
CTX-I was different from cycling (4.2%, 95%CI: 0.4–8.0%, p = 0.03) and resting (6.8%, 95%CI: 2.9–10.7%, p = 0.001) after running and the mean change in COMP was different from cycling (10.3%, 95%CI: 1.1–19.5%, p = 0.03), but not from resting (8.6%, 95%CI: − 0.7–17.8%, p = 0.07) after running. Overall, changes in other biomarkers were not different between interventions.
In this exploratory study, running, but not cycling, at a moderate intensity and duration induced acute changes in biomarkers of bone and cartilage extra-cellular matrix turnover.
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Body mass index
Coefficient of variation
Cartilage oligomeric matrix protein
C-terminal telopeptide of type I collagen
C-terminal telopeptide of type II collagen
MMP-generated fragment of type II collagen
MMP-generated fragment of type VI collagen
Enzyme-linked immunosorbent assays
Knee injury and osteoarthritis outcome score
Lower limit og quantification
Magnetic resonance imaging
Procollagen type II
Standard error of the mean
Upper limit of quantification
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The authors thank Heidi Rønberg for lab assistance, Melanie Kurell and Sarah á Rogvi for clinical assistance and Dr. Kamilla Mundbjerg for technical support.
This study was funded by Nordic Bioscience Clinical Development and the Danish Research Fund.
Conflicts of interest
JJB received funding from Nordic Bioscience Clinical Development and the Danish Research Fund. IB and CT are full-time employees of Nordic Bioscience. JRA, MK and ARB are full-time employees and shareholders of Nordic Bioscience. MB and ALM have no conflict of interest.
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Communicated by Kirsty Elliott-Sale.
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Bjerre-Bastos, J.J., Nielsen, H.B., Andersen, J.R. et al. A biomarker perspective on the acute effect of exercise with and without impact on joint tissue turnover: an exploratory randomized cross-over study. Eur J Appl Physiol 121, 2799–2809 (2021). https://doi.org/10.1007/s00421-021-04751-z