{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T20:11:52Z","timestamp":1784232712945,"version":"3.55.0"},"reference-count":46,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T00:00:00Z","timestamp":1774051200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Congested tournament schedules impose substantial physiological stress in team sports; however, the integrated endocrine and inflammatory responses to real competitive match load in female handball players remain insufficiently characterized. Objective: This study aimed to characterize the acute biochemical responses, including hormonal, inflammatory, muscle damage, and bone metabolism markers, elicited by competitive tournament load in female handball players and to provide practical insights for optimizing recovery strategies and load management during short-term competitive periods. Methods: In a pre\u2013post study design, venous blood samples were collected from competitive female athletes (n = 8; age 20.83 \u00b1 2.93 years) before the first match and after the fourth consecutive match of an official university qualification tournament. Biochemical analyses included cortisol, insulin, IL-6, creatine kinase (CK), IGF-1, irisin, lactate dehydrogenase (LDH), osteocalcin, and testosterone. Pre-to-post changes were assessed using paired t-tests and effect sizes. Results: Tournament load induced substantial multisystem physiological perturbations. Significant increases were observed in cortisol (p &lt; 0.001), insulin (p = 0.044), IL-6 (p &lt; 0.001), CK (p &lt; 0.001), and osteocalcin (p = 0.005), indicating activation of the hypothalamic\u2013pituitary\u2013adrenal axis, systemic inflammation, muscle membrane disruption, and enhanced bone turnover. Conversely, IGF-1 (p &lt; 0.001) and testosterone (p = 0.004) significantly decreased, reflecting suppression of anabolic signaling and a shift toward a catabolic hormonal environment under cumulative match stress. LDH significantly decreased (p = 0.002), while irisin showed no significant change (p &gt; 0.05). Conclusions: These findings demonstrate that congested tournament schedules provoke an integrated endocrine\u2013inflammatory stress response in female handball players. Importantly, the observed anabolic\u2013catabolic imbalance highlights the need for individualized recovery strategies, optimized load management, and adequate recovery periods to mitigate maladaptation and reduce injury risk during short-term competitive tournaments.<\/jats:p>","DOI":"10.3390\/life16030523","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T13:07:06Z","timestamp":1774271226000},"page":"523","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Acute Biochemical Responses to Competitive Tournament Load in Female Handball Players: Hormonal, Inflammatory and Muscle Damage Markers"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1659-2157","authenticated-orcid":false,"given":"Zarife","family":"Pancar","sequence":"first","affiliation":[{"name":"Department of Physical Education and Sports, Faculty of Sports Science, Gaziantep University, Gaziantep 27350, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6891-9916","authenticated-orcid":false,"given":"Y\u00fccel","family":"Makarac\u0131","sequence":"additional","affiliation":[{"name":"Department of Coaching Education, Faculty of Sports Sciences, Karamano\u011flu Mehmetbey University, Karaman 70100, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5568-1331","authenticated-orcid":false,"given":"Celal","family":"Gen\u00e7o\u011flu","sequence":"additional","affiliation":[{"name":"Department of Physical Education and Sports Teaching, Faculty of Sport Sciences, Dokuz Eyl\u00fcl University, \u0130zmir 35390, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0597-5689","authenticated-orcid":false,"given":"Burak","family":"Karaca","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, Department of Physical Education and Sports, Gaziantep University, Gaziantep 27310, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3890-2088","authenticated-orcid":false,"given":"Hasan","family":"Ulusal","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Faculty of Medicine, Gaziantep Islam Science and Technology University, Gaziantep 27010, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,21]]},"reference":[{"key":"ref_1","first-page":"878","article-title":"Physical demands in elite team handball: Comparisons between male and female players","volume":"55","author":"Michalsik","year":"2015","journal-title":"J. Sports Med. Phys. Fit."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1519\/JSC.0b013e3182a953b1","article-title":"Physiological demands of elite team handball with special reference to playing position","volume":"28","author":"Seabra","year":"2014","journal-title":"J. Strength Cond. Res."},{"key":"ref_3","first-page":"595","article-title":"Match performance and physiological capacity of female elite team handball players","volume":"35","author":"Michalsik","year":"2014","journal-title":"Int. J. Sports Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1519\/JSC.0b013e3182891535","article-title":"Performance factors in women\u2019s team handball: Physical and physiological aspects\u2014A review","volume":"27","author":"Manchado","year":"2013","journal-title":"J. Strength Cond. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s00421-009-1200-9","article-title":"Time course of changes in immunoendocrine markers following an international rugby game","volume":"108","author":"Cunniffe","year":"2010","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Morgans, R., Orme, P., Bezuglov, E., Di Michele, R., and Moreira, A. (2022). The immunological and hormonal responses to competitive match-play in elite soccer players. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191811784"},{"key":"ref_7","first-page":"73","article-title":"Specific physiological and biomechanical performance in elite, sub-elite and non-elite male team handball players","volume":"58","author":"Wagner","year":"2018","journal-title":"J. Sports Med. Phys. Fit."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"804873","DOI":"10.1155\/2011\/804873","article-title":"Cytokines and oxidative stress status following a handball game in elite male players","volume":"2011","author":"Marin","year":"2011","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_9","first-page":"808","article-title":"Individual and team performance in team-handball: A review","volume":"13","author":"Wagner","year":"2014","journal-title":"J. Sports Sci. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1002\/j.2040-4603.2013.tb00522.x","article-title":"Muscle as a secretory organ","volume":"3","author":"Pedersen","year":"2013","journal-title":"Compr. Physiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1007\/s11914-020-00599-y","article-title":"Muscle, bone, and fat crosstalk: The biological role of myokines, osteokines, and adipokines","volume":"18","author":"Kirk","year":"2020","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1007\/s00421-009-1139-x","article-title":"Cytokine and hormone responses to resistance training","volume":"107","author":"Izquierdo","year":"2009","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1093\/bmb\/ldm014","article-title":"Creatine kinase monitoring in sport medicine","volume":"81\u201382","author":"Brancaccio","year":"2007","journal-title":"Br. Med. Bull."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1055\/s-0044-101147","article-title":"The impact of soccer match play on the muscle damage response in youth female athletes","volume":"39","author":"Hughes","year":"2018","journal-title":"Int. J. Sports Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"103","DOI":"10.2165\/11539170-000000000-00000","article-title":"Two emerging concepts for elite athletes: The short-term effects of testosterone and cortisol on the neuromuscular system and the dose\u2013response training role of these endogenous hormones","volume":"41","author":"Crewther","year":"2011","journal-title":"Sports Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1007\/s13105-014-0368-6","article-title":"Critical difference applied to exercise-induced salivary testosterone and cortisol using enzyme-linked immunosorbent assay (ELISA): Distinguishing biological from statistical change","volume":"70","author":"Hayes","year":"2014","journal-title":"J. Physiol. Biochem."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s40279-021-01508-8","article-title":"Recommendations and nutritional considerations for female athletes: Health and performance","volume":"51","author":"Holtzman","year":"2021","journal-title":"Sports Med."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Welde, B., Kellawan, J.M., Larson, R.D., Morseth, B., Osborne, J.O., and Sandbakk, \u00d8. (2024). Editorial: The physiology of the female athlete\u2014Performance, health, and recovery. Front. Sports Act. Living, 6.","DOI":"10.3389\/fspor.2024.1433336"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s00421-012-2421-x","article-title":"Associations between Borg\u2019s rating of perceived exertion and physiological measures of exercise intensity","volume":"113","author":"Scherr","year":"2013","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"pdb.prot093740","DOI":"10.1101\/pdb.prot093740","article-title":"Direct competitive enzyme-linked immunosorbent assay (ELISA)","volume":"2017","author":"Kohl","year":"2017","journal-title":"Cold Spring Harb. Protoc."},{"key":"ref_21","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, Routledge Academic. [2nd ed.]."},{"key":"ref_22","unstructured":"Kazdin, A.E. (2016). An effect size primer: A guide for clinicians and researchers. Methodological Issues and Strategies in Clinical Research, American Psychological Association. [4th ed.]."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"253","DOI":"10.2478\/hukin-2019-0111","article-title":"Physical and physiological demands during handball matches in male adolescent players","volume":"72","year":"2020","journal-title":"J. Hum. Kinet."},{"key":"ref_24","first-page":"590","article-title":"Locomotion characteristics and match-induced impairments in physical performance in male elite team handball players","volume":"34","author":"Michalsik","year":"2013","journal-title":"Int. J. Sports Med."},{"key":"ref_25","first-page":"1","article-title":"Metabolic markers in sports medicine","volume":"56","author":"Banfi","year":"2012","journal-title":"Adv. Clin. Chem."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"833","DOI":"10.2165\/00007256-200333110-00004","article-title":"Effects of the menstrual cycle on exercise performance","volume":"33","year":"2003","journal-title":"Sports Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1210\/jc.2002-020369","article-title":"Luteinizing hormone pulsatility is disrupted at a threshold of energy availability in regularly menstruating women","volume":"88","author":"Loucks","year":"2003","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e158218","DOI":"10.5812\/mcj-158218","article-title":"Effects of Team Sports on Female Testosterone and Cortisol Hormones: A Systematic Review","volume":"22","author":"Khaleghi","year":"2025","journal-title":"Mod. Care J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"19554","DOI":"10.1038\/s41598-019-56090-x","article-title":"Changes in different salivary biomarkers related to physiologic stress in elite handball players: The case of females","volume":"9","author":"Mariscal","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Cselko, A., Szabo, E.I., Vaczi, M., Koszegi, T., Tekus, E., and Wilhelm, M. (2021). Relationship between anthropometric, physical and hormonal parameters among pre-pubertal handball players. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18199977"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Hackney, A.C. (2020). Hypogonadism in exercising males: Dysfunction or adaptive\u2013regulatory adjustment? Front. Endocrinol., 11.","DOI":"10.3389\/fendo.2020.00011"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1136\/bjsports-2018-099193","article-title":"IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update","volume":"52","author":"Mountjoy","year":"2018","journal-title":"Br. J. Sports Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1152\/japplphysiol.00223.2025","article-title":"Effects of menstrual cycle phases on athletic performance and related physiological outcomes: A systematic review of studies using high methodological standards","volume":"139","author":"Schlie","year":"2025","journal-title":"J. Appl. Physiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"S139","DOI":"10.1007\/s40279-014-0253-z","article-title":"Monitoring training load to understand fatigue in athletes","volume":"44","author":"Halson","year":"2014","journal-title":"Sports Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1249\/MSS.0b013e318279a10a","article-title":"Prevention, diagnosis, and treatment of the overtraining syndrome: Joint consensus statement of the European College of Sport Science and the American College of Sports Medicine","volume":"45","author":"Meeusen","year":"2013","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"906","DOI":"10.4085\/1062-6050-148-18","article-title":"Basal hormones and biochemical markers as predictors of overtraining syndrome in male athletes: The EROS-BASAL study","volume":"54","author":"Cadegiani","year":"2019","journal-title":"J. Athl. Train."},{"key":"ref_37","first-page":"553","article-title":"Short-term bone biochemical response to a single bout of high-impact exercise","volume":"8","author":"Rantalainen","year":"2009","journal-title":"J. Sports Sci. Med."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Zhang, W., Wang, X., Liu, Y., He, Q., Ding, Q., Mei, J., and Li, X. (2024). Effects of exercise on bone mass and bone metabolism in adolescents: A systematic review and meta-analysis. Front. Physiol., 15.","DOI":"10.3389\/fphys.2024.1512822"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1146\/annurev-nutr-061121-091348","article-title":"Osteocalcin: A Multifaceted Bone-Derived Hormone","volume":"43","author":"Karsenty","year":"2023","journal-title":"Annu. Rev. Nutr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"117238","DOI":"10.1016\/j.bone.2024.117238","article-title":"The role of bone in energy metabolism: A focus on osteocalcin","volume":"188","author":"Smith","year":"2024","journal-title":"Bone"},{"key":"ref_41","first-page":"360","article-title":"Osteocalcin: A new link between bone and energy metabolism. Some evolutionary clues","volume":"14","author":"Ricart","year":"2011","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1249\/MSS.0b013e31820abc5a","article-title":"Intermittent-Sprint Performance and Muscle Glycogen after 30 h of Sleep Deprivation","volume":"43","author":"Skein","year":"2011","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_43","first-page":"131","article-title":"Regulation of Muscle Glycogen Repletion, Muscle Protein Synthesis and Repair following Exercise","volume":"3","author":"Ivy","year":"2004","journal-title":"J. Sports Sci. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1152\/japplphysiol.00860.2016","article-title":"Postexercise Muscle Glycogen Resynthesis in Humans","volume":"122","author":"Burke","year":"2017","journal-title":"J. Appl. Physiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1046\/j.1365-201x.1999.00517.x","article-title":"High-Intensity Exercise and Muscle Glycogen Availability in Humans","volume":"165","author":"Balsom","year":"1999","journal-title":"Acta Physiol. Scand."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Carmichael, M.A., Thomson, R.L., Moran, L.J., and Wycherley, T.P. (2021). The Impact of Menstrual Cycle Phase on Athletes\u2019 Performance: A Narrative Review. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18041667"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/3\/523\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T13:20:13Z","timestamp":1774272013000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/3\/523"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,21]]},"references-count":46,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["life16030523"],"URL":"https:\/\/doi.org\/10.3390\/life16030523","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,21]]}}}