Skip to main content
Have a personal or library account? Click to login
Metabolic syndrome outcomes and insulin resistance among former elite middle-aged combat sports athletes with a history of rapid weight loss: A case–control study Cover

Metabolic syndrome outcomes and insulin resistance among former elite middle-aged combat sports athletes with a history of rapid weight loss: A case–control study

Open Access
|Sep 2026

References

  1. Altowerqi, Z. M., & Zainuddin, Z. A. B. (2021). Comparison of metabolic syndrome, uric acid and leisure time physical activity between former athletes and non-athlees. Journal of Pharmaceutical Research International, 32(48), 85–95. https://doi.org/10.9734/jpri/2020/v32i4831128
  2. Altowerqi, Z. M., Zainuddin, Z. A. B., Hashim, A. H. B. M., & Almarwaey, A. O. (2020). Are former athletes protected against obesity after retirement? Indian Journal of Public Health Research & Development, 11(2), 1995–2000. https://doi.org/10.37506/v11/i2/2020/ijphrd/195123
  3. Artioli, G. G., Gualano, B., Franchini, E., Scagliusi, F. B., Takesian, M., Fuchs, M., & Lancha, A. H. (2010). Prevalence, magnitude, and methods of rapid weight loss among judo competitors. Medicine and Science in Sports and Exercise, 42(3), 436–442. https://doi.org/10.1249/MSS.0b013e3181ba8055
  4. Bartoli, E., Fra, G. P., & Carnevale Schianca, G. P. (2011). The oral glucose tolerance test (OGTT) revisited. European Journal of Internal Medicine, 22(1), 8–12. https://doi.org/10.1016/j.ejim.2010.07.008
  5. Batista, C., & Soares, J. M. (2013). Are former elite athletes more protected against metabolic syndrome? Journal of Cardiology, 61(6), 440–445. https://doi.org/10.1016/j.jjcc.2013.01.011
  6. Batty, G. D., Bell, S., Kujala, U. M., Sarna, S. J., & Kaprio, J. (2024). Health characteristics and health behaviours in male former contact sports participants: Comparison with general population controls in a Finnish cohort study. Journal of Epidemiology and Community Health, 79(5), 354–358. https://doi.org/10.1136/jech-2024-222931
  7. Bonora, E. (2006). The metabolic syndrome and cardiovascular disease. Annals of Medicine, 38(1), 64–80. https://doi.org/10.1080/07853890500401234
  8. Chang, A. Y., FitzGerald, S. J., Cannaday, J., Zhang, S., Patel, A., Palmer, M. D., Reddy, G. P., Ordovas, K. G., Stillman, A. E., Janowitz, W., Radford, N. B., Roberts, A. J., & Levine, B. D. (2009). Cardiovascular risk factors and coronary atherosclerosis in retired National Football League players. The American Journal of Cardiology, 104(6), 805–811. https://doi.org/10.1016/j.amjcard.2009.05.008
  9. Chen, H., Cohen, P., & Chen, S. (2010). How big is a big odds ratio? Interpreting the magnitudes of odds ratios in epidemiological studies. Communications in Statistics—Simulation and Computation, 39(4), 860–864.
  10. Chen, Y. L., Huang, C. Y., Lee, S. D., Chou, S. W., Hsieh, P. S., Hsieh, C. C., Huang, Y. G., & Kuo, C. H. (2009). Discipline-specific insulin sensitivity in athletes. Nutrition, 25(11–12), 1137–1142.
  11. Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155–159. https://doi.org/10.1037//0033-2909.112.1.155
  12. Drid, P., Figlioli, F., Lakicevic, N., Gentile, A., Stajer, V., Raskovic, B., Vojvodic, N., Roklicer, R., Trivic, T., Tabakov, S., Eliseev, S., & Bianco, A. (2021). Patterns of rapid weight loss in elite sambo athletes. BMC Sports Science, Medicine & Rehabilitation, 13(1), 39. https://doi.org/10.1186/s13102-021-00267-3
  13. Emami, M., Behforouz, A., Jarahi, L., Zarifian, A., Rashidlamir, A., Rashed, M. M., Khaleghzade, H., Ghaneifar, Z., Safarian, M., Azimi-Nezhad, M., Nikroo, H., & Nematy, M. (2018). The risk of developing obesity, insulin resistance, and metabolic syndrome in former power-sports athletes—does sports career termination increase the risk. Indian Journal of Endocrinology and Metabolism, 22(4), 515–519. https://doi.org/10.4103/ijem.IJEM_83_18
  14. Galassi, A., Reynolds, K., & He, J. (2006). Metabolic syndrome and risk of cardiovascular disease: A meta-analysis. The American Journal of Medicine, 119(10), 812–819. https://doi.org/10.1016/j.amjmed.2006.02.031
  15. Gastaldelli, A. (2022). Measuring and estimating insulin resistance in clinical and research settings. Obesity, 30(8), 1549–1563. https://doi.org/10.1002/oby.23503
  16. Gonzalez-Chávez, A., Chávez-Fernández, J. A., Elizondo-Argueta, S., González-Tapia, A., León-Pedroza, J. I., & Ochoa, C. (2018). Metabolic syndrome and cardiovascular disease: A health challenge. Archives of Medical Research, 49(8), 516–521. https://doi.org/10.1016/j.arcmed.2018.10.003
  17. Grundy, S. M., Cleeman, J. I., Daniels, S. R., Donato, K. A., Eckel, R. H., Franklin, B. A., Gordon, D. J., Krauss, R. M., Savage, P. J., Smith, S. C., Spertus, J. A., & Costa, F. (2005). Diagnosis and management of the metabolic syndrome: An american heart association/national heart, lung, and blood institute scientific statement. Circulation, 112(17), 2735–2752. https://doi.org/10.1161/CIRCULATIONAHA.105.169404
  18. Hirode, G., & Wong, R. J. (2020). Trends in the prevalence of metabolic syndrome in the United States, 2011-2016. JAMA, 323(24), 2526–2528. https://doi.org/10.1001/jama.2020.4501
  19. Kassi, E., Pervanidou, P., Kaltsas, G., & Chrousos, G. (2011). Metabolic syndrome: Definitions and controversies. BMC Medicine, 9(1), 48. https://doi.org/10.1186/1741-7015-9-48
  20. Khodaee, M., Olewinski, L., Shadgan, B., & Kiningham, R. R. (2015). Rapid weight loss in sports with weight classes. Current Sports Medicine Reports, 14(6), 435–441. https://doi.org/10.1249/JSR.0000000000000206
  21. Laine, M. K., Eriksson, J. G., Kujala, U. M., Kaprio, J., Loo, B. M., Sundvall, J., Bäckmand, H. M., Peltonen, M., Jula, A., & Sarna, S. (2016). Former male elite athletes have better metabolic health in late life than their controls. Scandinavian Journal of Medicine & Science in Sports, 26(3), 284–290. https://doi.org/10.1111/sms.12442
  22. Lakicevic, N., Paoli, A., Roklicer, R., Trivic, T., Korovljev, D., Ostojic, S. M., Proia, P., Bianco, A., & Drid, P. (2021). Effects of rapid weight loss on kidney function in combat sport athletes. Medicina, 57(6), 551. https://doi.org/10.3390/medicina57060551
  23. Lebron, M. A., Stout, J. R., & Fukuda, D. H. (2024). Physiological perturbations in combat sports: Weight cycling and metabolic function-a narrative review. Metabolites, 14(2), 83. https://doi.org/10.3390/metabo14020083
  24. Lukic-Sarkanovic, M., Roklicer, R., Trivic, T., Manojlovic, M., Gilic, B., Milovancev, A., Rossi, C., Bianco, A., Carraro, A., Cvjeticanin, M., & Drid, P. (2024). Acute muscle damage as a metabolic response to rapid weight loss in wrestlers. Biomedical Human Kinetics, 16(1), 99–105. https://doi.org/10.2478/bhk-2024-0010
  25. Majerczak, J., Grandys, M., Frołow, M., Szkutnik, Z., Zakrzewska, A., Niżankowski, R., Duda, K., Chlopicki, S., & Zoladz, J. A. (2019). Age-dependent impairment in endothelial function and arterial stiffness in former high class male athletes is no different to that in men with no history of physical training. Journal of the American Heart Association, 8(18), e012670. https://doi.org/10.1161/JAHA.119.012670
  26. Maksimovic, N., Cvjeticanin, O., Rossi, C., Manojlovic, M., Roklicer, R., Bianco, A., Carraro, A., Sekulic, D., Milovancev, A., Trivic, T., & Drid, P. (2024). Prevalence of metabolic syndrome and its association with rapid weight loss among former elite combat sports athletes in Serbia. BMC Public Health, 24(1), 245. https://doi.org/10.1186/s12889-024-17763-z
  27. Milanović, Z., Pantelić, S., Trajković, N., Jorgić, B., Sporiš, G., & Bratić, M. (2014). Reliability of the serbian version of the International Physical Activity Questionnaire for older adults. Clinical Interventions in Aging, 9, 581–587. https://doi.org/10.2147/CIA.S57379
  28. Miller, M. A., Croft, L. B., Belanger, A. R., Romero-Corral, A., Somers, V. K., Roberts, A. J., & Goldman, M. E. (2008). Prevalence of metabolic syndrome in retired National Football League players. The American Journal of Cardiology, 101(9), 1281–1284. https://doi.org/10.1016/j.amjcard.2007.12.029
  29. Milovančev, A., Ilić, A., Miljković, T., Petrović, M., Stojšić Milosavljević, A., Roklicer, R., Trivic, T., Manojlovic, M., Rossi, C., Bianco, A., & Drid, P. (2024). Cardiac biomarkers alterations in rapid weight loss and high-intensity training in judo athletes: A crossover pilot study. The Journal of Sports Medicine and Physical Fitness, 64(11), 1224–1233. https://doi.org/10.23736/S0022-4707.24.15992-0
  30. Minh, H. V., Tien, H. A., Sinh, C. T., Thang, D. C., Chen, C. H., Tay, J. C., Siddique, S., Wang, T. D., Sogunuru, G. P., Chia, Y. C., & Kario, K. (2021). Assessment of preferred methods to measure insulin resistance in Asian patients with hypertension. The Journal of Clinical Hypertension, 23(3), 529–537. https://doi.org/10.1111/jch.14155
  31. Panayiotoglou, A., Grammatikopoulou, M. G., Maraki, M. I., Chourdakis, M., Gkiouras, K., Theodoridis, X., Papadopoulou, S. K., Famisis, K., & Hassapidou, M. N. (2017). Metabolic syndrome in retired soccer players: A pilot study. Obesity Medicine, 8, 15–22. https://doi.org/10.1016/j.obmed.2017.09.004
  32. Pihl, E., Zilmer, K., Kullisaar, T., Kairane, C., Pulges, A., & Zilmer, M. (2003). High-sensitive C-reactive protein level and oxidative stress-related status in former athletes in relation to traditional cardiovascular risk factors. Atherosclerosis, 171(2), 321–326. https://doi.org/10.1016/j.atherosclerosis.2003.08.015
  33. Reaven, G. M. (2011). Relationships among insulin resistance, type 2 diabetes, essential hypertension, and cardiovascular disease: Similarities and differences. Journal of Clinical Hypertension, 13(4), 238–243. https://doi.org/10.1111/j.1751-7176.2011.00439.x
  34. Roklicer, R., Lakicevic, N., Stajer, V., Trivic, T., Bianco, A., Mani, D., Milosevic, Z., Maksimovic, N., Paoli, A., & Drid, P. (2020). The effects of rapid weight loss on skeletal muscle in judo athletes. Journal of Translational Medicine, 18(1), 142. https://doi.org/10.1186/s12967-020-02315-x
  35. Roklicer, R., Rossi, C., Bianco, A., Stajer, V., Ranisavljev, M., Todorovic, N., Manojlovic, M., Gilic, B., Trivic, T., & Drid, P. (2022). Prevalence of rapid weight loss in Olympic style wrestlers. Journal of the International Society of Sports Nutrition, 19(1), 593–602. https://doi.org/10.1080/15502783.2022.2119095
  36. Sisk, M., Medawar, N., McClure, M., Cooke, B., Cannon, R., Kufner, D., D’Almeida, S., Jardaly, A., Asif, I., Momaya, A., & Ponce, B. (2024). Cardiovascular disease in retired NFL players: A systematic review. The Physician and Sportsmedicine, 52(5), 444–451. https://doi.org/10.1080/00913847.2024.2315929
  37. Štangar, M., Štangar, A., Shtyrba, V., Cigić, B., & Benedik, E. (2022). Rapid weight loss among elite-level judo athletes: Methods and nutrition in relation to competition performance. Journal of the International Society of Sports Nutrition, 19(1), 380–396. https://doi.org/10.1080/15502783.2022.2099231
  38. Street, J. H., Boos, Z. P., Fial, A., Lennon, S. L., Smith, C. S., Creasy, S. A., Hunter, S. K., Farquhar, W. B., & Capin, J. J. (2023). Long-term function, body composition and cardiometabolic health in midlife former athletes: A scoping review. BMJ Open Sport & Exercise Medicine, 9(4), e001605. https://doi.org/10.1136/bmjsem-2023-001605
  39. Sung, Y. C., Liao, Y. H., Chen, C. Y., Chen, Y. L., & Chou, C. C. (2017). Acute changes in blood lipid profiles and metabolic risk factors in collegiate elite taekwondo athletes after short-term de-training: A prospective insight for athletic health management. Lipids in Health and Disease, 16(1), 143. https://doi.org/10.1186/s12944-017-0534-2
  40. Thornton, J., Rosen, C., Davenport, M., Mountjoy, M. L., Dorian, P., Gouttebarge, V., Breau, B., Pila, E., Reilly, K., Yuan, J., Mok, K., Di Ciacca, S., Speechley, M., & Crossley, K. (2023). Beyond the medals: A cross-sectional study exploring retired elite female athletes’ health. BMJ Open Sport & Exercise Medicine, 9(1), e001479. https://doi.org/10.1136/bmjsem-2022-001479
  41. Trivic, T., Roklicer, R., Zenic, N., Modric, T., Milovancev, A., Lukic-Sarkanovic, M., Maksimovic, N., Bianco, A., Carraro, A., & Drid, P. (2023). Rapid weight loss can increase the risk of acute kidney injury in wrestlers. BMJ Open Sport & Exercise Medicine, 9(2), e001617. https://doi.org/10.1136/bmjsem-2023-001617
  42. Unt, E., Zilmer, K., Mägi, A., Kullisaar, T., Kairane, C., & Zilmer, M. (2008). Homocysteine status in former top-level male athletes: Possible effect of physical activity and physical fitness. Scandinavian Journal of Medicine & Science in Sports, 18(3), 360–366. https://doi.org/10.1111/j.1600-0838.2007.00674.x
  43. World Health Organization. (2000). Obesity: Preventing and managing the global epidemic: Report of a WHO consultation.
  44. Zhong, Y., Song, Y., Artioli, G. G., Gee, T. I., French, D. N., Zheng, H., Lyu, M., & Li, Y. (2024). The practice of weight loss in combat sports athletes: A systematic review. Nutrients, 16(7), 1050. https://doi.org/10.3390/nu16071050
DOI: https://doi.org/10.2478/bhk-2026-0022 | Journal eISSN: 2080-2234 | Journal ISSN: 2080-2234
Language: English
Page range: 247 - 257
Submitted on: Jun 2, 2026
Accepted on: Jun 29, 2026
Published on: Sep 4, 2026
Published by: University of Physical Education in Warsaw
In partnership with: Paradigm Publishing Services

© 2026 Nemanja Maksimovic, Marko Manojlovic, Tatjana Trivic, Yerlan Seisenbekov, Nemanja Lakicevic, Antonino Bianco, Patrik Drid, published by University of Physical Education in Warsaw
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.