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Review Article
Mineral, bone & muscle
Sarcopenia and Muscle Aging: Updated Insights into Molecular Mechanisms and Translational Therapeutics
Thanh T. Nguyen, Tam Dao, Ha Thu Nguyen, Jun-Hyeon Park, Seung-Jun Jeong, Sei Kim, Yunju Jo, Nhung T.H. Thieu, Jiangqi Zhao, Fuan Ding, Ying Yu, Vu Chi Dung, Karim Gariani, Beom-Jun Kim, Dongryeol Ryu
Endocrinol Metab. 2026;41(1):57-85.   Published online February 12, 2026
DOI: https://doi.org/10.3803/EnM.2025.2656
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  • 164 Download
  • 1 Web of Science
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AbstractAbstract PDFPubReader   ePub   
Sarcopenia is a progressive, age-related condition characterized by the loss of skeletal muscle mass, strength, and function, which increases the risk of falls, frailty, and loss of independence. Despite growing recognition and its incorporation into geriatric assessments, there is still no approved pharmacological treatment. This review provides an updated overview of sarcopenia, encompassing diagnostic criteria, biological mechanisms, and emerging therapeutic strategies. Key molecular features include mitochondrial dysfunction, nicotinamide adenine dinucleotide (NAD⁺) decline, fiber-type alterations, and dysregulation of myokines. Recent singlecell and multi-omics studies have revealed the heterogeneity of muscle tissue and distinct cell-type-specific aging patterns. Therapeutic efforts are evolving beyond lifestyle interventions toward targeted approaches, including myostatin inhibitors, NAD⁺ boosters, senolytics, and microbiome modulators. However, clinical translation remains constrained by heterogeneity in trial design and the absence of standardized outcome measures. Future sarcopenia care will likely involve precision medicine guided by biomarkers and supported by digital monitoring tools. Progressing from molecular discovery to clinical application will be essential for preserving muscle health and function in aging populations.

Citations

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  • Molecular Mechanisms and Nutritional Modulation in Sarcopenia: A Narrative Review
    Hui San Chin, Ling Liu, Pei-Ju Liao, Alexandra L. R. M. Wee, Xiu-Yi Kwek, Bin Tean Teh, Frederick H. Koh
    Nutrients.2026; 18(7): 1161.     CrossRef
  • Elevated Circulating Ceramides 18:0 and 24:1 as a Risk Factor for Sarcopenia: In Vitro, Animal, and Clinical Evidence
    So Jeong Park, Ji Yeon Baek, Shibo Wei, Jin Young Lee, Yuna Lee, Sang‐Hoon Lee, Il‐Young Jang, Hyuk Sakong, Hyun Ju Yoo, Hee‐Won Jung, Eunju Lee, Su Jung Kim, Yunju Jo, Kyunggon Kim, Dongryeol Ryu, Beom‐Jun Kim
    Journal of Cachexia, Sarcopenia and Muscle.2026;[Epub]     CrossRef
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Original Articles
Higher Circulating Kynurenine Levels Linked to Higher Risk of Sarcopenia in Older Adults: A Cohort Study and UK Biobank Analysis
June Yeon Kim, Yunju Jo, So Jeong Park, Ji Yeon Baek, Geonyoung Jang, Eunju Lee, Hyuk Sakong, Su Jung Kim, Sung-Jin Kim, Dongryeol Ryu, Hyun Ju Yoo, Beom-Jun Kim
Received August 1, 2025  Accepted September 30, 2025  Published online December 12, 2025  
DOI: https://doi.org/10.3803/EnM.2025.2586    [Epub ahead of print]
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
While experimental studies show kynurenine, a tryptophan metabolite, drives muscle catabolism through pro-oxidative and inflammatory mechanisms, clinical evidence linking circulating kynurenine to sarcopenia in humans remains scarce.
Methods
In a cross-sectional study of 165 community-dwelling older adults, sarcopenia was diagnosed using Asian-specific criteria and serum kynurenine levels were measured by liquid chromatography-tandem mass spectrometry. Using UK Biobank datasets, plasma indoleamine 2,3-dioxygenase 1 (IDO1)—the enzyme converting tryptophan to kynurenine—was quantified via Olink proteomics, and Mendelian randomization was used to assess the causal effect of plasma IDO1 on sarcopenia risk based on genomewide association study data.
Results
In multivariable adjusted analyses, older adults with sarcopenia, low muscle mass, or weak muscle strength had 21.3%–29.2% higher serum kynurenine concentrations than controls (P<0.001 to 0.010). Circulating kynurenine levels were inversely correlated with skeletal muscle index and grip strength (P=0.001 and 0.022, respectively). Each standard deviation increase in serum kynurenine was associated with a 1.80–2.97-fold increased risk for sarcopenia-related outcomes (P<0.001 to 0.010). In the UK Biobank, higher IDO1 activity was associated with reduced muscle mass and strength (P=0.007 and P=0.004, respectively), and Mendelian randomization indicated a significant causal relationship between plasma IDO1 levels and increased sarcopenia risk (P= 0.010, β=0.105).
Conclusion
These findings extend previous experimental evidence to the clinical setting, suggesting that elevated kynurenine—driven by IDO1 activity—contributes to sarcopenia in older adults. Circulating kynurenine may serve as an exploratory biomarker candidate for identifying individuals at heightened risk for muscle deterioration, warranting further validation in future studies.
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Mineral, Bone & Muscle
Carnitine Metabolite as a Potential Circulating Biomarker for Sarcopenia in Men
Je Hyun Seo, Jung-Min Koh, Han Jin Cho, Hanjun Kim, Young‑Sun Lee, Su Jung Kim, Pil Whan Yoon, Won Kim, Sung Jin Bae, Hong-Kyu Kim, Hyun Ju Yoo, Seung Hun Lee
Endocrinol Metab. 2025;40(1):93-102.   Published online November 28, 2024
DOI: https://doi.org/10.3803/EnM.2024.2117
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  • 2 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Sarcopenia, a multifactorial disorder involving metabolic disturbance, suggests potential for metabolite biomarkers. Carnitine (CN), essential for skeletal muscle energy metabolism, may be a candidate biomarker. We investigated whether CN metabolites are biomarkers for sarcopenia.
Methods
Associations between the CN metabolites identified from an animal model of sarcopenia and muscle cells and sarcopenia status were evaluated in men from an age-matched discovery (72 cases, 72 controls) and a validation (21 cases, 47 controls) cohort.
Results
An association between CN metabolites and sarcopenia showed in mouse and cell studies. In the discovery cohort, plasma C5-CN levels were lower in sarcopenic men (P=0.005). C5-CN levels in men tended to be associated with handgrip strength (HGS) (P=0.098) and were significantly associated with skeletal muscle mass (P=0.003). Each standard deviation increase in C5-CN levels reduced the odds of low muscle mass (odd ratio, 0.61; 95% confidence interval [CI], 0.42 to 0.89). The area under the receiver operating characteristic curve (AUROC) of CN score using a regression equation of C5-CN levels, for sarcopenia was 0.635 (95% CI, 0.544 to 0.726). In the discovery cohort, addition of CN score to HGS significantly improved AUROC from 0.646 (95% CI, 0.575 to 0.717; HGS only) to 0.727 (95% CI, 0.643 to 0.810; P=0.006; HGS+CN score). The improvement was confirmed in the validation cohort (AUROC=0.563; 95% CI, 0.470 to 0.656 for HGS; and AUROC=0.712; 95% CI, 0.569 to 0.855 for HGS+CN score; P=0.027).
Conclusion
C5-CN, indicative of low muscle mass, is a potential circulating biomarker for sarcopenia in men. Further studies are required to confirm these results and explore sarcopenia-related metabolomic changes.

Citations

Citations to this article as recorded by  
  • Clinical characteristics and risk factors of delayed ophthalmoplegia following cavernous sinus exploration in endoscopic pituitary adenoma surgery
    Sun Mo Nam, Jong Ha Hwang, Yoon Hwan Byun, Seung Shin Park, Jung Hee Kim, Min-Sung Kim, Chul-Kee Park, Hee-Pyoung Park, Yong Hwy Kim
    Pituitary.2026;[Epub]     CrossRef
  • Molecular Pathogenesis of Sarcopenia: Regulatory Networks Involving MicroRNAs in Age-Related Skeletal Muscle Decline
    Joseph Joju Kalan, Lijo N Varghese, Rajesh Katare
    Frontiers in Bioscience-Landmark.2025;[Epub]     CrossRef
  • Amino acid metabolites as potential circulating biomarkers for sarcopenia
    Je Hyun Seo, Jung-Min Koh, Su Jung Kim, Pil Whan Yoon, Won Kim, Sung Jin Bae, Hong-Kyu Kim, Hyun Ju Yoo, Seung Hun Lee
    Scientific Reports.2025;[Epub]     CrossRef
  • Chronic liver diseases as a cause of sarcopenia development
    D. P. Kurmaev, S. V. Bulgakova, E. V. Treneva, O. V. Kosareva, P. Ya. Merzlova, L. A. Sharonova, Yu. A. Dolgikh
    Experimental and Clinical Gastroenterology.2025; (3): 119.     CrossRef
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Miscellaneous
Differences in Type 2 Fiber Composition in the Vastus Lateralis and Gluteus Maximus of Patients with Hip Fractures
Jingwen Tian, Minchul Song, Kyu Jeong Cho, Ho Yeop Lee, Sang Hyeon Ju, Jung Ryul Lim, Ha Thi Nga, Thi Linh Nguyen, Ji Sun Moon, Hyo Ju Jang, Jung-Mo Hwang, Hyon-Seung Yi
Endocrinol Metab. 2024;39(3):521-530.   Published online June 11, 2024
DOI: https://doi.org/10.3803/EnM.2024.1935
  • 6,198 View
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Aging leads to sarcopenia, which is characterized by reduced muscle mass and strength. Many factors, including altered muscle protein turnover, diminished neuromuscular function, hormonal changes, systemic inflammation, and the structure and composition of muscle fibers, play a crucial role in age-related muscle decline. This study explored differences in muscle fiber types contributing to overall muscle function decline in aging, focusing on individuals with hip fractures from falls.
Methods
A pilot study at Chungnam National University Hospital collected muscle biopsies from hip fracture patients aged 20 to 80 undergoing surgical treatment. Muscle biopsies from the vastus lateralis and gluteus maximus were obtained during hip arthroplasty or internal fixation. Handgrip strength, calf and thigh circumference, and bone mineral density were evaluated in individuals with hip fractures from falls. We analyzed the relationships between each clinical characteristic and muscle fiber type.
Results
In total, 26 participants (mean age 67.9 years, 69.2% male) were included in this study. The prevalence of sarcopenia was 53.8%, and that of femoral and lumbar osteoporosis was 19.2% and 11.5%, respectively. Vastus lateralis analysis revealed an age-related decrease in type IIx fibers, a higher proportion of type IIa fibers in women, and an association between handgrip strength and type IIx fibers in men. The gluteus maximus showed no significant correlations with clinical parameters.
Conclusion
This study identified complex associations between age, sex, handgrip strength, and muscle fiber composition in hip fracture patients, offering insights crucial for targeted interventions combating age-related muscle decline and improving musculoskeletal health.

Citations

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  • Muscle Loss Driven by Extracellular Signal-Regulated Kinase Suppression via β-Adrenergic Activation in High-Normal Catecholamine Status
    Jieun Lee, Ju Yeon Kwak, Ho Yeop Lee, Ji Sun Moon, Hyo Ju Jang, Ha Thi Nga, Thi Linh Nguyen, Alfin Mohammad Abdillah, Junglyun Kim, Sihwan Kim, Yong Ryoul Yang, Jeong Eun Lee, Hyon-Seung Yi
    Endocrinology and Metabolism.2026; 41(2): 319.     CrossRef
  • Tourniquet Use During Anterior Cruciate Ligament Reconstruction Is Associated With Postoperative Quadriceps Atrophy and Pain but No Negative Effects in the Long Term: A Systematic Review
    Caleb V. Hayes, Saad M. Ibrahim, Anna E. Crawford, James R. Jones, Mathew D. Hargreaves, Clay A. Rahaman, Eugene W. Brabston, Thomas B. Evely, Aaron J. Casp, Kevin E. Wilk, Amit M. Momaya
    Arthroscopy, Sports Medicine, and Rehabilitation.2025;[Epub]     CrossRef
  • Volume and quality of the gluteal muscles are associated with early physical function after total hip arthroplasty
    Makoto Iwasa, Keisuke Uemura, Mazen Soufi, Yoshito Otake, Tomofumi Kinoshita, Tatsuhiko Kutsuna, Kazuma Takashima, Hidetoshi Hamada, Yoshinobu Sato, Nobuhiko Sugano, Seiji Okada, Masaki Takao
    International Journal of Computer Assisted Radiology and Surgery.2025; 20(4): 703.     CrossRef
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Mineral, Bone & Muscle
Familial Correlation and Heritability of Hand Grip Strength in Korean Adults (Korea National Health and Nutrition Examination Survey 2014 to 2019)
Seong Hee Ahn, Eun Byeol Park, Seongha Seo, Yongin Cho, Da Hea Seo, So Hun Kim, Young Ju Suh, Seongbin Hong
Endocrinol Metab. 2023;38(6):709-719.   Published online November 7, 2023
DOI: https://doi.org/10.3803/EnM.2023.1740
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  • 83 Download
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
The onset and progression of sarcopenia are highly variable among individuals owing to genetic and environmental factors. However, there are a limited number of studies measuring the heritability of muscle strength in large numbers of parent-adult offspring pairs. We aimed to investigate the familial correlation and heritability of hand grip strength (HGS) among Korean adults.
Methods
This family-based cohort study on data from the Korea National Health and Nutrition Examination Survey (2014 to 2019) included 5,004 Koreans aged ≥19 years from 1,527 families. HGS was measured using a digital grip strength dynamometer. Familial correlations of HGS were calculated in different pairs of relatives. Variance component methods were used to estimate heritability.
Results
The heritability estimate of HGS among Korean adults was 0.154 (standard error, 0.066). Correlation coefficient estimates for HGS between parent-offspring, sibling, and spouse pairs were significant at 0.07, 0.10, and 0.23 (P<0.001, P=0.041, and P<0.001, respectively). The total variance in the HGS phenotype was explained by additive genetic (15.4%), shared environmental (11.0%), and unique environmental (73.6%) influences. The odds of weak HGS significantly increased in the offspring of parents with weak HGS (odds ratio [OR], 1.69–3.10; P=0.027–0.038), especially in daughters (OR, 2.04–4.64; P=0.029–0.034).
Conclusion
HGS exhibits a familial correlation and significant heritable tendency in Korean adults. Therefore, Asian adults, especially women, who have parents with weak HGS, need to pay special attention to their muscle health with the help of healthy environmental stimuli.

Citations

Citations to this article as recorded by  
  • Association of Handgrip Strength with Diabetes, Hypertension, and Comorbidities in a Korean Population: A Large-Scale Cross-Sectional Study
    Bum Ju Lee
    Journal of Clinical Medicine.2025; 14(8): 2801.     CrossRef
  • Malnutrition and Handgrip Strength are Correlated in Community Dwelling Elderly
    Mehmet Göl, Ayse Elkoca, İbrahim Halil Türkbeyler, Melek Tarakçıoğlu, Alican Çelik, Kazım Ersin Altınsoy
    STED / Sürekli Tıp Eğitimi Dergisi.2024;[Epub]     CrossRef
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Mineral, Bone & Muscle
Higher Plasma Stromal Cell-Derived Factor 1 Is Associated with Lower Risk for Sarcopenia in Older Asian Adults
Sunghwan Ji, Kyunggon Kim, So Jeong Park, Jin Young Lee, Hee-Won Jung, Hyun Ju Yoo, Il-Young Jang, Eunju Lee, Ji Yeon Baek, Beom-Jun Kim
Endocrinol Metab. 2023;38(6):701-708.   Published online October 18, 2023
DOI: https://doi.org/10.3803/EnM.2023.1783
  • 5,634 View
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Despite the protective effects of stromal cell-derived factor 1 (SDF-1) in stimulating muscle regeneration shown in experimental research, there is a lack of clinical studies linking circulating SDF-1 concentrations with muscle phenotypes. In order to elucidate the role of SDF-1 as a potential biomarker reflecting human muscle health, we investigated the association of plasma SDF-1 levels with sarcopenia in older adults.
Methods
This cross-sectional study included 97 community-dwelling participants who underwent a comprehensive geriatric assessment at a tertiary hospital in South Korea. Sarcopenia was defined by specific cutoff values applicable to the Asian population, whereas plasma SDF-1 levels were determined using an enzyme immunoassay.
Results
After accounting for sex, age, and body mass index, participants with sarcopenia and low muscle mass exhibited plasma SDF-1 levels that were 21.8% and 18.3% lower than those without these conditions, respectively (P=0.008 and P=0.009, respectively). Consistently, higher plasma SDF-1 levels exhibited a significant correlation with higher skeletal muscle mass index (SMI) and gait speed (both P=0.043), and the risk of sarcopenia and low muscle mass decreased by 58% and 55% per standard deviation increase in plasma SDF-1 levels, respectively (P=0.045 and P=0.030, respectively). Furthermore, participants in the highest SDF-1 tertile exhibited significantly higher SMI compared to those in the lowest tertile (P=0.012).
Conclusion
These findings clinically corroborate earlier experimental discoveries highlighting the muscle anabolic effects of SDF- 1 and support the potential role of circulating SDF-1 as a biomarker reflecting human muscle health in older adults.

Citations

Citations to this article as recorded by  
  • Integration of multiple omics reveals key targets and cellular mechanisms for intervention in sarcopenia
    Zhu Zhu, Wenji Wang, Qi Zhang, Xiao Bi, Shaojun Ma, Yue Shen, Feng Ding
    Archives of Gerontology and Geriatrics.2026; 142: 106113.     CrossRef
  • Exercise-induced changes in circulatory aging-related biomarkers among older adults: longitudinal analysis of a multi-stage randomized clinical trial
    Qiaowei Li, Tingting Liu, Wei Lin, Zhiqiang Ye, Cai Jiang, Feng Huang, Zhonghua Lin, Pengli Zhu
    Immunity & Ageing.2026;[Epub]     CrossRef
  • Circulating BMP-7 Level is Independent of Sarcopenia in Older Asian Adults
    Ahin Choi, Ji Yeon Baek, Eunhye Ji, Il-Young Jang, Hee-Won Jung, So Jeong Park, Yunju Jo, Eunju Lee, Dongryeol Ryu, Beom-Jun Kim
    Annals of Geriatric Medicine and Research.2025; 29(1): 75.     CrossRef
  • From a Solitary Blood-Derived Biomarker to Combined Biomarkers of Sarcopenia: Experiences From the Korean Frailty and Aging Cohort Study
    Chang Won Won, Miji Kim, Hyung Eun Shin, Gustavo Duque
    The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences.2025;[Epub]     CrossRef
  • Unlocking diagnosis of sarcopenia: The role of circulating biomarkers – A clinical systematic review
    F. Veronesi, F. Salamanna, V. Borsari, A. Ruffilli, C. Faldini, G. Giavaresi
    Mechanisms of Ageing and Development.2024; 222: 112005.     CrossRef
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Miscellaneous
Association between N-Terminal Prohormone Brain Natriuretic Peptide and Decreased Skeletal Muscle Mass in a Healthy Adult Population: A Cross-Sectional Study
Tae Kyung Yoo, Marie Yung-Chen Wu, Moon Soo Kim, Mi-Yeon Lee, Yong-Taek Lee, Kyung Jae Yoon, Chul-Hyun Park
Endocrinol Metab. 2023;38(2):269-276.   Published online March 13, 2023
DOI: https://doi.org/10.3803/EnM.2022.1588
  • 6,591 View
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AbstractAbstract PDFPubReader   ePub   
Background
Although an inverse association between the N-terminal prohormone brain natriuretic peptide (NT-proBNP) and obesity exists, only few major studies have assessed the association between NT-proBNP levels and skeletal muscle mass in asymptomatic healthy adults. Therefore, this cross-sectional study was conducted.
Methods
We assessed participants who underwent health examinations at Kangbuk Samsung Hospital in South Korea from January 2012 to December 2019. Appendicular skeletal muscle mass was measured using a bioelectrical impedance analyzer, and the skeletal muscle mass index (SMI) was calculated. Participants were divided into the control, mildly low skeletal muscle mass (LMM) (−2 standard deviation [SD] < SMI ≤−1 [SD]), and severely LMM groups (SD ≤−2) based on their SMI. The association between elevated NT-proBNP level (≥125 pg/mL) and skeletal muscle mass was assessed using multivariable logistic regression analysis with adjustment for confounding factors.
Results
This study enrolled 15,013 participants (mean age, 37.52±9.52; men, 54.24%; control, n=12,827; mildly LMM, n=1,998; severely LMM, n=188). Prevalence of elevated NT-proBNP was higher in mildly and severely LMM groups than in the control group (control, 1.19%; mildly LMM, 1.4%; severely LMM, 4.26%; P=0.001). The adjusted odds ratio (OR) of elevated NT-proBNP was significantly higher in severely LMM (OR, 2.87; 95% confidence interval [CI], 1.3 to 6.37) than in control (OR, 1.00; reference) or mildly LMM groups (OR, 1.24; 95% CI, 0.81 to 1.89).
Conclusion
Our results showed that NT-proBNP elevation were more prevalent in participants with LMM. In addition, our study showed an association between skeletal muscle mass and NT-proBNP level in a relatively young and healthy adult population.

Citations

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  • N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP)—A Prognostic Biomarker in Older and/or Frail Adults with Advanced Gastroesophageal Cancer: A Post Hoc Analysis of the GO2 Clinical Trial
    Yuewei Tao, Chim C. Lang, Russell D. Petty, Peter S. Hall, Mark A. Baxter
    Cancers.2025; 17(4): 601.     CrossRef
  • Elevated Baseline NT-proBNP Identifies Poor Prognosis in Frail Gastroesophageal Cancer: GO2 Post-Hoc Analysis
    D. Rexhepi, A. Krasniqi, L. Gashi
    Asian Journal of Current Research in Clinical Cancer.2025; 5(2): 150.     CrossRef
  • Low calf circumference is associated with higher plasma N‐terminal pro‐B‐type natriuretic peptide in hospitalized heart failure patients: A retrospective study
    Jacob Jonatan Cruz‐Sánchez, Francisco Javier González‐Ruiz, Carla Gabriela Aguilar‐Rodríguez, Mario Gabriel Acosta‐Osuna, Iván Armando Osuna‐Padilla, María de la Luz Tovar‐Hernández, Alexandra Arias‐Mendoza, Francisco Martín Baranda‐Tovar
    Nutrition in Clinical Practice.2025;[Epub]     CrossRef
  • Differences in the Evaluation of Malnutrition and Body Composition Using Bioelectrical Impedance Analysis, Nutritional Ultrasound, and Dual-Energy X-ray Absorptiometry in Patients with Heart Failure
    Ana Benitez-Velasco, Carlos Alzas-Teomiro, Carmen Zurera Gómez, Concepción Muñoz Jiménez, José López Aguilera, Manuel Crespin, Juan Antonio Vallejo-Casas, María Ángeles Gálvez-Moreno, María José Molina Puerta, Aura D. Herrera-Martínez
    Nutrients.2024; 16(10): 1535.     CrossRef
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Miscellaneous
Protective Effect of Delta-Like 1 Homolog Against Muscular Atrophy in a Mouse Model
Ji Young Lee, Minyoung Lee, Dong-Hee Lee, Yong-ho Lee, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha
Endocrinol Metab. 2022;37(4):684-697.   Published online August 29, 2022
DOI: https://doi.org/10.3803/EnM.2022.1446
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Muscle atrophy is caused by an imbalance between muscle growth and wasting. Delta-like 1 homolog (DLK1), a protein that modulates adipogenesis and muscle development, is a crucial regulator of myogenic programming. Thus, we investigated the effect of exogenous DLK1 on muscular atrophy.
Methods
We used muscular atrophy mouse model induced by dexamethasone (Dex). The mice were randomly divided into three groups: (1) control group, (2) Dex-induced muscle atrophy group, and (3) Dex-induced muscle atrophy group treated with DLK1. The effects of DLK1 were also investigated in an in vitro model using C2C12 myotubes.
Results
Dex-induced muscular atrophy in mice was associated with increased expression of muscle atrophy markers and decreased expression of muscle differentiation markers, while DLK1 treatment attenuated these degenerative changes together with reduced expression of the muscle growth inhibitor, myostatin. In addition, electron microscopy revealed that DLK1 treatment improved mitochondrial dynamics in the Dex-induced atrophy model. In the in vitro model of muscle atrophy, normalized expression of muscle differentiation markers by DLK1 treatment was mitigated by myostatin knockdown, implying that DLK1 attenuates muscle atrophy through the myostatin pathway.
Conclusion
DLK1 treatment inhibited muscular atrophy by suppressing myostatin-driven signaling and improving mitochondrial biogenesis. Thus, DLK1 might be a promising candidate to treat sarcopenia, characterized by muscle atrophy and degeneration.

Citations

Citations to this article as recorded by  
  • A Systematic Review and User Reference of Phenotypic and Molecular Characteristics of Dexamethasone‐Mediated C2C12 Muscle Atrophy
    Alexa J. Klein, Roger A. Vaughan
    Journal of Cachexia, Sarcopenia and Muscle.2026;[Epub]     CrossRef
  • Advancements in the study of DLK1 in the pathogenesis of diabetes
    Min Li, Yanqiu Peng, Yuke Shi, Yunfei Liu, Jian Zhang
    Life Sciences.2025; 369: 123535.     CrossRef
  • Molecular mechanism of Activin receptor inhibition by DLK1
    Daniel Antfolk, Qianqian Ming, Anna Manturova, Erich J. Goebel, Thomas B. Thompson, Vincent C. Luca
    Nature Communications.2025;[Epub]     CrossRef
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Mineral, Bone & Muscle
Decreased Serum Level of Sclerostin in Older Adults with Sarcopenia
Seong Hee Ahn, Hee-Won Jung, Eunju Lee, Ji Yeon Baek, Il-Young Jang, So Jeong Park, Jin Young Lee, Eunah Choi, Yun Sun Lee, Seongbin Hong, Beom-Jun Kim
Endocrinol Metab. 2022;37(3):487-496.   Published online May 27, 2022
DOI: https://doi.org/10.3803/EnM.2022.1428
  • 7,668 View
  • 185 Download
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AbstractAbstract PDFPubReader   ePub   
Background
Although muscles and bones interact with each other through various secretory factors, the role of sclerostin, an osteocyte-secreted factor, on muscle metabolism has not been well studied. We investigated the levels of serum sclerostin in Korean older adults with sarcopenia.
Methods
Blood samples were collected from 129 participants who underwent evaluation of muscle mass and function in an outpatient geriatric clinic of a teaching hospital. Sarcopenia and related parameters were determined using cutoff values for the Asian population. Serum sclerostin levels were measured using an enzyme-linked immunosorbent assay.
Results
The mean age of the participants was 69.6 years, and 20 participants (15.5%) were classified as having sarcopenia. After adjusting for age, sex, and body mass index, serum sclerostin levels were significantly lower in participants with sarcopenia, low muscle mass, or weak muscle strength (P=0.003 to 0.045). Serum sclerostin levels were positively associated with skeletal muscle index and grip strength after adjusting for confounders (P=0.001 and P=0.003), whereas sarcopenic phenotype score showed a negative association (P=0.006). These increases in muscle mass and strength were also dose dependent as serum sclerostin levels increased (P for trends=0.003 and P for trends=0.015). Higher serum sclerostin levels were associated with lower odds ratio (ORs) for sarcopenia, low muscle mass, and weak muscle strength after adjusting for confounders (OR, 0.27 to 0.50; P<0.001 to 0.025).
Conclusion
Higher serum sclerostin levels were associated with a lower risk of sarcopenia, low muscle mass, and weak muscle strength in Korean older adults.

Citations

Citations to this article as recorded by  
  • Exploring osteosarcopenia from the gut microbiota perspective: mechanistic insights and therapeutic potentials based on the gut-muscle-bone Axis
    Hao-bo Jiang, Jun-qi Zhang, Hao Liang, Li-ying Sun, Chang-qing Deng, Shao-feng Yang
    Frontiers in Microbiology.2026;[Epub]     CrossRef
  • Combined effects of a low-dose multi-target supplement (CaHMB, CBP, and HA) on delaying musculoskeletal aging
    Haoqi Chen, Junhong Peng, Shanshan Guo, Ting Chen, Si Chen, Xinyuan Jin, Wenge Huang, Chao Xu, Mengchu Li, Mengxing Xie, Mengtao Yang, Jinzhu Pang, Huilian Zhu
    Food & Function.2026;[Epub]     CrossRef
  • Bone and muscle crosstalk in ageing and disease
    Ben Kirk, Giovanni Lombardi, Gustavo Duque
    Nature Reviews Endocrinology.2025; 21(6): 375.     CrossRef
  • Elevated Circulating Sclerostin Levels in Frail Older Adults: Implications beyond Bone Health
    Ji Yeon Baek, Seong Hee Ahn, Il-Young Jang, Hee-Won Jung, Eunhye Ji, So Jeong Park, Yunju Jo, Eunju Lee, Dongryeol Ryu, Seongbin Hong, Beom-Jun Kim
    Endocrinology and Metabolism.2025; 40(1): 73.     CrossRef
  • Sclerostin's role in bone–muscle crosstalk and osteoporosis pathogenesis
    Hamzah Shahid, Vivek Kumar Morya, Kyu-Cheol Noh
    Osteoporosis and Sarcopenia.2025; 11(3): 69.     CrossRef
  • Rethinking Osteoporosis Drugs: Can We Simultaneously Address Sarcopenia?
    Zoran Gavrilov, Jasna Lojk
    International Journal of Molecular Sciences.2025; 26(14): 6924.     CrossRef
  • The role of bone-derived factors in bone and muscle communication
    Guobin Li, Mingyan Qi, Shibin Liang
    Frontiers in Endocrinology.2025;[Epub]     CrossRef
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    Jan Štěpán
    Clinical Osteology.2025; 30(3): 145.     CrossRef
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    Zhonghan Zhao, Kai Yan, Qiao Guan, Qiang Guo, Can Zhao
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
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    Viktoria N. Karetnikova, Anastasiya G. Neeshpapa, Evgenia I. Carpova, Olga L. Barbarash
    CardioSomatics.2024; 15(1): 55.     CrossRef
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    Jingwen Tian, Minchul Song, Kyu Jeong Cho, Ho Yeop Lee, Sang Hyeon Ju, Jung Ryul Lim, Ha Thi Nga, Thi Linh Nguyen, Ji Sun Moon, Hyo Ju Jang, Jung-Mo Hwang, Hyon-Seung Yi
    Endocrinology and Metabolism.2024; 39(3): 521.     CrossRef
  • Determinants of bone mass in older adults with normal- and overweight derived from the crosstalk with muscle and adipose tissue
    Carina O. Walowski, Catrin Herpich, Janna Enderle, Wiebke Braun, Marcus Both, Mario Hasler, Manfred J. Müller, Kristina Norman, Anja Bosy-Westphal
    Scientific Reports.2023;[Epub]     CrossRef
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    Anika Shimonty, Lynda F. Bonewald, Fabrizio Pin
    Current Osteoporosis Reports.2023; 21(3): 303.     CrossRef
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    Hewen Jiang, Dijie Li, Ying Han, Nanxi Li, Xiaohui Tao, Jin Liu, Zongkang Zhang, Yuanyuan Yu, Luyao Wang, Sifan Yu, Ning Zhang, Huan Xiao, Xin Yang, Yihao Zhang, Ge Zhang, Bao-Ting Zhang
    Biochemical Pharmacology.2023; 215: 115694.     CrossRef
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    Liu Guo, Menchus Quan, Weijun Pang, Yulong Yin, Fengna Li
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    Antimo Moretti, Giovanni Iolascon
    Journal of International Medical Research.2023;[Epub]     CrossRef
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    Giovanni Iolascon, Sara Liguori, Marco Paoletta, Giuseppe Toro, Antimo Moretti
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    Hyon-Seung Yi
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    Giulia Minniti, Letícia Maria Pescinini-Salzedas, Guilherme Almeida dos Santos Minniti, Lucas Fornari Laurindo, Sandra Maria Barbalho, Renata Vargas Sinatora, Lance Alan Sloan, Rafael Santos de Argollo Haber, Adriano Cressoni Araújo, Karina Quesada, Jesse
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Close layer
Mineral, Bone & Muscle
Association between Elevated Plasma Homocysteine and Low Skeletal Muscle Mass in Asymptomatic Adults
Jae-Hyeong Choi, Jin-Woo Seo, Mi-Yeon Lee, Yong-Taek Lee, Kyung Jae Yoon, Chul-Hyun Park
Endocrinol Metab. 2022;37(2):333-343.   Published online February 8, 2022
DOI: https://doi.org/10.3803/EnM.2021.1202
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Background
Homocysteine has been drawing attention with a closed linkage with skeletal muscle. However, the association of hyperhomocysteinemia with decreased skeletal muscle mass remains unclear. We aimed to investigate the association of hyperhomocysteinemia with low skeletal muscle mass (LMM) in asymptomatic adults.
Methods
This was a cross-sectional study of 114,583 community-dwelling adults without cancer, stroke, or cardiovascular diseases who underwent measurements of plasma homocysteine and body composition analysis from 2012 to 2018. Hyperhomocysteinemia was defined as >15 μmol/L. Skeletal muscle mass index (SMI) was calculated based on appendicular muscle mass (kg)/height (m)2. Participants were classified into three groups based on SMI: “normal,” “mildly low,” and “severely low.”
Results
The prevalence of hyperhomocysteinemia was the highest in subjects with severely LMM (12.9%), followed by those with mildly LMM (9.8%), and those with normal muscle mass (8.5%) (P for trend <0.001). In a multivariable logistic regression model, hyperhomocysteinemia was significantly associated with having a mildly LMM (odds ratio [OR], 1.305; 95% confidence interval [CI], 1.224 to 1.392) and severely LMM (OR, 1.958; 95% CI, 1.667 to 2.286), respectively. One unit increment of log-transformed homocysteine was associated with 1.360 and 2.169 times higher risk of having mildly LMM and severely LMM, respectively.
Conclusion
We demonstrated that elevated homocysteine has an independent association with LMM in asymptomatic adults, supporting that hyperhomocysteinemia itself can be a risk for decline in skeletal musculature.

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Close layer
Mineral, Bone & Muscle
Comparison of Two DXA Systems, Hologic Horizon W and GE Lunar Prodigy, for Assessing Body Composition in Healthy Korean Adults
Seung Shin Park, Soo Lim, Hoyoun Kim, Kyoung Min Kim
Endocrinol Metab. 2021;36(6):1219-1231.   Published online December 16, 2021
DOI: https://doi.org/10.3803/EnM.2021.1274
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Dual-energy X-ray absorptiometry (DXA) is the most widely used method for evaluating muscle masses. The aim of this study was to investigate the agreement between muscle mass values assessed by two different DXA systems.
Methods
Forty healthy participants (20 men, 20 women; age range, 23 to 71 years) were enrolled. Total and regional body compositional values for fat and lean masses were measured consecutively with two DXA machines, Hologic Horizon and GE Lunar Prodigy. Appendicular lean mass (ALM) was calculated as the sum of the lean mass of four limbs.
Results
In both sexes, the ALM values measured by the GE Lunar Prodigy (24.8±4.3 kg in men, 15.8±2.9 kg in women) were significantly higher than those assessed by Hologic Horizon (23.0±4.0 kg in men, 14.8±3.2 kg in women). Furthermore, BMI values or body fat (%), either extremely higher or lower levels, contributed greater differences between two systems. Bland-Altman analyses revealed a significant bias between ALM values assessed by the two systems. Linear regression analyses were performed to develop equations to adjust for systematic differences (men: Horizon ALM [kg]=0.915×Lunar Prodigy ALM [kg]+0.322, R2=0.956; women: Horizon ALM [kg]=1.066×Lunar Prodigy ALM [kg]–2.064, R2=0.952).
Conclusion
Although measurements of body composition including muscle mass by the two DXA systems correlated strongly, significant differences were observed. Calibration equations should enable mutual conversion between different DXA systems.

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Close layer
Mineral, Bone & Muscle
Computed Tomography-Derived Skeletal Muscle Radiodensity Is an Early, Sensitive Marker of Age-Related Musculoskeletal Changes in Healthy Adults
Yeon Woo Jung, Namki Hong, Joon Chae Na, Woong Kyu Han, Yumie Rhee
Endocrinol Metab. 2021;36(6):1201-1210.   Published online December 13, 2021
DOI: https://doi.org/10.3803/EnM.2021.1206
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
A decrease in computed tomography (CT)-derived skeletal muscle radiodensity (SMD) reflects age-related ectopic fat infiltration of muscle, compromising muscle function and metabolism. We investigated the age-related trajectory of SMD and its association with vertebral trabecular bone density in healthy adults.
Methods
In a cohort of healthy adult kidney donors aged 19 to 69 years (n=583), skeletal muscle index (SMI, skeletal muscle area/height2), SMD, and visceral-to-subcutaneous fat (V/S) ratio were analyzed at the level of L3 from preoperative CT scans. Low bone mass was defined as an L1 trabecular Hounsfield unit (HU) <160 HU.
Results
L3SMD showed constant decline from the second decade (annual change –0.38% and –0.43% in men and women), whereas the decline of L3SMI became evident only after the fourth decade of life (–0.37% and –0.18% in men and women). One HU decline in L3SMD was associated with elevated odds of low bone mass (adjusted odds ratio, 1.07; 95% confidence interval, 1.02 to 1.13; P=0.003), independent of L3SMI, age, sex, and V/S ratio, with better discriminatory ability compared to L3SMI (area under the receiver-operating characteristics curve 0.68 vs. 0.53, P<0.001). L3SMD improved the identification of low bone mass when added to age, sex, V/S ratio, and L3SMI (category-free net reclassification improvement 0.349, P<0.001; integrated discrimination improvement 0.015, P=0.0165).
Conclusion
L3SMD can be an early marker for age-related musculoskeletal changes showing linear decline throughout life from the second decade in healthy adults, with potential diagnostic value for individuals with low bone mass.

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Adrenal Gland
Aldosterone Inhibits In Vitro Myogenesis by Increasing Intracellular Oxidative Stress via Mineralocorticoid Receptor
Jin Young Lee, Da Ae Kim, Eunah Choi, Yun Sun Lee, So Jeong Park, Beom-Jun Kim
Endocrinol Metab. 2021;36(4):865-874.   Published online July 30, 2021
DOI: https://doi.org/10.3803/EnM.2021.1108
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AbstractAbstract PDFPubReader   ePub   
Background
Despite clinical evidence indicating poor muscle health in subjects with primary aldosteronism (PA), it is still unclear whether the role of aldosterone in muscle metabolism is direct or mediated indirectly via factors, such as electrolyte imbalance or impaired glucose uptake. As one approach to clarify this issue, we investigated the effect of aldosterone on in vitro myogenesis and the potential mechanism explaining it.
Methods
Myogenesis was induced in mouse C2C12 myoblasts with 2% horse serum. Immunofluorescence, quantitative reversetranscription polymerase chain reaction, Western blot, viability, and migration analyses were performed for experimental research.
Results
Recombinant aldosterone treatment suppressed muscle differentiation from mouse C2C12 myoblasts in a dose-dependent manner, and consistently reduced the expression of myogenic differentiation markers. Furthermore, aldosterone significantly increased intracellular reactive oxygen species (ROS) levels in myotubes, and treatment with N-acetyl cysteine, a potent biological thiol antioxidant, reversed the decrease of myotube area, myotube area per myotube, nucleus number per myotube, and fusion index due to aldosterone through decreasing oxidative stress. A binding enzyme-linked immunosorbent assay confirmed that mineralocorticoid receptor (MR) interacted with aldosterone in C2C12 myoblasts, while eplerenone, an MR inhibitor, blocked aldosterone-stimulated intracellular ROS generation during myogenesis and markedly attenuated the suppression of in vitro myogenesis by aldosterone.
Conclusion
These findings support the hypothesis that hypersecretion of aldosterone, like PA, directly contributes to muscular deterioration and suggest that antioxidants and/or MR antagonists could be effective therapeutic options to reduce the risk of sarcopenia in these patients.

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    Daiji Kawanami, Yuichi Takashi, Yoshimi Muta, Naoki Oda, Dai Nagata, Hiroyuki Takahashi, Makito Tanabe
    Frontiers in Pharmacology.2021;[Epub]     CrossRef
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Review Article
Diabetes, Obesity and Metabolism
Receptor-Mediated Muscle Homeostasis as a Target for Sarcopenia Therapeutics
Jong Hyeon Yoon, Ki-Sun Kwon
Endocrinol Metab. 2021;36(3):478-490.   Published online June 28, 2021
DOI: https://doi.org/10.3803/EnM.2021.1081
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AbstractAbstract PDFPubReader   ePub   
Sarcopenia is a disease characterized by age-related decline of skeletal muscle mass and function. The molecular mechanisms of the pathophysiology of sarcopenia form a complex network due to the involvement of multiple interconnected signaling pathways. Therefore, signaling receptors are major targets in pharmacological strategies in general. To provide a rationale for pharmacological interventions for sarcopenia, we herein describe several druggable signaling receptors based on their role in skeletal muscle homeostasis and changes in their activity with aging. A brief overview is presented of the efficacy of corresponding drug candidates under clinical trials. Strategies targeting the androgen receptor, vitamin D receptor, Insulin-like growth factor-1 receptor, and ghrelin receptor primarily focus on promoting anabolic action using natural ligands or mimetics. Strategies involving activin receptors and angiotensin receptors focus on inhibiting catabolic action. This review may help to select specific targets or combinations of targets in the future.

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Close layer
Original Articles
Diabetes, Obesity and Metabolism
Reference Values for Skeletal Muscle Mass at the Third Lumbar Vertebral Level Measured by Computed Tomography in a Healthy Korean Population
Ja Kyung Yoon, Sunyoung Lee, Kyoung Won Kim, Ji Eun Lee, Jeong Ah Hwang, Taeyong Park, Jeongjin Lee
Endocrinol Metab. 2021;36(3):672-677.   Published online June 8, 2021
DOI: https://doi.org/10.3803/EnM.2021.1041
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AbstractAbstract PDFPubReader   ePub   
Background
Sarcopenia is defined as the loss of skeletal muscle mass and is associated with negative clinical outcomes. This study aimed to establish sex-specific cutoff values for the skeletal muscle area (SMA) and skeletal muscle index (SMI) at the third lumbar vertebral (L3) level using computed tomography (CT) imaging to identify sarcopenia in healthy Korean liver donors.
Methods
This retrospective study included 659 healthy liver donors (408 men and 251 women) aged 20 to 60 years who had undergone abdominal CT examinations between January 2017 and December 2018. Assessment of body composition was performed with an automated segmentation technique using a deep-learning system. Sex-specific SMA and SMI distributions were assessed, and cutoff values for determining sarcopenia were defined as values at either two standard deviations (SDs) below the mean reference value or below the fifth percentile.
Results
Using the SD definition, cutoff values for SMA and SMI were 117.04 cm2 and 39.33 cm2/m2, respectively, in men and 71.39 cm2 and 27.77 cm2/m2, respectively, in women. Using the fifth percentile definition, cutoff values for SMA and SMI were 126.88 cm2 and 40.96 cm2/m2, respectively, in men and 78.85 cm2 and 30.60 cm2/m2, respectively, in women.
Conclusion
Our data provide sex-specific cutoff values for the SMA and SMI at the L3 level measured by CT imaging in a healthy Korean population, which may be applicable for identifying sarcopenia in this population.

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Close layer
Endocrine Research
Effect of CCL11 on In Vitro Myogenesis and Its Clinical Relevance for Sarcopenia in Older Adults
Da Ae Kim, So Jeong Park, Jin Young Lee, Jeoung Hee Kim, Seungjoo Lee, Eunju Lee, Il-Young Jang, Hee-Won Jung, Jin Hoon Park, Beom-Jun Kim
Endocrinol Metab. 2021;36(2):455-465.   Published online April 14, 2021
DOI: https://doi.org/10.3803/EnM.2020.942
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
The C-C motif chemokine ligand 11 (CCL11) has been receiving attention as a potential pro-aging factor. Accordingly, it may be involved in muscle metabolism and sarcopenia, a key component of aging phenotypes. To clarify this potential, we investigated the effects of CCL11 on in vitro muscle biology and its clinical relevance for sarcopenia parameters in older adults.
Methods
Myogenesis was induced in mouse C2C12 myoblasts with 2% horse serum. Human blood samples were collected from 79 participants who underwent a functional assessment. Thereafter, CCL11 level was measured using a quantikine ELISA kit. Sarcopenia was defined using the Asian-specific guideline.
Results
Recombinant CCL11 treatment significantly stimulated myogenesis in a dose-dependent manner, and consistently increased the expression of myogenic differentiation markers. Among the C-C chemokine receptors (CCRs), CCR5, not CCR2 and CCR3, was predominantly expressed in muscle cells. Further, the CCR5 inhibitor blocked recombinant CCL11-stimulated myogenesis. In a clinical study, serum CCL11 level was not significantly different according to the status of sarcopenia, low muscle mass, weak muscle strength, and poor physical performance, and was not associated with skeletal muscle index, grip strength, short physical performance battery score, gait speed, and time to complete 5 chair stands, after adjusting for sex, age, and body mass index.
Conclusion
Contrary to expectations, CCL11 exerted beneficial effects on muscle metabolism at least in vitro system. However, its impact on human muscle health was not evident, suggesting that circulating CCL11 may not be a useful biomarker for sarcopenia risk assessment in older adults.

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Review Article
Miscellaneous
Sarcopenia and Muscle Aging: A Brief Overview
Tam Dao, Alexander E. Green, Yun A Kim, Sung-Jin Bae, Ki-Tae Ha, Karim Gariani, Mi-ra Lee, Keir J. Menzies, Dongryeol Ryu
Endocrinol Metab. 2020;35(4):716-732.   Published online December 23, 2020
DOI: https://doi.org/10.3803/EnM.2020.405
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AbstractAbstract PDFPubReader   ePub   
The world is facing the new challenges of an aging population, and understanding the process of aging has therefore become one of the most important global concerns. Sarcopenia is a condition which is defined by the gradual loss of skeletal muscle mass and function with age. In research and clinical practice, sarcopenia is recognized as a component of geriatric disease and is a current target for drug development. In this review we define this condition and provide an overview of current therapeutic approaches. We further highlight recent findings that describe key pathophysiological phenotypes of this condition, including alterations in muscle fiber types, mitochondrial function, nicotinamide adenine dinucleotide (NAD+) metabolism, myokines, and gut microbiota, in aged muscle compared to young muscle or healthy aged muscle. The last part of this review examines new therapeutic avenues for promising treatment targets. There is still no accepted therapy for sarcopenia in humans. Here we provide a brief review of the current state of research derived from various mouse models or human samples that provide novel routes for the development of effective therapeutics to maintain muscle health during aging.

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Close layer
Original Article
Clinical Study
Relationship of Sarcopenia with Microcirculation Measured by Skin Perfusion Pressure in Patients with Type 2 Diabetes
Chan-Hee Jung, Yoon Young Cho, Dughyun Choi, Bo-Yeon Kim, Chul-Hee Kim, Ji-Oh Mok
Endocrinol Metab. 2020;35(3):578-586.   Published online September 22, 2020
DOI: https://doi.org/10.3803/EnM.2020.679
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Few studies have examined the relationship of sarcopenia with the microcirculation. The current study investigated the relationship of sarcopenia with microcirculatory function, as assessed by skin perfusion pressure (SPP), in type 2 diabetes mellitus (T2DM) patients.
Methods
In total, 102 T2DM patients who underwent SPP measurements and bioelectrical impedance analysis (BIA) were enrolled in this cross-sectional study. SPP was assessed using the laser Doppler technique. Sarcopenia was defined as low height-adjusted appendicular muscle mass (men, <7 kg/m2; women, <5.7 kg/m2) using BIA. We divided the participants into two groups based on SPP (≤50 and >50 mm Hg), and an SPP below 50 mm Hg was considered to reflect impaired microcirculation.
Results
Fourteen patients (13.7%) were diagnosed with impaired microcirculatory function of the lower limb based on SPP. The prevalence of sarcopenia in all subjects was 11.8%, but the percentage of patients with an SPP ≤50 mm Hg who had sarcopenia was more than triple that of patients with an SPP >50 mm Hg (28.6% vs. 9.1%, P=0.036). A significant positive correlation was found between SPP and appendicular muscle mass adjusted for height (P=0.041 for right-sided SPP). Multiple logistic regression analysis showed that patients with sarcopenia had an odds ratio of 4.1 (95% confidence interval, 1.01 to 24.9) for having an SPP ≤50 mm Hg even after adjustment for confounding factors.
Conclusion
These results suggest that sarcopenia may be significantly associated with impaired microcirculation in patients with T2DM. Nonetheless, the small number of patients and wide CI require cautious interpretation of the results.

Citations

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Close layer
Namgok Lecture 2019
Obesity and Metabolism
Impact of Skeletal Muscle Mass on Metabolic Health
Gyuri Kim, Jae Hyeon Kim
Endocrinol Metab. 2020;35(1):1-6.   Published online March 19, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.1.1
  • 27,170 View
  • 539 Download
  • 124 Web of Science
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AbstractAbstract PDFPubReader   ePub   

Skeletal muscle is regarded as an endocrine and paracrine organ. Muscle-derived secretory proteins, referred to as myokines, mediate interactions between skeletal muscle mass and other organs such as the liver, adipose tissue, pancreas, bone, and the cardiovascular system. As individuals age, reduced levels of physical activity and sarcopenia (loss of skeletal muscle mass and strength) are associated with physical frailty and disability. Recently, several studies have suggested that the loss of skeletal muscle mass may contribute to metabolic disease. Therefore, herein, we focus on the relationships between skeletal muscle mass and metabolic diseases, including metabolic syndrome and non-alcoholic fatty liver disease.

Citations

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Close layer
Original Article
Clinical Study
Changes in Body Composition According to Age and Sex among Young Non-Diabetic Korean Adults: The Kangbuk Samsung Health Study
Seul-Ki Kim, Yu-Hyun Kwon, Jung Hwan Cho, Da Young Lee, Se Eun Park, Hyung-Geun Oh, Cheol-Young Park, Won-Young Lee, Ki-Won Oh, Sung-Woo Park, Eun-Jung Rhee
Endocrinol Metab. 2017;32(4):442-450.   Published online November 21, 2017
DOI: https://doi.org/10.3803/EnM.2017.32.4.442
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AbstractAbstract PDFPubReader   
Background

Age-related decreases in lean mass represent a serious health problem. We aimed to analyze the risks of rapid decreases in lean mass by age and sex in relatively young Korean adults during a 4-year follow-up study.

Methods

A total of 65,856 non-diabetic participants (59.5% men, mean age 39.1 years) in a health screening program were subjected to bioimpedance body composition analyses and metabolic parameter analyses at baseline and after 4 years. The participants were sub-divided according to age, and additionally to six groups by age and the degree of body weight change over the 4-year period. The actual changes in body weight, lean mass, and fat mass and the percent changes over the 4-year period were assessed.

Results

The percent change in lean mass decreased and the percent change of fat mass increased with increasing age in every age and sex group. However, the annual percent decrease in lean mass and percent increase in fat mass were significantly higher among women than among men (−0.26% vs. −0.15% and 0.34% vs. 0.42%, respectively; P<0.01). Participants who were older than 50 years and had a weight loss <−5% during the 4 years had significantly greater decreases in lean mass and smaller decreases in fat mass, compared to those who were younger than 50 years. An odds ratio analysis to determine the lowest quartile of the percent change in lean mass according to age group revealed that participants older than 60 years had a significantly increased risk of a rapid decrease in the lean mass percentage (2.081; 95% confidence interval, 1.678 to 2.581).

Conclusion

Even in this relatively young study population, the lean mass decreased significantly with age, and the risk of a rapid decrease in lean mass was higher among women than among men. Furthermore, the elderly exhibited a significantly more rapid decrease in lean mass, compared with younger participants.

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Close layer
Review Articles
Mineral, Bone & Muscle
Dual-Energy X-Ray Absorptiometry: Beyond Bone Mineral Density Determination
Yong Jun Choi
Endocrinol Metab. 2016;31(1):25-30.   Published online March 16, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.1.25
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AbstractAbstract PDFPubReader   

Significant improvements in dual-energy X-ray absorptiometry (DXA) concerning quality, image resolution and image acquisition time have allowed the development of various functions. DXA can evaluate bone quality by indirect analysis of micro- and macro-architecture of the bone, which and improve the prediction of fracture risk. DXA can also detect existing fractures, such as vertebral fractures or atypical femur fractures, without additional radiologic imaging and radiation exposure. Moreover, it can assess the metabolic status by the measurement of body composition parameters like muscle mass and visceral fat. Although more studies are required to validate and clinically use these parameters, it is clear that DXA is not just for bone mineral densitometry.

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Close layer
Obesity and Metabolism
Sarcopenia and Sarcopenic Obesity
Kyung Mook Choi
Endocrinol Metab. 2013;28(2):86-89.   Published online June 18, 2013
DOI: https://doi.org/10.3803/EnM.2013.28.2.86
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AbstractAbstract PDFPubReader   

The aging process is associated with progressive loss of muscle mass and strength, as well as decline in physical functioning. Although consensus diagnosis has not been reached, sarcopenia is increasingly defined by both loss of muscle mass and loss of muscle function or strength. The cause of sarcopenia is suggested as multifactorial, including hormonal changes, inflammatory pathway activation, fatty infiltration, poor nutrition, and decreased physical activity. Sarcopenia is often associated with visceral obesity. Sarcopenic obesity in the elderly impacts metabolic complications and represents a major public health challenge in a rapidly aging society. Further research about sarcopenia and sarcopenic obesity may be needed to confront the influence of aging society in Korea.

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