Therapeutic advances in sarcopenia management: From traditional interventions to personalized medicine

作者：Xiangliang Liu, Xinqiao Chen, Jiuwei Cui · 发表于：Clinical Nutrition · 年份：2025 · DOI：10.1016/j.clnu.2025.06.007 · 被引用次数：26 · 研究领域：Nutrition and Health in Aging、Nutrition, Genetics, and Disease

Sarcopenia, a progressive decline in skeletal muscle mass and function, has emerged as a critical geriatric syndrome affecting 10-40% of older adults, contributing to increased disability and mortality. This comprehensive review evaluates evidence-based strategies for sarcopenia management, from established interventions to emerging personalized approaches. Pathophysiological insights reveal multifactorial mechanisms involving anabolic resistance, chronic inflammation (elevated IL-6, TNF-α), hormonal imbalances (e.g., testosterone/IGF-1 decline), neuromuscular junction dysfunction, mitochondrial impairment, and novel mediators like GDF-15, which drive proteolysis and appetite suppression. Non-pharmacological interventions demonstrate robust efficacy: combined resistance-aerobic exercise regimens (2-3 sessions/week) improve muscle strength by 20-35%, while optimized protein intake (1.0-1.5 g/kg/day) with leucine or vitamin D supplementation enhances muscle synthesis and functional capacity. Pharmacological trials highlight selective androgen receptor modulators (SARMs) and myostatin inhibitors (e.g., bimagrumab) increasing lean mass by 3-5% in phase II studies, with GDF-15-neutralizing antibodies emerging as promising anti-catabolic agents. Advanced therapies, including stem cell transplantation and AAV-mediated gene editing targeting myostatin/IGF-1 pathways, show preclinical regenerative potential. However, clinical translation requires validation through large-scale trials....