Insights into Pathogenesis, Nutritional and Drug Approach in Sarcopenia: A Systematic Review

Abstract

Sarcopenia is a multifactorial condition related to the loss of muscle mass and strength due to aging, eating habits, physical inactivity, or even caused by another disease. Affected individuals have a higher risk of falls and may be associated with heart disease, respiratory diseases, cognitive impairment, and consequently an increased risk of hospitalization, in addition to causing an economic impact due to the high cost of care during the stay in hospitals. The standardization of appropriate treatment for patients with sarcopenia that could help reduce pathology-related morbidity is necessary. For these reasons, this study aimed to perform a systematic review of the role of nutrition and drugs that could ameliorate the health and quality of life of sarcopenic patients and PRISMA guidelines were followed. Lifestyle interventions have shown a profound impact on sarcopenia treatment but using supplements and different drugs can also impact skeletal muscle maintenance. Creatine, leucine, branched-chain amino acids, omega 3, and vitamin D can show benefits. Although with controversial results, medications such as Metformin, GLP-1, losartan, statin, growth hormone, and dipeptidyl peptidase 4 inhibitors have also been considered and can alter the sarcopenic's metabolic parameters, protect against cardiovascular diseases and outcomes, while protecting muscles.

Keywords: amino acids; drugs; inflammation; sarcopenia.

Figure 1

Sarcopenia-related risk factors and sarcopenia-related outcomes. ↑, increase; ↓, decrease; GH, growth hormone; IGF-1, insulin-like growth factor-1; IL-1β, interleukin 1 beta; IL-6, interleukin 6; IL, insulin resistance; ROS, reactive oxygen species; TNF-α, tumor necrosis factor-alpha.

Figure 2

Flowchart showing the study selection of the studies.

Figure 3

Relationships between chronic inflammation, hormonal dysfunctions, and sarcopenia. ↑, increase; ↓, decrease; Akt, protein kinase b; FOX-O, forkhead box O proteins; GH, growth hormone; mTOR, mammalian target of rapamycin; IGF-1, insulin-like growth factor-1; IL-1β, interleukin 1 beta; IL-6, interleukin 6; NF-kB, nuclear factor kappa b; TNF-α, tumor necrosis factor-alpha.

Figure 4

Vitamin D, skeletal muscles, and bones perform crosstalk in sarcopenia development. ↑, increase; ↓, decrease; FGF23, fibroblast growth factor 23; FOXO1, forkhead box protein 1; IGF-1, insulin-like growth factor-1, UVB, ultraviolet B; VEGF, vascular endothelial growth factor.