Sarcopenia is recognized as a complex and multifactorial disorder that includes nutritional deficiency, inactivity, proinflammatory status, hormonal changes, neurological degeneration, and metabolic disturbances. Its’ pathogenesis is not fully understood. Therefore, identifying specific biomarkers of sarcopenia will help us understand its pathophysiology. The most frequently reported blood-derived biomarkers of sarcopenia are growth factors, neuromuscular junctions, endocrine systems, mitochondrial dysfunction, inflammation-mediated and redox processes, muscle protein turnover, blood metabolomics, and behavior-mediated biomarkers. Here, we address the implications of sarcopenia biomarkers based on our research experience with KFACS cohort data. It includes free testosterone, myostatin, fibroblast growth factor 21 (FGF-21), growth differentiation factor 15 (GDF-15), procollagen type III N-terminal peptide (P3NP), creatinine-based biomarkers, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), brain-derived neurotrophic factor (BDNF), metabolites (proline, alanine, tryptophan), and multi-biomarker risk score. We attempted to explain the paradoxical findings of myostatin and FGF-21 levels in relation to sarcopenia. GDF-15 levels were associated with sarcopenia prevalence but not its incidence. Plasma P3NP and BDNF levels may be biomarkers of muscle quality rather than quantity. Lower erythrocyte EPA and DHA levels were associated with slow gait speed, and erythrocyte EPA levels were associated with low handgrip strength. We developed a multi-biomarker risk score for sarcopenia and found that its accuracy in diagnosing sarcopenia was higher than that of any single biomarker.

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从单独的血液来源生物标志物到肌肉减少症的组合生物标志物：韩国衰弱和衰老队列研究的经验


肌肉减少症被认为是一种复杂的多因素疾病，包括营养缺乏、缺乏活动、促炎状态、荷尔蒙变化、神经退化和代谢紊乱。其发病机制尚不完全清楚。因此，识别肌肉减少症的特定生物标志物将有助于我们了解其病理生理学。最常报道的肌肉减少症的血液来源生物标志物是生长因子、神经肌肉接头、内分泌系统、线粒体功能障碍、炎症介导和氧化还原过程、肌肉蛋白周转、血液代谢组学和行为介导的生物标志物。在这里，我们根据我们对 KFACS 队列数据的研究经验解决了肌肉减少症生物标志物的影响。它包括游离睾酮、肌肉生长抑制素、成纤维细胞生长因子 21 （FGF-21）、生长分化因子 15 （GDF-15）、III 型前胶原 N 末端肽 （P3NP）、基于肌酐的生物标志物、二十碳五烯酸 （EPA） 和二十二碳六烯酸 （DHA）、脑源性神经营养因子 （BDNF）、代谢物（脯氨酸、丙氨酸、色氨酸）和多生物标志物风险评分。我们试图解释肌肉生长抑制素和 FGF-21 水平与肌肉减少症相关的矛盾发现。GDF-15 水平与肌肉减少症患病率相关，但与发病率无关。血浆 P3NP 和 BDNF 水平可能是肌肉质量而不是数量的生物标志物。较低的红细胞 EPA 和 DHA 水平与缓慢的步态速度相关，红细胞 EPA 水平与低握力有关。我们开发了肌肉减少症的多生物标志物风险评分，发现其诊断肌肉减少症的准确性高于任何单一生物标志物。