Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Oct 8;60(10):1648.
doi: 10.3390/medicina60101648.

Age-Related Changes in Insulin Resistance and Muscle Mass: Clinical Implications in Obese Older Adults

Ali A Rizvi  1 , Manfredi Rizzo  2   3
Affiliations
Review

Age-Related Changes in Insulin Resistance and Muscle Mass: Clinical Implications in Obese Older Adults

Ali A Rizvi et al. Medicina (Kaunas). .

Abstract

The older segment of the global population is increasing at a rapid pace. Advancements in public health and modern medicine lengthened life expectancy and reduced the burden of disease in communities worldwide. Concurrent with this demographic change is the rise in overweight people and obesity, which is evident in all age groups. There is also an aging-related reduction in muscle mass and function, or sarcopenia, that is exacerbated by sedentary lifestyle and poor nutrition. The coexistence of muscle loss and elevated body mass index, termed "sarcopenic obesity", has particularly deleterious consequences in older individuals. Worsening insulin resistance and a proinflammatory state operate at the pathophysiologic level and lead to adverse health outcomes such as a proclivity to cardiovascular disease, type 2 diabetes, and even cognitive dysfunction. Although the concept of sarcopenic obesity as a disease construct is being increasingly recognized, a clearer understanding is warranted in order to define its components and health impact. Research is needed at the molecular-cellular level to tie together derangements in insulin action, cytokines, myokines, and endothelial dysfunction with clinical outcomes. Lifestyle modifications as well as targeted nonpharmacologic approaches, such as supplements and antioxidants, appear to have a promising role in reducing the chronic burden of this emerging disorder. Breakthroughs in drug therapies that retard or even reverse the underlying dynamics of sarcopenia and obesity in older persons are being actively explored.

Keywords: diabetes; metabolic syndrome; muscle mass; obesity; older adults; sarcopenia.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The relationships of insulin resistance, glucose effectiveness, and first-phase insulin secretion in men and women with age (from: Huang et al., 2023, available at https://www.mdpi.com/2075-4418/13/13/2158, accessed on 1 August 2024).
Figure 2
Figure 2
Sarcopenia: EWGSOP2 algorithm for case-finding, making a diagnosis and quantifying severity in practice. The steps of the pathway are represented as find-assess-confirm-severity or F-A-C-S. (from: Cruz-Jentoft et al., 2019, available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322506/, accessed on 1 August 2024).
Figure 3
Figure 3
Diagrammatic depiction of myokines exerting paracrine and autocrine effects because of contraction of skeletal muscles. Release of stimulatory cytokines and the inhibitory mediator are shown by green and red arrows, respectively, while black arrows indicate downstream effects. GDF-15 = growth differentiation factor-15, IL-6 = interleukin-6, and FGF-21 = fibroblast growth factor-21. (From: Feraco et al., 2021, available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8430804/, accessed on 1 August 2024).
Figure 4
Figure 4
HOMA-IR Index in the control (nonobese–nonsarcopenic), obese–nonsarcopenic, nonobese–sarcopenic, and obese–sarcopenic study groups: mean HOMA-IR values were 2.35, 4.38, 2.60, and 2.22, respectively, (from Rizvi et al., 2024, available at: https://doi.org/10.2337/db24-158-OR).
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Chooi Y.C., Ding C., Magkos F. The epidemiology of obesity. Metabolism. 2019;92:6–10. doi: 10.1016/j.metabol.2018.09.005. - DOI - PubMed
    1. Hruby A., Hu F.B. The Epidemiology of Obesity: A Big Picture. Pharmacoeconomics. 2015;33:673–689. doi: 10.1007/s40273-014-0243-x. - DOI - PMC - PubMed
    1. Xie W.Q., Xiao G.L., Fan Y.B., He M., Lv S., Li Y.S. Sarcopenic obesity: Research advances in pathogenesis and diagnostic criteria. Aging Clin. Exp. Res. 2021;33:247–252. doi: 10.1007/s40520-019-01435-9. - DOI - PubMed
    1. Zamboni M., Rubele S., Rossi A.P. Sarcopenia and obesity. Curr. Opin. Clin. Nutr. Metab. Care. 2019;22:13–19. doi: 10.1097/MCO.0000000000000519. - DOI - PubMed
    1. Barazzoni R., Bischoff S., Boirie Y., Busetto L., Cederholm T., Dicker D., Toplak H., Van Gossum A., Yumuk V., Vettor R. Sarcopenic Obesity: Time to Meet the Challenge. Obes. Facts. 2018;11:294–305. doi: 10.1159/000490361. - DOI - PMC - PubMed

Grants and funding

This research received no external funding.

LinkOut - more resources