Mitochondrial oxidative capacity and NAD+ biosynthesis are reduced in human sarcopenia across ethnicities
Open accessAbstract
The causes of impaired skeletal muscle mass and strength during aging are well-studied in healthy populations. Less is known on pathological age-related muscle wasting and weakness termed sarcopenia, which directly impacts physical autonomy and survival. Here, we compare genome-wide transcriptional changes of sarcopenia versus age-matched controls in muscle biopsies from 119 older men from Singapore, Hertfordshire UK and Jamaica. Individuals with sarcopenia reproducibly demonstrate a prominent transcriptional signature of mitochondrial bioenergetic dysfunction in skeletal muscle, with low PGC-1α/ERRα signalling, and downregulation of oxidative phosphorylation and mitochondrial proteostasis genes. These changes translate functionally into fewer mitochondria, reduced mitochondrial respiratory complex expression and activity, and low NAD + levels through perturbed NAD + biosynthesis and salvage in sarcopenic muscle. We provide an integrated molecular profile of human sarcopenia across ethnicities, demonstrating a fundamental role of altered mitochondrial metabolism in the pathological loss of skeletal muscle mass and function in older people.
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TL;DR
In a multi-ethnic case-control study of muscle biopsies from older men, sarcopenia was reproducibly characterized by a dominant transcriptional signature of mitochondrial bioenergetic dysfunction, including low PGC-1α/ERRα signaling and downregulated oxidative phosphorylation and mitochondrial proteostasis genes. These changes translated into fewer mitochondria, reduced respiratory complex expression and activity, and 32% lower muscle NAD+ through perturbed NAD+ biosynthesis and salvage.
Key findings
- In the Singapore Sarcopenia Study (SSS), 179 genes were altered in sarcopenic muscle at FDR < 10% (133 downregulated, 46 upregulated), with 133 genes annotated to the mitochondrion GO term; oxidative phosphorylation, mitochondrial respiratory chain, and TCA cycle gene sets were repressed at FDR < 10E−10, and age-adjusted gene ranks were highly conserved (Spearman rs = 0.95).
- Mitochondrial dysfunction replicated across ethnicities: HSS and JSS showed lower oxidative phosphorylation, mitochondrial respiratory ETC, and TCA cycle gene sets at FDR < 10E−04 and 10%, respectively; low ALMi and low muscle function also associated with depleted mitochondrial gene sets.
- Functional validation showed NDUFA9, SDHa, UQCR2, and ATP5a protein levels down by 44–51%, lower complexes I–IV activity, strongly reduced citrate synthase and succinate dehydrogenase activity, and 32% lower muscle NAD+; NAD+ correlated positively with ALMi, grip strength, gait speed, and complex I activity, while NMNAT1 and NAMPT were reduced and CD38, PARPs, and sirtuins were not increased.
- Other signatures included repressed mTOR signaling (FDR = 1.2E−02) but less than OXPHOS; no denervation/NMJ or inflammatory signatures except weak inflammation in JSS; ALMi associated with 318 genes at FDR < 10%, whereas grip strength and gait speed associated with only 7 and 9 genes at nominal p < 0.001 but FDR > 10%.
Methods
- Multi-ethnic case-control MEMOSA study of 119 older men from Singapore (SSS), Hertfordshire UK (HSS), and Jamaica (JSS); SSS included 20 sarcopenic Chinese men and 20 age-matched controls, HSS included 40 Caucasian men, and JSS included 40 Afro-Caribbean men. Sarcopenia was defined by AWGSOP (SSS) or EWGSOP (HSS/JSS) criteria using ALMi, grip strength, and gait speed.
- Vastus lateralis muscle biopsies were profiled by high-coverage total RNA sequencing (>70 million reads per sample; SSS 75–104 million, HSS 51–110 million, JSS 55–88 million); differential expression used limma/edgeR, pathway enrichment used CAMERA with MSigDB, and selected genes were validated by nanoString nCounter.
- Functional assays included mitochondrial enzymatic activity on mitochondrial fractions from 15–30 mg muscle, western blot for respiratory complex subunits and mitochondrial proteins, and NAD+ quantification in remaining biopsies, benchmarked against UHPLC-MS.
Limitations
- Stated: NAD+ results require further validation because they were analyzed in a subset of SSS individuals with sufficient remaining muscle biopsy (Fig. 6b, n = 4–6 per group); complex IV western blot was detected in less than 20% of samples and was excluded from analysis.
- Stated/evident: the cross-sectional case-control design cannot establish causality, and all cohorts were older men, so findings may not generalize to women.
- Evident: functional validation sample sizes were small and varied by assay and cohort; replication cohorts had variable sample sizes per phenotype (e.g., NAD+ metabolic process gene-set analysis n = 4–28 per group), and no independent prospective validation is reported.
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- Findingown data
Expression profiles of genes controlling mitochondrial dynamics through fusion and fission were lower in sarcopenic individuals.
“Expression profiles of genes controlling mitochondrial dynamics through fusion and fission were lower in sarcopenic individuals, both through single gene and pathway enrichment analyses (Fig. 2g; Fig. S2d).”
Quote in the paperSubstantial claim - Findingown data
Many genes controlling the UPRmt were strongly downregulated in muscle of sarcopenic participants, including mitochondrial heat-shock proteins, protease CLPP and transcriptional effectors UBL5, ATF4, and CHOP/DDIT3.
“Interestingly, many genes controlling the UPRmt were strongly downregulated in the muscle of sarcopenic participants, including those encoding the mitochondrial heat-shock proteins, the protease CLPP and their transcriptional effectors UBL5, ATF4, and CHOP/DDIT3 (Fig. 2i; Supplementary Fig. 2f).”
Quote in the paperSubstantial claim - Findingown data
Gene sets controlling mitochondrial function were consistently depleted in participants with low ALMi and low muscle function in HSS and JSS cohorts.
“Gene sets controlling mitochondrial function were also consistently depleted in participants with low ALMi (Fig. 3b) and low muscle function (Fig. 3c) in HSS and JSS cohorts.”
Quote in the paperSubstantial claim - Findingown data
Mitochondrial respiratory chain, TCA cycle regulator, and oxidative phosphorylation gene sets were repressed in sarcopenic muscle with FDRs < 10E−10.
“Mitochondrial respiratory chain, TCA cycle regulator, and oxidative phosphorylation gene sets were repressed in sarcopenic muscle with highly significant FDRs (<10E−10).”
Quote in the paperSubstantial claim - Findingown data
mRNA levels of PGC-1α and ERRα were reduced in sarcopenic muscle.
“mRNA levels of PGC-1α and ERRα were reduced in sarcopenic muscle (Fig. 2c)”
Quote in the paperSubstantial claim
- Findingown data
Promoters of genes downregulated in sarcopenic muscle were highly enriched in ERRα and NRF1 binding sites.
“In addition, the promoters of the genes downregulated in sarcopenic muscle were highly enriched in ERRα and nuclear respiratory factor 1 (NRF1) binding sites (Fig. 2e, f).”
Quote in the paperSubstantial claim - Findingown data
Many genes encoding both small and large subunits of the mitochondrial ribosome were downregulated in sarcopenic muscle.
“Many genes encoding both the small and large subunits of the mitochondrial ribosome were downregulated in sarcopenic muscle (Fig. 2h; Supplementary Fig. 2e)”
Quote in the paperSubstantial claim - Findingown data
Sets of genes controlling neuromuscular processes, NMJ structure and acetylcholine receptor signaling were not deregulated in sarcopenic muscle across the three cohorts.
“Sets of genes controlling neuromuscular processes, NMJ structure and acetylcholine receptor signaling were not deregulated in sarcopenic muscle across the three cohorts (Supplementary Fig. 2i, k, l)”
Quote in the paperSubstantial claim - Findingown data
Pathway enrichment analyses revealed lower expression of transcriptional networks regulated by ERRα and PGC-1α in sarcopenic muscle.
“The pathway enrichment analyses of sarcopenic muscle also revealed lower expression of the transcriptional networks regulated by the ERRα nuclear receptor (gene name ESRRA) and the PGC-1α transcriptional coactivator (PPARGCA1) (Fig. 2a)”
Quote in the paperSubstantial claim - Findingown data
Case-control analysis in SSS found 179 genes encoding 150 proteins and 29 noncoding RNAs altered in sarcopenic muscle at FDR < 10%.
“Case–control analysis in SSS revealed a strong perturbation of muscle gene expression in sarcopenic participants where 179 genes encoding 150 proteins and 29 noncoding RNAs were altered in sarcopenic muscle with false-discovery rate (FDR) < 10% (Fig. 1a; Supplementary Data 2).”
Quote in the paperSubstantial claim - Findingown data
Mitochondrial complex genes were downregulated in sarcopenic muscle across the five complexes.
“Mitochondrial complex genes were downregulated in sarcopenic muscle across the five complexes (Fig. 5b)”
Quote in the paperSubstantial claim - Findingown data
Genes of the NAD metabolic process GO term were repressed in sarcopenia versus control in SSS, HSS, and JSS.
“In gene-set enrichment analysis, genes of the NAD metabolic process GO term were repressed in sarcopenia vs. control in SSS, HSS, and JSS (Fig. 6a).”
Quote in the paperSubstantial claim - Findingown data
Expression of UPRmt genes was low in sarcopenic muscle.
“The expression of UPRmt genes (including mitochondrial heat-shock proteins, proteases and the downstream transcriptional response regulating mitohormesis from the nucleus) was low in sarcopenic muscle.”
Quote in the paperSubstantial claim - Findingown data
Expression of 318 genes encoding 276 proteins and 42 noncoding RNAs was associated with ALMi at FDR < 10%.
“The expression of 318 genes encoding 276 proteins and 42 noncoding RNAs were associated with ALMi at FDR < 10%.”
Quote in the paperSubstantial claim - Findingnone given
NAMPT is downregulated in sarcopenia.
“which is downregulated in by sarcopenia”
Quote in the paperSubstantial claim - Findingown data
Sarcopenic muscle had reduced expression of NMNAT1 and NAMPT, two rate-limiting enzymes of NAD+ biosynthesis and salvage.
“Sarcopenic muscle had reduced expression of NMNAT1 and NAMPT, two rate-limiting enzymes of NAD+ biosynthesis and salvage (Fig. 6d and Supplementary Fig. 4c).”
Quote in the paperSubstantial claim - Findingown data
Muscle NAD+ levels were decreased by 32% in sarcopenics versus controls.
“Muscle NAD+ levels were decreased by 32% in sarcopenics vs. controls (Fig. 6b)”
Quote in the paperSubstantial claim - Findingown data
At the pathway level, mitochondrial function was the strongest biological process associated with muscle mass and muscle function as continuous variables.
“At the pathway level, mitochondrial function was the strongest biological process associated with muscle mass and muscle function as continuous variables (Fig. 4b).”
Quote in the paperSubstantial claim - Findingown data
No increase in expression of NAD+ consuming enzymes such as CD38, PARPs or sirtuins was observed in sarcopenic muscle.
“In contrast, no increase in the expression of NAD+ consuming enzymes such as CD38 (Fig. 6e, f), PARPs (Supplementary Fig. 4e) or sirtuins (Supplementary Fig. 4f) was observed”
Quote in the paperSubstantial claim - Findingown data
Enzymatic activity of complexes I-IV was lower in sarcopenic muscle.
“In particular, the enzymatic activity of complexes I–IV was lower in sarcopenic muscle (Fig. 5e)”
Quote in the paperSubstantial claim - Findingown data
Activity of the TCA cycle enzymes citrate synthase (CS) and succinate dehydrogenase (SDH) was strongly reduced in sarcopenic muscle.
“The activity of the two mitochondrial TCA cycle enzymes citrate synthase (CS) and succinate dehydrogenase (SDH) were strongly reduced in sarcopenic muscle (Fig. 5e)”
Quote in the paperSubstantial claim - Findingown data
JSS revealed a weak inflammatory response in sarcopenic muscle.
“JSS revealed a weak inflammatory response in sarcopenic muscle (Supplementary Fig. 2l)”
Quote in the paperNot a substantial claim - Interpretationreasoning
Reduced transcriptional activity of ERRα and PGC-1α-dependent transcription factors in sarcopenic muscle may contribute to the global mitochondrial alterations observed in sarcopenia.
“Thus, reduced transcriptional activity of ERRα and of PGC-1α-dependent transcription factors in sarcopenic muscle may contribute to the global mitochondrial alterations observed in sarcopenia.”
Quote in the paperSubstantial claim - Interpretationown data
Mitochondrial energy production is the strongest transcriptional signature of sarcopenia and pathological muscle dysfunction.
“Thus, mitochondrial energy production is the strongest transcriptional signature of sarcopenia and pathological muscle dysfunction.”
Quote in the paperSubstantial claim - Interpretationown data
Transcriptomic analyses in three independent cohorts confirmed a prominent contribution of genes controlling mitochondrial energy production and oxidative phosphorylation in maintaining muscle mass and function in older individuals of different ethnicity.
“Together, transcriptomic analyses in the three independent cohorts confirmed a prominent contribution of genes controlling mitochondrial energy production and oxidative phosphorylation in maintaining muscle mass and function in older individuals of different ethnicity.”
Quote in the paperSubstantial claim - Premisecitation
Loss of mitochondrial oxidative capacity can be assessed non-invasively using 31P imaging as a biomarker.
“which can be assessed non-invasively using 31P imaging as a biomarker60”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [60] Conley, K. E., Ali, A. S., Flores, B., Jubrias, S. A. & Shankland, E. G. Mitochondrial NAD(P)H In vivo: identifying natural indicators of oxidative phosphorylation in the (31)P magnetic resonance spectrum. Front. Physiol. 7, 45 (2016). source
Not checked in the free run.
- Interpretationreasoning
Reduced NAD+ levels in human sarcopenia primarily result from inability to synthesize and recycle NAD+.
“suggesting that reduced NAD+ levels in human sarcopenia primarily result from inability to synthesize and recycle NAD+.”
Quote in the paperSubstantial claim - Interpretationown data
Inflammation may associate with sarcopenia only in a specific subset of people.
“suggesting that inflammation may associate with sarcopenia only in a specific subset of people.”
Quote in the paperNot a substantial claim - Premisecitation
Conversion of NAD+ precursors (NR or NMN) to NAD+ bypasses the rate-limited enzyme NAMPT.
“the conversion of these precursors to NAD+ bypasses the rate limited enzyme NAMPT”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [46] Rajman, L., Chwalek, K. & Sinclair, D. A. Therapeutic potential of NAD-boosting molecules: the in vivo evidence. Cell Metab. 27, 529–547 (2018). source
Not checked in the free run.
- cites [53] Zhang, H. et al. NAD(+) repletion improves mitochondrial and stem cell function and enhances life span in mice. Science 352, 1436–1443 (2016). source
Not checked in the free run.
- cites [54] Khan, N. A. et al. Effective treatment of mitochondrial myopathy by nicotinamide riboside, a vitamin B3. EMBO Mol. Med. 6, 721–731 (2014). source
Not checked in the free run.
- Interpretationown data
Loss of mitochondrial oxidative capacity is a major mechanism of sarcopenia.
“Our work establishes loss of mitochondrial oxidative capacity as a major mechanism of sarcopenia”
Quote in the paperSubstantial claim - Interpretationcitation
Low NAD+ levels in sarcopenic people could directly contribute to impaired mitochondrial activity and sarcopenia progression in humans.
“suggesting that low NAD+ levels in sarcopenic people could directly contribute to impaired mitochondrial activity and sarcopenia progression in humans.”
Quote in the paperSubstantial claim - Interpretationown data
Mitochondrial alterations in sarcopenia involve perturbation of a transcriptional module with reduced expression or activity of ERRα and NRF1 and their coactivator PGC-1α.
“At the molecular level, mitochondrial alterations in sarcopenia involve the perturbation of a transcriptional module with reduced expression or activity in sarcopenic muscle of the transcriptional regulators ERRα and NRF1 and their coactivator PGC-1α.”
Quote in the paperSubstantial claim - Premisecitation
Low NAD+ is a causal mechanism for mitochondrial perturbations in age-related pathologies in model organisms.
“However, low NAD+ is a causal mechanism for mitochondrial perturbations in age-related pathologies in model organisms49–51.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [49] Camacho-Pereira, J. et al. CD38 dictates age-related NAD Decline and mitochondrial dysfunction through an SIRT3-dependent mechanism. Cell Metab. 23, 1127–1139 (2016). source
Not checked in the free run.
- cites [50] Gomes, A. P. et al. Declining NAD(+) induces a pseudohypoxic state disrupting nuclear-mitochondrial communication during aging. Cell 155, 1624–1638 (2013). source
Not checked in the free run.
- cites [51] Canto, C. et al. The NAD(+) precursor nicotinamide riboside enhances oxidative metabolism and protects against high-fat diet-induced obesity. Cell Metab. 15, 838–847 (2012). source
Not checked in the free run.
- Interpretationown data
Neuromuscular dysfunction is not a major transcriptional mechanism of human sarcopenia.
“suggesting that neuromuscular dysfunction is not a major transcriptional mechanism of human sarcopenia.”
Quote in the paperSubstantial claim - Interpretationreasoning
Altered mitochondrial bioenergetic capacity through low oxidative phosphorylation is a strong and prominent determinant of the transition to disability in aged skeletal muscle.
“Thus, our findings establish altered mitochondrial bioenergetic capacity through low oxidative phosphorylation as a strong and prominent determinant of the transition to disability in aged skeletal muscle.”
Quote in the paperSubstantial claim - Interpretationcitation
The downregulation of mitochondrial dynamics genes observed in sarcopenia could be causal in the loss of muscle mass and strength.
“suggesting that the down regulation we observed in sarcopenia could be causal in the loss of muscle mass and strength.”
Quote in the paperSubstantial claim - Interpretationown data
Low mitochondrial bioenergetic capacity is the dominant signal in the transition from physiological to pathological muscle aging across ethnic groups.
“The molecular signatures of sarcopenia vs. healthy older people revealed low mitochondrial bioenergetic capacity as the dominant signal in the transition from physiological to pathological muscle aging across ethnic groups.”
Quote in the paperSubstantial claim - Premisecitation
New therapeutic strategies have emerged to restore NAD+ levels in muscle by administration of dietary NAD+ precursors such as NR or NMN.
“new therapeutic strategies have emerged to restore NAD+ levels in muscle by administration of dietary NAD+ precursors such as NR or NMN46,53,54”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [46] Rajman, L., Chwalek, K. & Sinclair, D. A. Therapeutic potential of NAD-boosting molecules: the in vivo evidence. Cell Metab. 27, 529–547 (2018). source
Not checked in the free run.
- cites [53] Zhang, H. et al. NAD(+) repletion improves mitochondrial and stem cell function and enhances life span in mice. Science 352, 1436–1443 (2016). source
Not checked in the free run.
- cites [54] Khan, N. A. et al. Effective treatment of mitochondrial myopathy by nicotinamide riboside, a vitamin B3. EMBO Mol. Med. 6, 721–731 (2014). source
Not checked in the free run.
- May combine two claims. 17
- Classified as probably not a substantial claim. 11
May combine two claims.
Findingown datamTOR signaling was repressed in sarcopenic muscle (FDR = 1.2E−02), but to a much lesser extent than oxidative phosphorylation (FDR < 10E−10).
“As a sign of altered protein anabolism, mTOR signaling was repressed in sarcopenic muscle (FDR = 1.2E−02; Supplementary Fig. 2g), but to a much lesser extent than oxidative phosphorylation (FDR < 10E−10; Supplementary Fig. 1b).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe sarcopenic transcriptional signature was enriched in downregulated genes, with 133 genes annotated under the mitochondrion GO term.
“This sarcopenic signature was enriched in downregulated genes, out of which 133 genes were annotated under the mitochondrion gene ontology term (Fig. 1b, green ticks).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataGene-set enrichment analysis confirmed mitochondrial bioenergetic dysfunction is a strong signature of sarcopenia in all cohorts/ethnicities, including lower oxidative phosphorylation, mitochondrial respiratory ETC and TCA cycle at FDR < 10E−04 and 10% in HSS and JSS.
“Gene-set enrichment analysis following high coverage RNA sequencing of sarcopenic and control muscle confirmed that mitochondrial bioenergetic dysfunction is a strong signature of sarcopenia in all cohorts/ethnicities (Fig. 3a), including lower oxidative phosphorylation, mitochondrial respiratory ETC and TCA cycle at FDR < 10E−04 and 10% in HSS and JSS, respectively (Fig. 3a).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataNDUFA9, SDHa, UQCR2, and ATP5a, representing complexes I, II, III, and V, were downregulated by 44-51% in sarcopenic muscle.
“NDUFA9, SDHa, UQCR2, and ATP5a, representing complexes I, II, III, and V, respectively, were downregulated by 44–51% in sarcopenic muscle (Fig. 5d).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataMuscle NAD+ levels correlated positively with ALMi, grip strength, gait speed, and complex I activity.
“and correlated positively with ALMi, grip strength, gait speed, and complex I activity (Fig. 6c).”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductown dataAge-adjustment slightly decreased statistical significance of differentially expressed genes but the rank of genes differentially expressed in sarcopenic muscle was highly conserved (Spearman rs = 0.95).
“Age-adjustment slightly decreased the statistical significance of the differentially expressed genes (Supplementary Fig. 1c), but the rank of genes differentially expressed in sarcopenic muscle was highly conserved (Supplementary Fig. 1d, Spearman rank correlation rs = 0.95).”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductown dataIndependent nanoString nCounter mRNA profiling of 80 selected genes tightly correlated with RNAseq data and confirmed lower expression of mitochondrial function genes in sarcopenic muscle.
“Independent mRNA gene expression validation of 80 selected genes using nanoString nCounter demonstrated tight correlation with RNAseq data (Supplementary Fig. 1a; Supplementary Data 3), and confirmed lower expression of mitochondrial function genes in sarcopenic muscle (Fig. 1c).”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataA large cluster of MRPs was downregulated in sarcopenia and likely contributed to decreased protein expression of mitochondrial respiratory chain subunits.
“Translational mechanisms also overlapped with this transcriptional regulation as a large cluster of MRPs was downregulated in sarcopenia and likely contributed to the decreased protein expression of mitochondrial respiratory chain subunits.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim. May combine two claims.
PremisecitationReduced NAD+ levels in skeletal muscle of aged or Nampt deficient mice alter mitochondrial bioenergetics and impair muscle mass, strength and endurance.
“Reduced NAD+ levels in skeletal muscle of aged or Nampt deficient mice alter mitochondrial bioenergetics and impair muscle mass, strength and endurance49,50,52,53”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [49] Camacho-Pereira, J. et al. CD38 dictates age-related NAD Decline and mitochondrial dysfunction through an SIRT3-dependent mechanism. Cell Metab. 23, 1127–1139 (2016). source
Not checked in the free run.
- cites [50] Gomes, A. P. et al. Declining NAD(+) induces a pseudohypoxic state disrupting nuclear-mitochondrial communication during aging. Cell 155, 1624–1638 (2013). source
Not checked in the free run.
- cites [52] Frederick, D. W. et al. Loss of NAD homeostasis leads to progressive and reversible degeneration of skeletal muscle. Cell Metab. 24, 269–282 (2016). source
Not checked in the free run.
- cites [53] Zhang, H. et al. NAD(+) repletion improves mitochondrial and stem cell function and enhances life span in mice. Science 352, 1436–1443 (2016). source
Not checked in the free run.
May combine two claims.
InterpretationreasoningHuman sarcopenia is driven by a major mitochondrial deficit detected both transcriptionally and functionally, for which reduced levels of NAD+ in muscle impair metabolic homeostasis and contribute to functional decline by altering muscle bioenergetics.
“Thus, human sarcopenia is driven by a major mitochondrial deficit detected both transcriptionally and functionally, for which reduced levels of NAD+ in muscle impair metabolic homeostasis and contribute to functional decline by altering muscle bioenergetics.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataReduced complex activity was linked to lower amounts of mitochondria, as it was not affected when normalized to CS activity.
“Reduced complex activity was linked to lower amounts of mitochondria as it was not affected when normalized to CS activity (Supplementary Fig. 3b).”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataAll clinical parameters used to diagnose sarcopenia contribute to the molecular profiles of sarcopenic muscle, with the strongest contribution from low muscle mass followed by grip strength and gait speed.
“Together, these results demonstrate that all clinical parameters used to diagnose sarcopenia contribute to the molecular profiles of sarcopenic muscle, with the strongest contribution from low muscle mass followed by grip strength and gait speed.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationGenetic loss of function of Mfn2 and Opa1 in mice is sufficient to cause sarcopenia.
“Interestingly, genetic loss of function of Mfn2 and Opa1 in mice is sufficient to cause sarcopenia43–45”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [43] Chen, H. et al. Mitochondrial fusion is required for mtDNA stability in skeletal muscle and tolerance of mtDNA mutations. Cell 141, 280–289 (2010). source
Not checked in the free run.
- cites [44] Sebastian, D. et al. Mfn2 deficiency links age-related sarcopenia and impaired autophagy to activation of an adaptive mitophagy pathway. EMBO J. 35, 1677–1693 (2016). source
Not checked in the free run.
- cites [45] Tezze, C. et al. Age-associated Loss of OPA1 in muscle impacts muscle mass, metabolic homeostasis, systemic inflammation, and epithelial senescence. Cell Metab. 25, 1374–1389.e6 (2017). source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductown dataThe NAD+ results require further validation as they were analyzed in a subset of individuals with sufficient remaining muscle biopsy from SSS.
“Although our NAD+ results require further validation as they were analyzed in a subset of individuals with sufficient amounts of remaining muscle biopsy from SSS”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationNAD+ decline during aging is well documented in preclinical models and has recently emerged in humans where skin and brain NAD+ decreases across the lifespan.
“NAD+ decline during aging is well documented in preclinical models and has recently emerged in humans where skin and brain NAD+ decreases across the lifespan46.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [46] Rajman, L., Chwalek, K. & Sinclair, D. A. Therapeutic potential of NAD-boosting molecules: the in vivo evidence. Cell Metab. 27, 529–547 (2018). source
Not checked in the free run.
May combine two claims.
InterpretationreasoningSarcopenia arises from a general bioenergetic deficit which differs mechanistically from primary mitochondrial myopathies caused by decreased activity of a specific complex.
“Thus, sarcopenia arises from a general bioenergetic deficit which differs mechanistically from primary mitochondrial myopathies caused by decreased activity of a specific complex.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Interpretationown dataThe MEMOSA study results provide a genome-wide molecular resource of mechanisms and biomarkers of pathological muscle aging across ethnicities.
“Collectively, the MEMOSA study results provide a genome-wide molecular resource of mechanisms and biomarkers of pathological muscle aging across ethnicities.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationPhysical activity has established benefits on mitochondrial efficiency in aged skeletal muscle.
“The established benefits of physical activity on mitochondrial efficiency in aged skeletal muscle2,47,59”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [2] Cartee, G. D., Hepple, R. T., Bamman, M. M. & Zierath, J. R. Exercise promotes healthy aging of skeletal muscle. Cell Metab. 23, 1034–1047 (2016). source
Not checked in the free run.
- cites [47] Greggio, C. et al. Enhanced respiratory chain supercomplex formation in response to exercise in human skeletal muscle. Cell Metab. 25, 301–311 (2017). source
Not checked in the free run.
- cites [59] Broskey, N. T. et al. Skeletal muscle mitochondria in the elderly: effects of physical fitness and exercise training. J. Clin. Endocrinol. Metab. 99, 1852–1861 (2014). source
Not checked in the free run.
May combine two claims.
PremisecitationNAD+ precursor interventions are safe and increase NAD+ levels in early human clinical testing.
“the demonstration that these interventions are safe and increase NAD+ levels in early human clinical testing46,55,56”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [46] Rajman, L., Chwalek, K. & Sinclair, D. A. Therapeutic potential of NAD-boosting molecules: the in vivo evidence. Cell Metab. 27, 529–547 (2018). source
Not checked in the free run.
- cites [55] Elhassan, Y. S. et al. Nicotinamide riboside augments the aged human skeletal muscle NAD(+) metabolome and induces transcriptomic and anti-inflammatory signatures. Cell Rep. 28, 1717–1728 (2019). e1716. source
Not checked in the free run.
- cites [56] Martens, C. R. et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD(+) in healthy middle-aged and older adults. Nat. Commun. 9, 1286 (2018). source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataOne sample from the SSS cohort was excluded from the analysis because it did not reach the threshold of >35 million uniquely mapped reads due to an abnormally low percentage of uniquely mapped reads.
“One sample (from the SSS cohort) which did not reach this threshold because of an abnormally low percentage of uniquely mapped reads was excluded from the analysis.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningThe study creates the mechanistic basis to test the clinical efficacy of NAD+ precursors on muscle strength and physical function in older people with sarcopenia.
“our study creates the mechanistic basis to test the clinical efficacy of NAD+ precursors on muscle strength and physical function in older people with sarcopenia.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataAll RNA samples were homogeneous and passed quality control with 260/280 nm ratio > 1.8 and RIN scores > 7.
“All RNA samples were homogeneous and passed quality control with 260/280 nm ratio > 1.8 and RIN scores > 7.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataComplexes I-III and V were correctly detected in all samples but complex IV was only detected in less than 20% of samples and was excluded from the analysis.
“Complexes I–III and V were correctly detected in all samples but complex IV was only detected in less than 20% of samples and was excluded from the analysis.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningThe study provides a strong rationale for intervention trials targeting muscle mitochondrial bioenergetics to manage sarcopenia in older people.
“provides a strong rationale for intervention trials targeting muscle mitochondrial bioenergetics to manage sarcopenia in older people.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
Little is known about the molecular processes of pathological sarcopenia compared with healthy muscle aging.
“While the molecular processes associated with the average functional decline of muscle in the healthy population have been well studied, little is known about the pathological state of sarcopenia, the pathological muscle wasting and weakness of the old age recently assigned an ICD-10 disease code due to its negative impact on physical function, quality of life, and survival6,19–21.”
The paper relies on this without support.
The clinical definition of sarcopenia is standardized enough to characterize a molecular signature of sarcopenia in older people.
“Standardization of the clinical definition now provides an opportunity to characterize the molecular “signature” of sarcopenia in older people.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Mitochondrial dysfunction and low NAD+ levels are hallmarks of skeletal muscle ageing and sarcopenia.
“Mitochondrial dysfunction and low nicotinamide adenine dinucleotide (NAD+) levels are hallmarks of skeletal muscle ageing and sarcopenia1–3”
From Trigonelline Is an NAD+ Precursor That Improves Muscle Function during Ageing and Is Reduced in Human Sarcopenia (2024) · cites this paper as [3]
Mitochondrial dysfunction and reduced NAD+ are prominent features of pathological progression and sarcopenia, as revealed by previous profiling of muscle biopsies from patients with sarcopenia versus age-matched healthy controls.
“Our previous profiling of muscle biopsies from patients with sarcopenia versus age-matched healthy controls revealed that mitochondrial dysfunction and reduced NAD+, two well-established molecular hallmarks of organismal ageing11, are prominent features of pathological progression and sarcopenia3.”
From Trigonelline Is an NAD+ Precursor That Improves Muscle Function during Ageing and Is Reduced in Human Sarcopenia (2024) · cites this paper as [3]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Protein-coding differential gene count differs by one
MinorThe Results count 150 protein-encoding genes among the 179 differentially expressed genes, while the Methods describe 149 protein-coding genes differentially regulated in sarcopenia.
“179 genes encoding 150 proteins and 29 noncoding RNAs were altered in sarcopenic muscle”
“Protein interaction networks were generated with the 149 protein coding genes differentially regulated in sarcopenia”
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NAD+ metabolism: pathophysiologic mechanisms and therapeutic potential
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“Controlling NAD-biosynthesis pathway Enhancing NAD-biosynthesis is one alternative approach to elevate NAD concentration through either increasing the activity of enzymes in NAD-biosynthetic pathway or inhibiting the activity of enzymes in the side branch pathway.(633) NAD is synthesized from both de novo pathway and…”
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Sarcopenia and Muscle Aging: A Brief Overview
Dao, T., Green, A. E., Kim, Y.-A., Bae, S., Ha, K., Gariani, K., Lee, M.-R., Menzies, K. J., & Ryu, D. (2020) · Endocrinology and Metabolism · doi:10.3803/enm.2020.405 · Cited by 229 · see citing works
“As aforementioned, NAD biosynthesis is reduced in skeletal muscle from Caucasian, African, and Asian sarcopenic cohorts [35].”
BackgroundLi, H.-R., Liu, Q., Zhu, C., Sun, X., Sun, C.-Y., Yu, C.-M., Li, P., Deng, X., & Wang, J. (2023) · Redox Biology · doi:10.1016/j.redox.2023.102745 · Cited by 172 · see citing works
Membrez, M., Migliavacca, E., Christen, S., Yaku, K., Trieu, J., Lee, A. K., Morandini, F., Giner, M. P., Stiner, J., Makarov, M. V., et al. (2024) · Nature Metabolism · doi:10.1038/s42255-024-00997-x · Cited by 148 · see citing works
Self-citationSarcopenia and Cognitive Function: Role of Myokines in Muscle Brain Cross-Talk
Scisciola, L., Fontanella, R. A., Surina, S., Cataldo, V., Paolisso, G., & Barbieri, M. (2021) · Life · doi:10.3390/life11020173 · Cited by 148 · see citing works
“These changes decreased mitochondria, mitochondrial respiratory complex expression and activity, and NAD+ levels via perturbed NAD+ biosynthesis [26].”
BackgroundThe role of NAD+ metabolism and its modulation of mitochondria in aging and disease
Yusri, K., Jose, S., Vermeulen, K. S., Tan, T. C. M., & Sorrentino, V. (2025) · npj Metabolic Health and Disease · doi:10.1038/s44324-025-00067-0 · Cited by 171 · see citing works
“Sarcopenia is a progressive skeletal muscle disorder characterized by a decline in muscle mass, strength, and gait speed 124,249,250 .”
InfluentialMuscle Wasting and Sarcopenia in Heart Failure—The Current State of Science
Lena, A., Anker, M. S., & Springer, J. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21186549 · Cited by 140 · see citing works
Mitochondrial dysfunction and skeletal muscle atrophy: Causes, mechanisms, and treatment strategies
Kubat, G. B., Bouhamida, E., Ülger, Ö., Türkel, İ., Pedriali, G., Ramaccini, D., Ekinci, Ö., Özerkliğ, B., Atalay, Ö., Patergnani, S., et al. (2023) · Mitochondrion · doi:10.1016/j.mito.2023.07.003 · Cited by 128 · see citing works
Granic, A., Suetterlin, K., Shavlakadze, T., Grounds, M. D., & Sayer, A. A. (2023) · Clinical Science · doi:10.1042/cs20230319 · Cited by 118 · see citing works
“Notably, transcriptional down-regulation of gene pathways linked with mitochondrial function (tricarboxylic acid (TCA) cycle, oxidative phosphorylation, mitochondrial respiration) have the strongest association with human muscle mass and function [172].”
BackgroundSelf-citationEpigenetic Mechanisms of Aging and Aging-Associated Diseases
la Torre, A., Vecchio, F. L., & Greco, A. (2023) · Cells · doi:10.3390/cells12081163 · Cited by 120 · see citing works
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Healthy aging and muscle function are positively associated with NAD+ abundance in humans
Janssens, G. E., Grevendonk, L., Perez, R. Z., Schomakers, B. V., de Vogel-van den Bosch, J., Geurts, J. M. W., van Weeghel, M., Schrauwen, P., Houtkooper, R. H., & Hoeks, J. (2022) · Nature Aging · doi:10.1038/s43587-022-00174-3 · Cited by 103 · see citing works
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Self-citationBörsch, A., Ham, D. J., Mittal, N., Tintignac, L. A., Migliavacca, E., Feige, J. N., Rüegg, M. A., & Zavolan, M. (2021) · Communications Biology · doi:10.1038/s42003-021-01723-z · Cited by 85 · see citing works
Self-citationMulti-omics research in sarcopenia: Current progress and future prospects
Liu, J., Dong, S., Shen, H., Yang, D.-Y., Chen, B., Ma, X., Peng, Y., Xiao, H., & Deng, H. (2022) · Ageing Research Reviews · doi:10.1016/j.arr.2022.101576 · Cited by 83 · see citing works
Biomarkers of aging in frailty and age-associated disorders: State of the art and future perspective
Salvioli, S., Basile, M. S., Bencivenga, L., Carrino, S., Conte, M., Damanti, S., LORENZO, R. D., Fiorenzato, E., Gialluisi, A., Ingannato, A., et al. (2023) · Ageing Research Reviews · doi:10.1016/j.arr.2023.102044 · Cited by 85 · see citing works
Mitochondrial heterogeneity in diseases
Chen, L., Zhou, M., Li, H., Liu, D., Liao, P., Yao, Z., Zhang, C., Zou, W., & Gao, J. (2023) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-023-01546-w · Cited by 86 · see citing works
Zuo, X., Zhao, R., Wu, M., Wang, Y., Wang, S., Tang, K., Wang, Y., Chen, J., Yan, X., Cao, Y., et al. (2025) · Nature Aging · doi:10.1038/s43587-024-00797-8 · Cited by 82 · see citing works
“Our pathway analysis highlights metabolism as the most prominent molecular signature of sarcopenia, consistent with previous studies showing altered mitochondrial oxidative capacity in sarcopenia 22 .”
Muscle Stem Cell Quiescence: Controlling Stemness by Staying Asleep
Ancel, S., Stuelsatz, P., & Feige, J. N. (2021) · Trends in Cell Biology · doi:10.1016/j.tcb.2021.02.006 · Cited by 75 · see citing works
Self-citationExercise and mitochondrial mechanisms in patients with sarcopenia
Pahlavani, H. A., Laher, I., Knechtle, B., & Zouhal, H. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2022.1040381 · Cited by 76 · see citing works
“reduction in ATP production in older mice (Marzetti et al., 2008; Migliavacca et al., 2019; Harper et al., 2021), and ETS abnormalities in sarcopenic muscle are also affected by decreases”
BackgroundZhu, H., Xu, W., Wang, N., Jiang, W., Cheng, Y., Guo, Y., Yao, W., Hu, B., Du, P., & Qian, H. (2021) · Food & Function · doi:10.1039/d1fo00383f · Cited by 73 · see citing works
Impact of Adipose Tissue and Lipids on Skeletal Muscle in Sarcopenia
Jang, S. Y., & Choi, K. M. (2025) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.70000 · Cited by 81 · see citing works
“Furthermore, human sarco-penic muscle showed reduced expression of genes regulating mitochondrial unfolded protein response (UPRmt), whose function is a repair or salvage of dysfunctional mitochondria [47].”
NAD+ repletion with niacin counteracts cancer cachexia
Beltrà, M., Pöllänen, N., Fornelli, C., Tonttila, K., Hsu, M. Y., Zampieri, S., Moletta, L., Corrà, S., Porporato, P. E., Kivelä, R., et al. (2023) · Nature Communications · doi:10.1038/s41467-023-37595-6 · Cited by 71 · see citing works
Determinants of Adherence in Time-Restricted Feeding in Older Adults: Lessons from a Pilot Study
Lee, S. A., Sypniewski, C., Bensadon, B. A., McLaren, C., Donahoo, W. T., Sibille, K. T., & Anton, S. D. (2020) · Nutrients · doi:10.3390/nu12030874 · Cited by 67 · see citing works
“In a recent multi-ethnic study (MEMOSA—Multi-Ethnic Molecular determinants of Sarcopenia) involving participants from Singapore, the UK, and Jamaica [9], the genome-wide transcriptomic profiles of skeletal muscle biopsies in 119 older men diagnosed with sarcopenia compared with age-matched controls were examined using…”
MethodBrain-muscle communication prevents muscle aging by maintaining daily physiology
Kumar, A., Vaca-Dempere, M., Mortimer, T., Deryagin, O., Smith, J. G., Petrus, P., Koronowski, K. B., Greco, C. M., Segalés, J., Andrés, E., et al. (2024) · Science · doi:10.1126/science.adj8533 · Cited by 70 · see citing works
Zullo, A., Fleckenstein, J., Schleip, R., Hoppe, K., Wearing, S. C., & Klingler, W. (2020) · Frontiers in Physiology · doi:10.3389/fphys.2020.00592 · Cited by 70 · see citing works
“These data were also supported by a recent study in humans, which showed that sarcopenia is associated with altered expression of genes regulating mitochondrial energy production in skeletal muscle (Migliavacca et al., 2019).”
BackgroundResultHosoda, R., Nakashima, R., Yano, M., Iwahara, N., Asakura, S., Nojima, I., Saga, Y., Kunimoto, R., Horio, Y., & Kuno, A. (2023) · Journal of Pharmacological Sciences · doi:10.1016/j.jphs.2023.04.001 · Cited by 75 · see citing works
Basse, A. L., Agerholm, M., Farup, J., Dalbram, E., Nielsen, J., Ørtenblad, N., Altıntaş, A., Ehrlich, A. M., Krag, T. O. B., Bruzzone, S., et al. (2021) · Molecular Metabolism · doi:10.1016/j.molmet.2021.101271 · Cited by 62 · see citing works
“NAMPT and NADþ levels were previously found to be decreased in muscle from a small number of individuals with sarcopenia [68].”
BackgroundReactive oxygen species in the pathogenesis of sarcopenia
Xu, H., Brown, J. L., Bhaskaran, S., & Van Remmen, H. (2025) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2024.11.046 · Cited by 61 · see citing works
“Patients experiencing sarcopenia have reduced expression and activity of mitochondrial respiratory complexes and downregulated oxidative phosphorylation and mitochondrial protein homeostasis genes in skeletal muscle when compared to patients without sarcopenia [74].”
Yan, X., Shen, Z.-L., Yu, D., Zhao, C., Zou, H., Ma, B., Dong, W.-X., Chen, W., Huang, D., & Yu, Z. (2021) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2021.11.030 · Cited by 60 · see citing works
Neuromuscular impairment at different stages of human sarcopenia
Sarto, F., Franchi, M. V., McPhee, J. S., Stashuk, D. W., Paganini, M., Monti, E., Rossi, M., Sirago, G., Zampieri, S., Motanova, E. S., et al. (2024) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.13531 · Cited by 67 · see citing works
“…with recent data showing that gene sets involved in NMJ regulation were not altered in sarcopenic compared with non-sarcopenic individuals of different ethnicities, 29 although a caveat of that study is that it used bulk RNA-Seq and did not assess the signalling from single subsynaptic myonuclei.”
BackgroundMitochondrial Quality Control in Sarcopenia: Updated Overview of Mechanisms and Interventions
Liu, D., Fan, Y., Tao, X., Pan, W., Wu, Y., Wang, X., He, Y., Xiao, W., & Li, Y. (2021) · Aging and Disease · doi:10.14336/ad.2021.0427 · Cited by 60 · see citing works
“Notably, three prominent metabolic regulators (AMPK, PGC-1α and SIRT1) apparently cooperate to hinder the progression of sarcopenia.”
BackgroundInfluentialAutophagy in sarcopenia: Possible mechanisms and novel therapies
Xie, G., Jin, H., Mikhail, H., Pavel, V., Yang, G., Ji, B., Lu, B., & Li, Y. (2023) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2023.115147 · Cited by 57 · see citing works
Sarcopenia in aging, obesity, and cancer
Ligibel, J. A., Schmitz, K. H., & Berger, N. A. (2020) · Translational Cancer Research · doi:10.21037/tcr-2019-eaoc-05 · Cited by 58 · see citing works
“By preserving NAD+ pools, PARP inhibitors, commonly used in chemotherapy, can improve mitochondrial metabolism, which may preserve muscle mass (34-40).”
BackgroundGDF‐15 is associated with sarcopenia and frailty in acutely admitted older medical patients
Kamper, R. S., Nygaard, H. H., Praeger‐Jahnsen, L., Ekmann, A., Ditlev, S. B., Schultz, M., Hansen, S. K., Hansen, P., Pressel, E., & Suetta, C. (2024) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.13513 · Cited by 55 · see citing works
Evidence of superconducting Fermi arcs
Kuibarov, A., Suvorov, O., Vocaturo, R., Fedorov, A. V., Lou, R., Merkwitz, L., Voroshnin, V. Y., Facio, J. I., Koepernik, K., Yaresko, A. N., et al. (2024) · Nature · doi:10.1038/s41586-023-06977-7 · Cited by 52 · see citing works
SIRT1 signaling pathways in sarcopenia: Novel mechanisms and potential therapeutic targets
Yang, L., Liu, D., Jiang, S., Li, H., Chen, L., Wu, Y., Essien, A. E., Opoku, M., Naranmandakh, S., Liu, S., et al. (2024) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2024.116917 · Cited by 54 · see citing works
Standpoints in mitochondrial dysfunction: Underlying mechanisms in search of therapeutic strategies
Videla, L. A., Mariman, A. P., Ramos, B., Silva, M. J., & del Campo, A. (2022) · Mitochondrion · doi:10.1016/j.mito.2021.12.006 · Cited by 48 · see citing works
Impaired age-associated mitochondrial translation is mitigated by exercise and PGC-1α
de Smalen, L. M., Börsch, A., Leuchtmann, A. B., Gill, J. F., Ritz, D., Zavolan, M., & Handschin, C. (2023) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2302360120 · Cited by 46 · see citing works
“Given that we and others (35) did not observe any upregulation of UPR mt markers in sarcopenic muscle, it is unlikely that the reduced translation rates that we observed are caused by this mechanism.”
BackgroundInfluentialNunes-Pinto, M., de Mello, R. G. B., Pinto, M. N., Moro, C., Vellas, B. J., Martinez, L. O., Rolland, Y., & Barreto, P. D. S. (2024) · Ageing Research Reviews · doi:10.1016/j.arr.2024.102587 · Cited by 47 · see citing works
Endoplasmic reticulum stress in human chronic wound healing: Rescue by 4‐phenylbutyrate
Bachar-Wikström, E., Manchanda, M., Bansal, R., Karlsson, M. G., Pettersson, P. K., Sköldenberg, O. G., & Wikström, J. D. (2020) · International Wound Journal · doi:10.1111/iwj.13525 · Cited by 45 · see citing works
“Seattle, WA) to measure the gene expression levels of candidate genes, as previously described.(47)”
MethodShavlakadze, T., Xiong, K., Mishra, S., McEwen, C., Gadi, A., Wakai, M., Salmon, H. A., Stec, M. J., Negron, N., Ni, M., et al. (2023) · Skeletal Muscle · doi:10.1186/s13395-023-00321-3 · Cited by 48 · see citing works
Muscle aging and sarcopenia: The pathology, etiology, and most promising therapeutic targets
Grima-Terrén, M., Campanario, S., Ramírez‐Pardo, I., Cisneros, A., Hong, X., Perdiguero, E., Serrano, A. L., Isern, J., & Muñoz‐Cánoves, P. (2024) · Molecular Aspects of Medicine · doi:10.1016/j.mam.2024.101319 · Cited by 49 · see citing works
Antoun, E., Garratt, E. S., Taddei, A., Burton, M. A., Barton, S. J., Titcombe, P., Westbury, L. D., Baczynska, A., Migliavacca, E., Feige, J. N., et al. (2021) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.12876 · Cited by 43 · see citing works
“RNA was extracted from frozen muscle tissue using the mirVana miRNA Isolation Kit (Ambion, Life Technologies), and RNA sequencing carried out as described in Migliavacca et al.(17)”
InfluentialSelf-citationNAD+ Precursors: A Questionable Redundancy
Cantó, C. (2022) · Metabolites · doi:10.3390/metabo12070630 · Cited by 41 · see citing works
Nicotinamide Adenine Dinucleotide in Aging Biology: Potential Applications and Many Unknowns
Bhasin, S., Seals, D. R., Migaud, M. E., Musi, N., & Baur, J. A. (2023) · Endocrine Reviews · doi:10.1210/endrev/bnad019 · Cited by 47 · see citing works
Dozio, E., Vettoretti, S., Lungarella, G., Messa, P., & Romanelli, M. M. C. (2021) · Biomedicines · doi:10.3390/biomedicines9040405 · Cited by 42 · see citing works
“Worth noting is the observation that one molecular signature of the transition between healthy to sarcopenic muscle is low mitochondrial bioenergetic capacity [54].”
BackgroundKim, J., Lee, J.-Y., & Kim, C. Y. (2023) · Nutrients · doi:10.3390/nu15112625 · Cited by 41 · see citing works
“In a human biopsy study, the protein expression levels of mitochondrial fusion factor Mfn2 were revealed to be significantly reduced in older individuals with sarcopenia than those in control individuals [75].”
BackgroundFrom mitochondria to sarcopenia: Role of inflammaging and RAGE-ligand axis implication
Daussin, F., Boulanger, É., & Lancel, S. (2021) · Experimental Gerontology · doi:10.1016/j.exger.2021.111247 · Cited by 41 · see citing works
The Role of Mitochondria in Mediation of Skeletal Muscle Repair
Alway, S., Paez, H., & Pitzer, C. R. (2023) · Muscles · doi:10.3390/muscles2020011 · Cited by 43 · see citing works
Identification of a KLF5-dependent program and drug development for skeletal muscle atrophy
Liu, L., Koike, H., Ono, T., Hayashi, S., Kudo, F., Kaneda, A., Kagechika, H., Manabe, I., Nakashima, T., & Oishi, Y. (2021) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2102895118 · Cited by 42 · see citing works
“GSE111017 contained data from three cohorts.”
InfluentialKameda, M., Teruya, T., Yanagida, M., & Kondoh, H. (2021) · Aging · doi:10.18632/aging.203498 · Cited by 39 · see citing works
“Consistently, recent comparative RNA analysis in muscle biopsy also identified mitochondrial dysfunction in sarcopenia [52].”
BackgroundAging and putative frailty biomarkers are altered by spaceflight
Camera, A., Tabetah, M., Castañeda, V., Kim, J., Galsinh, A. S., Haro-Vinueza, A., Salinas, I., Seylani, A., Arif, S., Das, S., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-57948-5 · Cited by 41 · see citing works
“…from 118 people with and without sarcopenia (GSE111006, GSE111010, and GSE111016) 27 , 6,892 DEGs were identified by performing Mann–Whitney U tests 28 on gene expression data for every single gene (i.e., 65,217 genes) in a pair-wise manner across samples from both sets of patients (Supplementary…”
MethodZeng, H., Xu, J., Wang, X., Li, S., & Han, Z. (2022) · Ecotoxicology and Environmental Safety · doi:10.1016/j.ecoenv.2022.113441 · Cited by 39 · see citing works
NAD+ centric mechanisms and molecular determinants of skeletal muscle disease and aging
Wagner, S., Manickam, R., Brotto, M. A. P., & Tipparaju, S. M. (2022) · Molecular and Cellular Biochemistry · doi:10.1007/s11010-022-04408-1 · Cited by 39 · see citing works
“Further investigation demonstrated a significant decrease in many mitochondrial genes, including those forming the electron transport chain, Complex I–V in the sarcopenia muscle biopsies [73].”
BackgroundShero, J. A., Lindholm, M. E., Sandri, M. F., & Stanford, K. I. (2025) · Circulation Research · doi:10.1161/circresaha.124.325614 · Cited by 43 · see citing works
Physiological Systems in Promoting Frailty
Perazza, L. R., Brown‐Borg, H. M., & Thompson, L. V. (2022) · Comprehensive physiology · doi:10.1002/cphy.c210034 · Cited by 64 · see citing works
A transition to degeneration triggered by oxidative stress in degenerative disorders
Stern, M., & McNew, J. A. (2020) · Molecular Psychiatry · doi:10.1038/s41380-020-00943-9 · Cited by 33 · see citing works
Mitochondrial mechanisms in the pathogenesis of chronic inflammatory musculoskeletal disorders
Wu, K., Shieh, J.-S., Qin, L., & Guo, J. J. (2024) · Cell & Bioscience · doi:10.1186/s13578-024-01259-9 · Cited by 36 · see citing works
Romani, M., Berger, M. M., & D’Amelio, P. (2022) · Nutrients · doi:10.3390/nu14030483 · Cited by 34 · see citing works
“Mitochondrial potential and transport, two altered features of sarcopenic muscles, are essential for mitochondrial quality control mechanisms; hence, UPRmt and mitophagy are altered during pathological muscle aging [53,54] (Figure 2).”
BackgroundMakhnovskii, P., Bokov, R. O., Kolpakov, F., & Popov, D. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22031208 · Cited by 27 · see citing works
“Notably, a previous study found that the same number of genes encoding mitochondrial proteins were expressed at lower levels in sarcopenic human VL muscle showing low mitochondrial density than in age-matched controls [70].”
ResultMeng, L., Yang, R., Wang, D., Wu, W., Shi, J. C., Shen, J., Dang, Y.-M., Fan, G., Shi, H., Dong, J., et al. (2022) · BMC Geriatrics · doi:10.1186/s12877-022-02953-4 · Cited by 32 · see citing works
“The results provided an integrated molecular profile of human sarcopenia across ethnicities, demonstrating a fundamental role of altered mitochondrial metabolism in the pathological losses of skeletal muscle mass and function in older people [60].”
BackgroundAssociation of plasma mitochondrial DNA with COPD severity and progression in the SPIROMICS cohort
Zhang, W. Z., Hoffman, K. L., Schiffer, K. T., Oromendia, C., Rice, M. C., Barjaktarević, I., Peters, S. P., Putcha, N., Bowler, R. P., Wells, J. M., et al. (2021) · Respiratory Research · doi:10.1186/s12931-021-01707-x · Cited by 29 · see citing works
“grip strength), phenotypes which are commonly observed in patients with severe COPD and which may be attributable to mitochondrial dysfunction [47, 48].”
BackgroundParathyroid hormone-related peptide.
Kaiser, S. M., & Goltzman, D. (1993) · PubMed · Cited by 30 · see citing works
Jeong, I., Cho, E., Yook, J.-S., Choi, Y., Park, D., Kang, J., Lee, S.-H., Seo, D. Y., Jung, S., & Kwak, H. (2024) · Life · doi:10.3390/life14080962 · Cited by 33 · see citing works
“…adults with sarcopenia, skeletal muscle mitochondria demonstrate a characteristic decline in the expression and activity of mitochondrial respiratory complexes, accompanied by suppressed oxidative phosphorylation and downregulation of genes responsible for mitochondrial protein quality control [9].”
BackgroundXu, J., Wakai, M., Xiong, K., Yang, Y., Prabakaran, A., Wu, S. P., Ahrens, D., Molina‐Portela, M. D. P., Ni, M., Bai, Y., et al. (2025) · Cell Reports · doi:10.1016/j.celrep.2025.115403 · Cited by 32 · see citing works
Physiological Systems in Promoting Frailty
Perazza, L. R., Brown‐Borg, H. M., & Thompson, L. V. (2022) · Comprehensive physiology · doi:10.1002/j.2040-4603.2022.tb00224.x · Cited by 30 · see citing works
Implications of NAD + boosters in translational medicine
Kang, B. E., Choi, J., Stein, S., & Ryu, D. (2020) · European Journal of Clinical Investigation · doi:10.1111/eci.13334 · Cited by 32 · see citing works
Ginseng and ginsenosides: Therapeutic potential for sarcopenia
Zha, W., Sun, Y., Gong, W., Li, L., Kim, W., & Li, H. (2022) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2022.113876 · Cited by 29 · see citing works
Relevance of endoplasmic reticulum and mitochondria interactions in age-associated diseases
Gil-Hernández, A., & Silva‐Palacios, A. (2020) · Ageing Research Reviews · doi:10.1016/j.arr.2020.101193 · Cited by 30 · see citing works
Mau, T., Barnes, H. N., BLACKWELL, T. L., Kramer, P. A., Bauer, S. R., Marcinek, D. J., Ramos, S. V., Forman, D. E., Toledo, F. G. S., Hepple, R. T., et al. (2023) · GeroScience · doi:10.1007/s11357-023-01002-1 · Cited by 27 · see citing works
“2 and 3 Discussion Frailty may stem from individuals having diminished or scarcer energy reserves in musculoskeletal systems [8, 33, 34], where some older adults could become frail sooner due to an accelerated onset of muscle and physical decline.”
Mishra, S., Welch, N., Karthikeyan, M., Bellar, A., Musich, R. J., Singh, S. S., Zhang, D., Sekar, J., Attaway, A. H., Chelluboyina, A. K., et al. (2023) · Aging Cell · doi:10.1111/acel.13852 · Cited by 26 · see citing works
FOXO-regulated DEAF1 controls muscle regeneration through autophagy
Goh, K. Y., Lee, W. X., Choy, S. M., Priyadarshini, G. K., Chua, K., Tan, Q. H., Low, S. Y., Chin, H. S., Wong, C. S., Huang, S., et al. (2024) · Autophagy · doi:10.1080/15548627.2024.2374693 · Cited by 30 · see citing works
“RNA-seq data investigating sarcopenia in human patients was downloaded from GEO (GSE111010 and GSE111016) [71].”
Targeting Mitochondria to Control Ageing and Senescence
Protasoni, M., & Serrano, M. (2023) · Pharmaceutics · doi:10.3390/pharmaceutics15020352 · Cited by 28 · see citing works
Vintila, A. R., Slade, L., Cooke, M., Willis, C. R. G., Torregrossa, R., Rahman, M., Anupom, T., Vanapalli, S. A., Gaffney, C. J., Gharahdaghi, N., et al. (2023) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2216141120 · Cited by 26 · see citing works
“Conversely, sarcopenia associates with postdevelopmental FoxO upregulation across species (58), corresponding with later life metabolic reprogramming to compensate for aging health decline (57, 58).”
Wang, Y., Li, J., Zhang, Z., Wang, R., Hai, B., & Zhang, Y. (2023) · Life · doi:10.3390/life13041006 · Cited by 28 · see citing works
“In skeletal muscle from aging mice, the levels of UPRmt proteins are reduced, and in muscle biopsy samples from sarcopenic humans, the expression of UPRmt genes is decreased, indicating an insufficient UPRmt response to repair or neutralize oxidative stress-induced damage to mitochondrial proteins [82,83].”
BackgroundSong, L., Xue, J., Xu, L., Cheng, L., Zhang, Y., & Wang, X. (2024) · Experimental Gerontology · doi:10.1016/j.exger.2024.112468 · Cited by 26 · see citing works
“Many studies have shown that PGC-1 α degradation is closely associated with mitochondrial dysfunction in aged sarcopenia (Migliavacca et al., 2019; Ji and Kang, 2015; Fern ´ andez-L ´ azaro et al., 2022; Derbr ´ e et al., 2012).”
BackgroundExercise reduces intramuscular stress and counteracts muscle weakness in mice with breast cancer
Mader, T., Chaillou, T., Alves, E. S., Jude, B., Cheng, A. J., Kenne, E. M., Mijwel, S., Kurzejamska, E., Vincent, C. T., Rundqvist, H., et al. (2022) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.12944 · Cited by 25 · see citing works
“Reduced mitochondrial function and mitochondrial damage is linked to reduced muscle function and muscle weakness.(13,20,21) Moreover, recent transcriptomics and proteomics analyses showed that mitochondrial ETC genes and proteins were lower in skeletal muscle from breast cancer patients than healthy controls.”
BackgroundPulse Wave Velocity and Sarcopenia in Older Persons—A Systematic Review and Meta-Analysis
Piotrowicz, K., Klich‐Rączka, A., Skalska, A., Gryglewska, B., Grodzicki, T. K., & Gąsowski, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19116477 · Cited by 26 · see citing works
Wu, W., Yuan, S., Tang, Y., Meng, X., Peng, M., Hu, Z., & Liu, W. (2023) · Nutrients · doi:10.3390/nu15132851 · Cited by 26 · see citing works
Artificial‐intelligence‐driven discovery of prognostic biomarker for sarcopenia
Chung, H., Jo, Y., Ryu, D., Jeong, C., Choe, S., & Lee, J. (2021) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.12840 · Cited by 25 · see citing works
“Sarcopenia is often associated with physical frailty,(23) reduced muscle function,(27) and mitochondrial dysfunction.(14) In addition, recent studies revealed that amyloidosis in skeletal muscle is associated with mitochondrial dysfunction(28,29) and muscle diseases including inclusion body myositis,(30,31) indicating…”
InfluentialNAD depletion in skeletal muscle does not compromise muscle function or accelerate aging
Chubanava, S., Karavaeva, I. E., Ehrlich, A. M., Justicia, R. M., Basse, A. L., Kulik, I., Dalbram, E., Ahwazi, D., Heaselgrave, S. R., Trôst, K., et al. (2025) · Cell Metabolism · doi:10.1016/j.cmet.2025.04.002 · Cited by 28 · see citing works
Bae, J., Jo, A., Cho, S. C., Lee, Y., Kam, T., You, C.-L., Jeong, H., Kim, H., Jeong, M., Jeong, Y., et al. (2023) · Science Translational Medicine · doi:10.1126/scitranslmed.abh3489 · Cited by 23 · see citing works
Aging-Related Sarcopenia: Metabolic Characteristics and Therapeutic Strategies
Chen, Y., & Wu, J. (2024) · Aging and Disease · doi:10.14336/ad.2024.0407 · Cited by 24 · see citing works
“Not only that, but several studies have also indicated an age-related decline in both the quantity and functionality of mitochondria in skeletal muscle [130-133].”
New insights into healthy ageing, inflammageing and frailty using metabolomics
Abdullah, G. A., Akpan, A., Phelan, M. M., & Wright, H. L. (2024) · Frontiers in Aging · doi:10.3389/fragi.2024.1426436 · Cited by 22 · see citing works
The recent development, application, and future prospects of muscle atrophy animal models
Zhang, G., Hu, F., Huang, T., Ma, X., Cheng, Y., Liu, X., Jiang, W., Dong, B., & Fu, C. (2024) · MedComm – Future Medicine · doi:10.1002/mef2.70008 · Cited by 22 · see citing works
Meng, L., Shi, H., Wang, D., Shi, J. C., Wu, W., Dang, Y.-M., Fan, G., Shen, J., Yu, P., Dong, J., et al. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.816045 · Cited by 23 · see citing works
“Of importance, the causes of impaired muscle mass and strength with aging were examined in 119 older men; the results demonstrated a fundamental role of altered mitochondrial metabolism in the pathological losses in sarcopenia among older people (67).”
BackgroundVo, T. T. T., Huynh, T. D., Wang, C., Lai, K.-H., Lin, Z., Lin, W., Chen, Y., Peng, T., Wu, H., & Lee, I. (2022) · Antioxidants · doi:10.3390/antiox11081619 · Cited by 22 · see citing works
“Suggestive of potential relevance in mammals, the UPRmt network is also active in various tissues [73], which is deregulated in age-related diseases such as sarcopenia (muscle wasting and weakness) [74] and Alzheimer’s disease [75,76].”
BackgroundMaruta, H., Abe, R., & Yamashita, H. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23094691 · Cited by 22 · see citing works
“The bioenergetics of skeletal muscle largely rely on the metabolic flexibility of its mitochondria [3,4].”
BackgroundFu, Y., Tao, L., Wang, X., Wang, B., Qin, W., & Song, L. (2024) · Experimental Gerontology · doi:10.1016/j.exger.2024.112428 · Cited by 21 · see citing works
- Authors
- Migliavacca, E., Tay, S. K. H., Patel, H. P., Sonntag, T., Civiletto, G., McFarlane, C., Forrester, T., Barton, S. J., Leow, M. K., Antoun, E., Charpagne, A., Seng Chong, Y., Descombes, P., Feng, L., Francis-Emmanuel, P., Garratt, E. S., Giner, M. P., Green, C. O., Karaz, S., Kothandaraman, N., Marquis, J., Metairon, S., Moco, S., Nelson, G., Ngo, S., Pleasants, T., Raymond, F., Sayer, A. A., Ming Sim, C., Slater-Jefferies, J., Syddall, H. E., Fang Tan, P., Titcombe, P., Vaz, C., Westbury, L. D., Wong, G., Yonghui, W., Cooper, C., Sheppard, A., Godfrey, K. M., Lillycrop, K. A., Karnani, N., & Feige, J. N.
- Affiliations
- École Polytechnique Fédérale de Lausanne (CH)
- National University of Singapore (SG)
- University Hospital Southampton NHS Foundation Trust (GB)
- James Cook University (AU)
- University of the West Indies (JM)
- MRC Lifecourse Epidemiology Unit (GB)
- Agency for Science, Technology and Research (SG)
- University of Southampton (GB)
- University of Auckland (NZ)
- NIHR Newcastle Biomedical Research Centre (GB)
- Corresponding author
- Godfrey, Keith M.
- Lillycrop, Karen A.
- Karnani, Neerja
- ORCID
- Migliavacca, Eugenia
- Tay, Stacey K. H.
- Patel, Harnish P.
- Civiletto, Gabriele
- McFarlane, Craig
- Barton, Sheila J.
- Leow, Melvin K.
- Antoun, Elie
- Charpagne, Aline
- Seng Chong, Yap
- Descombes, Patrick
- Francis-Emmanuel, Patrice
- Garratt, Emma S.
- Giner, Maria Pilar
- Marquis, Julien
- Metairon, Sylviane
- Moco, Sofia
- Raymond, Frederic
- Sayer, Avan A.
- Slater-Jefferies, Jo
- Syddall, Holly E.
- Titcombe, Philip
- Vaz, Candida
- Westbury, Leo D.
- Cooper, Cyrus
- Godfrey, Keith M.
- Lillycrop, Karen A.
- Karnani, Neerja
- Feige, Jerome N.
- Venue
- Nature Communications
- Published
- 2019-12-20
- Volume
- 10
- Issue
- 1
- Pages
- 5808-5808
- ISSN
- 2041-1723 (ISSN-L)
- PMC
- PMC6925228
- OpenAlex
- W2992356442
- Semantic Scholar
- d022163e1837e1b77bb72fbeb26e8415b92d6063
- Cited by
- 365
- References
- 75
- Citations by year
- 2026: 66 · 2025: 74 · 2024: 65 · 2023: 56 · 2022: 50 · 2021: 37 · 2020: 16
- FWCI
- 8.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Nature Communications (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ResearchOnline at James Cook University (James Cook University) (submittedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- National University of Singapore (submittedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion, cc-by-nc-nd)
- Funders
- University Hospital Southampton NHS Foundation Trust
- National Institute for Health and Care Research (NF-SI-0515-10042, NIHR200286, NF-SI-0508-10082, U24AG047867, 289346, CL-2011-26-002, NF-SI-0617-10109, NF-SI-0513-10085)
- National Osteoporosis Society
- University of Southampton
- University of Oxford
- European Commission (FP7/2007, 289346)
- Agency for Science, Technology and Research
- National University of Singapore
- Singapore Institute for Clinical Sciences
- International Osteoporosis Foundation
- National Institute for Health Research Southampton Biomedical Research Centre (289346)
- National Institutes of Health
- Directorate for Biological Sciences
- Medical Research Council (MC_UU_20/4, MC_UU_12011/4, MC_UU_12011/2, MC_U47585827, MC_UU_12011/1, MC_ST_U2055)
- Biotechnology and Biological Sciences Research Council (ES/M0099X)
- Economic and Social Research Council
- National Institute on Aging (U24AG047867)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Mitochondrial Function and Pathology
- Keywords
- sarcopenia, mitochondrial oxidative capacity, NAD biosynthesis, NAD+ salvage pathway, skeletal muscle aging, oxidative phosphorylation, mitochondrial proteostasis, mitochondrial respiratory chain, mitochondrial mass, ethnic differences, older men
- MeSH terms
- Proteostasis, Aged, Aged, 80 and over, Aging, Biopsy, Energy Metabolism, United Kingdom, Humans, Jamaica, Male, Middle Aged, Mitochondria, NAD, Oxidation-Reduction, Oxidative Phosphorylation, Singapore, Case-Control Studies, Oxidative Stress, Muscle, Skeletal, Sarcopenia
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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