Novel biomarkers for sarcopenia: a narrative review

Sarcopenia is an age-related syndrome characterized by the progressive loss of skeletal muscle mass, strength, and function. It is associated with an increased risk of falls, disability, and mortality, as well as a significant healthcare burden. Traditional assessment of sarcopenia relies on imaging techniques and physical function tests, which have important limitations, including operational complexity, difficulty in early identification, and inability to reflect underlying molecular mechanisms. The emergence of candidate biomarkers-including muscle-specific factors, inflammation-related proteins, non-coding RNAs, and nutritional metabolites-has enabled a more precise elucidation of the pathophysiological mechanisms of the disease across multiple dimensions, such as protein homeostasis, chronic inflammation, post-transcriptional regulation, and energy metabolism. These advances provide new avenues for early identification, risk stratification, identification of disease subtypes, and the development of personalized intervention strategies. This article reviews the potential applications and current challenges of these candidate biomarkers in both clinical practice and research on sarcopenia.