Association between bile acid metabolism and sarcopenia in older adults

Sarcopenia poses a significant global health challenge, yet its metabolic underpinnings remain incompletely understood. Bile acids (BAs), acting as potent signaling molecules, are increasingly recognized for their role in skeletal muscle homeostasis. However, clinical evidence linking BA metabolic profiles to primary sarcopenia in older adults remains scarce.

We conducted a matched case-control study utilizing LC-MS/MS-based metabolomics to comprehensively characterize serum BA profiles in older adults with sarcopenia compared to healthy controls.

We observed six differential BAs, among which 3β-hyodeoxycholic acid (3β-HDCA) and glycolithocholic acid (GLCA) showed significant elevation in the sarcopenia group compared to controls. In conditional logistic regression analyses, elevated 3β-HDCA levels exhibited an independent association with sarcopenia risk across multiple adjustment models. A combined biomarker model yielded an Area Under the Curve (AUC) of 0.738. Furthermore, 3β-HDCA levels were found to be correlated with physical performance, specifically 6-m gait speed. Notably, interaction analysis indicated that the risk of sarcopenia associated with elevated taurolithocholic acid (TLCA) levels was significantly higher in individuals with long sleep duration (>8 h) (OR = 8.244, P = 0.022).

This study characterizes a distinct BA metabolic profile, identifying elevated 3β-HDCA and GLCA as potential biomarkers for sarcopenia. Moreover, our findings imply a potential interaction between sleep duration and BA metabolism (specifically TLCA) in the context of muscle loss. These observations may provide insights for future preventative strategies and warrant further investigation into the underlying mechanisms.