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老龄化背景下肌少症与肥胖的共病机制研究进展

田浩冬^1,2, 陆玉坤^1,2,3, 黄丽^1,2, 刘昊为^1,2, 余杭林^1,2, 吴进龙^1,2, 李汉森⁴, 彭莉^1,2,*

¹西南大学体育学院，重庆 400715；²西南大学国家体育总局体质评价与运动机能监控重点实验室，重庆 400715；³新疆和田学院体育学院，和田 848000；⁴四川农业大学体育学院，雅安 625014

摘要

老龄化的加剧使得肌少症与肥胖共病日趋常见且复杂，对社会经济与公共卫生安全造成了巨大负担。目前，相关研究已对两者各自的发病机制进行了较为系统的探索，但对于二者的共病机制仍不明晰。对此，本研究梳理了老年人群肌少症与肥胖的研究现状与共病机制，着重探讨了与衰老密切相关的两类共病机制，包含以细胞自噬损失、巨噬细胞功能异常、线粒体功能障碍和性激素分泌减少为主的生物学共病机制；以胰岛素抵抗、维生素D代谢异常、铁代谢失调，烟酰胺腺嘌呤二核苷酸水平下降及肠道微生物代谢异常为主的代谢共病机制；此外，本综述还探讨了等位基因及microRNA等遗传学因素在二者共病中的重要作用。这对于理解肌少症与肥胖的发病规律、制定临床干预和预防策略具有重要意义。

关键词： 老年人; 肌少症; 肥胖; 共病机制

Research progress on the comorbidity mechanism of sarcopenia and obesity in the aging population

TIAN Hao-Dong^1,2, LU Yu-Kun^1,2,3, HUANG Li^1,2, LIU Hao-Wei^1,2, YU Hang-Lin^1,2, WU Jin-Long^1,2, LI Han-Sen⁴, PENG Li^1,2,*

¹College of Physical Education, Southwest University, Chongqing 400715, China；²Key Laboratory of Physical Fitness Evaluation and Sports Function Monitoring of General Administration of Sport of China, Southwest University, Chongqing 400715, China；³College of Physical Education, Xinjiang Hetian College, Hetian 848000, China; 4School of Physical Education, Sichuan Agricultural University, Ya'an 625014, China；⁴School of Physical Education, Sichuan Agricultural University, Ya'an 625014, China

Abstract

The increasing prevalence of aging has led to a rising incidence of comorbidity of sarcopenia and obesity, posing significant burdens on socioeconomic and public health. Current research has systematically explored the pathogenesis of each condition; however, the mechanisms underlying their comorbidity remain unclear. This study reviews the current literature on sarcopenia and obesity in the aging population, focusing on their shared biological mechanisms, which include loss of autophagy, abnormal macrophage function, mitochondrial dysfunction, and reduced sex hormone secretion. It also identifies metabolic mechanisms such as insulin resistance, vitamin D metabolism abnormalities, dysregulation of iron metabolism, decreased levels of nicotinamide adenine dinucleotide, and gut microbiota imbalances. Additionally, this study also explores the important role of genetic factors, such as alleles and microRNAs, in the co-occurrence of sarcopenia and obesity. A better understanding of these mechanisms is vital for developing clinical interventions and preventive strategies.

Key words: the older adults; sarcopenia; obesity; comorbid mechanism

收稿日期：　　录用日期：

通讯作者：彭莉　　E-mail:

DOI: 10.13294/j.aps.2025.0079

引用本文：

田浩冬, 陆玉坤, 黄丽, 刘昊为, 余杭林, 吴进龙, 李汉森, 彭莉. 老龄化背景下肌少症与肥胖的共病机制研究进展[J]. 生理学报 2025; 77 (5): 905-924.

TIAN Hao-Dong, LU Yu-Kun, HUANG Li, LIU Hao-Wei, YU Hang-Lin, WU Jin-Long, LI Han-Sen, PENG Li. Research progress on the comorbidity mechanism of sarcopenia and obesity in the aging population. Acta Physiol Sin 2025; 77 (5): 905-924 (in Chinese with English abstract).