Mechanism and physical activities in bone-skeletal muscle crosstalk

Novel Aptamers Targeting Sclerostin Loop3 Improve Skeletal and Muscle Properties Without Adverse Cardiovascular Effects in Orchiectomized Mice

BACKGROUND

The Wnt/β-catenin pathway and its bone-specific inhibitor, sclerostin, play important roles in skeletal development and homeostasis. The humanized sclerostin antibody, romosozumab, can significantly increase bone mineral density (BMD) of patients with osteoporosis, but it may also increase cardiovascular adverse events, particularly in male patients. We try to investigate the effects of novel aptamers targeting the sclerostin loop3 on the skeleton and muscle of orchiectomized (ORX) mice.

METHODS

After 12 weeks of ORX surgery, mice were randomly assigned to receive treatment with sclerostin aptamers (Apc001OA or Apc001OA-d6), alendronate (ALN), teriparatide (PTH 1-34) or phosphate-buffered saline (PBS). After 12 weeks of treatment, skeletal and muscle properties and safety indicators were evaluated in detail.

RESULTS

Treatment with Apc001OA and Apc001OA-d6 significantly increased trabecular BMD at the femur by +11.9% and +17.1%, improved parameters of bone microarchitecture (BV/TV by +84.5% and +106.8%), bone strength (maximum load by +30.5% and +31.6%) and bone histological properties (all p < 0.05 vs. PBS group). The therapeutic effects were similar among Apc001OA, Apc001OA-d6, ALN and PTH 1-34 groups (all p > 0.05). After treatment with Apc001OA or Apc001OA-d6, serum sclerostin levels significantly decreased by 25.0% and 24.9% (p < 0.05 vs. PBS group). The expression levels of key genes in the Wnt/β-catenin pathway, Ctnnb1 and Lef1 significantly increased by 2.4- and 3.4-fold in the Apc001OA group and by 2.5- and 3.5-fold in the Apc001OA-d6 group (p < 0.05 vs. PBS group), indicating that the aptamers improved bone properties through activating Wnt/β-catenin pathway. Apc001OA and Apc001OA-d6 significantly improved rotarod latency (p < 0.05 vs. PBS group) of ORX mice, and Apc001OA-d6 could increase forelimb grip strength. Apc001OA, Apc001OA-d6 and PTH 1-34 improved histological properties of muscle in ORX mice. No lesions or pathological changes were observed in the heart, aortic roots, liver, spleen, lungs or kidneys. Immunohistochemistry revealed no abnormal staining of interleukin 6 (IL-6) and tumour necrosis factor-α (TNF-α) in the heart. There was no significant difference in serum concentrations of cardiac functional biomarkers, including creatine kinase-MB (CK-MB), cardiac troponin I (cTnI), B-type natriuretic peptide (BNP) and inflammatory mediators (IL-6 and TNF-α) across all groups, indicating that Apc001OA and Apc001OA-d6 had no adverse cardiovascular effects in ORX mice.

CONCLUSIONS

The novel aptamers Apc001OA and Apc001OA-d6, targeting sclerostin loop3, could significantly increase BMD and improve bone microarchitecture, bone biomechanics, muscle function and histological properties of muscle and bone in ORX mice, without adverse cardiovascular effects. These aptamers may serve as potential agents for treating osteoporosis and sarcopenia in men.

A Study of the Effects of Oleuropein and Polydatin Association on Muscle and Bone Metabolism

Sarcopenia and osteoporosis are age-related musculoskeletal pathologies that often develop in parallel, and numerous studies support the concept of a bone-muscle unit, where deep interaction between the two tissues takes place. In Mediterranean areas, the lowest incidence of osteoporosis within Europe is observed, so the Mediterranean diet was suggested to play an important role. Consequently, in this study, oleuropein, a phenolic compound found in olive oil, and polydatin, another natural polyphenol found in the Mediterranean diet, were evaluated to determine their beneficial effects on bone and muscle metabolism. In human osteoblasts and skeletal muscle myoblasts, the effects were examined, and, after analyzing the cytotoxic effect to find non-toxic doses, the modulation of bone and muscle differentiation markers was evaluated at the gene and protein levels using PCR, Western blot, and immunohistochemistry. Interestingly, the compounds increased markers involved in osteoblast differentiation, such as osteocalcin, type I collagen, and dentin-sialo-phosphoprotein, as well as markers involved in myoblast differentiation, such as myogenic regulatory factors and creatine kinase. These effects were most noticeable when the compounds were administered together. These results suggest a beneficial role for oleuropein-polydatin association on bone and muscle tissue pathologies simultaneously.

Osteocalcin and GPR158: linking bone and brain function

Osteocalcin (OCN), a small protein secreted by osteoblasts, has attracted significant attention for its role as an endocrine factor in regulating the central nervous system (CNS) via the bone-brain axis. As a critical receptor for OCN, G protein-coupled receptor 158 (GPR158) facilitates the proliferation, differentiation, and survival of neural cells while directly influencing neurons' structural and functional plasticity, thereby modulating cognitive function. Additionally, GPR158 is involved in cellular energy metabolism and interacts with proteins such as regulators of G protein signaling 7 (RGS7), broadening the understanding of OCN's impact on neural activity. Notably, GPR158 displays region- and cell type-specific bidirectional effects under certain pathological conditions, such as tumor development and mood regulation, adding complexity to its mechanisms of action. Although the precise biological mechanisms underlying the OCN/GPR158 signaling pathway remain incompletely understood, its association with neurodegenerative diseases (NDs), including Alzheimer's disease (AD) and Parkinson's disease (PD), is becoming increasingly evident. Thus, a systematic summary of OCN/GPR158 in CNS regulation and NDs will deepen understanding of its role in brain function and support the development of new therapeutic targets and strategies.

Osteosarcopenia, osteoarthritis and frailty: a two-sample Mendelian randomization study

BACKGROUND

Musculoskeletal disease, which has a complicated relationship with frailty, is a common clinical problem among elderly individuals.

AIMS

This study evaluated the potential causal relationships between osteosarcopenia, osteoarthritis and frailty by Mendelian Randomization (MR) analysis.

METHODS

This study employed a two-sample MR approach to investigate the causal relationships among osteosarcopenia, osteoarthritis and frailty. Published summary statistics were used to obtain instrumental variables at the genome-wide significance level.

RESULTS

Among the age groups with osteoporosis, high total bone mineral density (TBMD) (45-60, OR = 0.966, 95% CI 0.940-0.993, P = 0.013) and TBMD (over 60, OR = 0.974, 95% CI 0.954-0.994, P = 0.011) reduced the risk of frailty. Similarly, high forearm BMD (FA-BMD), high ultradistal forearm BMD (UFA-BMD), and high Heel-BMD at different sites also reduced the risk of frailty (OR = 0.966, 95% CI 0.936-0.996, P = 0.028; OR = 0.975, 95% CI 0.953-0.997, P = 0.029; OR = 0.981, 95% CI 0.967-0.995, P = 0.008). Among the characteristics related to sarcopenia, grip strength in the left hand, grip strength in the right hand, appendicular lean mass, and walking pace were all protective factors for frailty (OR = 0.788, 95% CI 0.721-0.862, P < 0.001; OR = 0.800, 95% CI 0.737-0.869, P < 0.001; OR = 0.955, 95% CI 0.937-0.974, P = 0.000; OR = 0.480, 95% CI 0.388-0.593, P < 0.001), with low grip strength in those over 60 years of age significantly positively correlated with frailty (OR = 1.168, 95% CI 1.059-1.289, P = 0.002). The MR results of osteoarthritis and frailty revealed a causal relationship between specific joint sites and frailty, including KOA (OR = 1.086, 95% CI 1.017-1.160, P = 0.014), HOA (OR = 1.028, 95% CI 1.007-1.049, P = 0.009), and KOA/HOA (OR = 1.082, 95% CI 1.053-1.113, P = 0.000), increasing the risk of frailty.

CONCLUSION

Osteosarcopenia, osteoarthritis and frailty exhibit significant causal effects, rendering them risk factors for frailty. Therefore, in clinical practice, patients with osteosarcopenia and osteoarthritis should be required to undergo relevant interventions to reduce the risk of frailty.

Roles of Insulin-Like Growth Factor-1 in Muscle Wasting and Osteopenia in Mice with Hyponatremia

Hyponatremia is associated with sarcopenia and osteoporosis in elderly individuals. Skeletal muscle releases myokines, which affect distant organs, including bone. However, the detailed mechanisms by which hyponatremia influences muscle and bone remain unclear. We herein investigated the effects of hyponatremia on muscle, bone, and myokines linking muscle to bone in mice treated with 1-desamino-8-D-arginine vasopressin (dDAVP) or furosemide, which induce hyponatremia. Muscle mass and bone mineral density (BMD) were analyzed 8 weeks after the administration of dDAVP or furosemide. dDAVP significantly reduced grip strength, but did not affect tissue weights of gastrocnemius or soleus muscles of mice. Furosemide significantly decreased muscle mass, tissue weights of gastrocnemius and soleus muscles, and grip strength in mice. dDAVP and furosemide decreased trabecular BMD, trabecular bone volume, and cortical BMD at the femurs. Among myokines linking muscle to bone, hyponatremia reduced expression of insulin-like growth factor (IGF)-1 in gastrocnemius and soleus muscles and serum IGF-1 levels in mice. In simple regression analyses, serum IGF-1 levels were positively related to muscle IGF-1 expression, trabecular bone volume, and cortical BMD in mice. The administration of sodium chloride solution to mice ameliorated the decreases in grip strength, muscle mass, trabecular bone volume, cortical BMD, and the levels of muscle and circulating IGF-1 in furosemide-treated mice. The present study demonstrated that hyponatremia induces muscle and bone loss as well as a decrease in muscle IGF-1 expression in mice. The present findings suggest that IGF-1 might be related to muscle wasting and bone loss induced by hyponatremia in mice.

Puerarin Delays the Progression of Muscle Atrophy in Mice With Dexamethasone-Induced Sarcopenia Through Inhibiting the TNF-α/NF-κB Pathway

Sarcopenia, marked by the loss of muscle mass and function, is a chronic condition that worsens with age. Currently, there are no effective drugs for its treatment. Puerarin, a potent natural compound extracted from the root of Pueraria lobata, exhibits various pharmacological properties, including anti-inflammatory, antioxidative, and anti-apoptotic effects. It remains unclear whether puerarin possesses anti-muscle atrophy capabilities. This study aims to evaluate the effectiveness of puerarin in delaying the development of muscle atrophy in mice with dexamethasone-induced sarcopenia and to explore the underlying molecular mechanisms. Experimental findings reveal that puerarin effectively alleviates a range of physiological and behavioral changes caused by dexamethasone, including weight loss, deterioration in muscle mass and function, and destruction of the ultrastructure of muscle fibers. Notably, puerarin significantly enhances muscle mass and function in mice with dexamethasone-induced sarcopenia, reduces the release of pro-inflammatory cytokines while promoting the production of anti-inflammatory factors, lowers oxidative stress, inhibits the expression of muscle apoptosis proteins, and decelerates muscle atrophy development by suppressing the TNF-α/NF-κB signaling pathway. In conclusion, these findings not only further confirm the potential value of puerarin as a therapeutic drug for sarcopenia but also provide new directions and theoretical foundations for future research.

SIRT1 and exercise-induced bone metabolism: a regulatory nexus

Regular exercise positively influences bone health, enhances bone density and strength, and reduces the risk of osteoporosis. Silent information regulator of transcription 1 (SIRT1) is a deacetylase that plays a pivotal role in the regulation of various biological processes. In this review, we explore the role of SIRT1 in modulating bone metabolism in response to exercise. SIRT1 regulates crucial cellular processes, including inflammation, aging, autophagy, and oxidative stress, in bone cells such as bone marrow mesenchymal stem cells, osteoblasts, and osteoclasts, in response to exercise-induced stimuli. Notably, exercise influences bone metabolism by modulating muscle metabolism and neurotransmitters, with SIRT1 acting as a key mediator. A comprehensive understanding of SIRT1's regulatory mechanisms will facilitate a deeper exploration of the principles underlying exercise-induced improvements in bone metabolism, ultimately providing novel insights into the treatment of bone metabolic disorders.

The L-shaped association between body roundness index and all-cause mortality in osteoporotic patients: a cohort study based on NHANES data

Purpose

This study aims to investigate the relationship between the body roundness index (BRI) and overall mortality rates in individuals with osteoporosis (OP), utilizing information sourced from the NHANES database, in order to assess BRI's capability as an indicator for predicting mortality risk.

Methods

Data from NHANES (2005 to 2010, 2013-2014, and 2017-2018) were analyzed, including 1,596 osteoporotic individuals aged 50 and above. BRI was calculated based on waist circumference (WC) and height, categorizing participants into high (>4.07) and low (≤4.07) BRI groups. To analyze the relationship between BRI and mortality while accounting for important covariates, we employed weighted Cox proportional hazards models, conducted Kaplan-Meier survival analyses, and utilized restricted cubic splines (RCS).

Results

Higher BRI was significantly associated with better long-term survival, showing an "L"-shaped nonlinear inverse relationship with mortality, with a threshold at BRI = 5. In subgroup analyses, this association remained relatively stable.

Conclusion

The "L"-shaped association between BRI and mortality indicates that BRI may serve as a useful indicator for evaluating mortality risk in patients with OP, thereby informing clinical interventions and public health approaches.

Bone Adaptations to a Whole Body Vibration Protocol in Murine Models of Different Ages: A Preliminary Study on Structural Changes and Biomarker Evaluation

Background/Objectives: Whole body vibration (WBV) is a valuable tool to mitigate physiological adaptations related to age and inactivity. Although significant benefits have been found at the musculoskeletal level, including increased bone mass and reduced muscle atrophy, the underlying biological mechanisms remain largely unknown. Therefore, our study aimed to evaluate the effects of vibratory training on bone tissue in murine models of different age groups by investigating the structural and distribution changes in some crucial biomarkers involved in musculoskeletal homeostasis. Methods: Specifically, 4-, 12-, and 24-month-old mice were trained with a WBV protocol characterized by three series of 2 min and 30 s, interspersed with a recovery period of the same duration, on a 3-weekly frequency for 3 months. At the end of the training, histological and morphometric analyses were conducted, in association with immunohistochemical analysis to investigate changes in the distribution of fibronectin type III domain-containing protein 5 (FNDC5), NADPH oxidase 4 (NOX4), and sirtuin 1 (SIRT1). Results: Our preliminary results showed that WBV improves musculoskeletal health by preserving bone architecture and promoting up-regulation of FNDC5 and SIRT1 and down-regulation of NOX4. Conclusions: Our study confirms vibratory training as a viable alternative to counter musculoskeletal decline in elderly and/or sedentary subjects. Further investigations should be conducted to deepen knowledge in this field and explore the role of other molecular mediators in physiological adaptations to vibration.

Modeling Musculoskeletal Disorders in Zebrafish: Advancements in Muscle and Bone Research

Zebrafish (Danio rerio) have emerged as a valuable model organism for investigating musculoskeletal development and the pathophysiology of associated diseases. Key genes and biological processes in zebrafish that closely mirror those in humans, rapid development, and transparent embryos make zebrafish ideal for the in vivo studies of bone and muscle formation, as well as the molecular mechanisms underlying musculoskeletal disorders. This review focuses on the utility of zebrafish in modeling various musculoskeletal conditions, with an emphasis on bone diseases such as osteoporosis and osteogenesis imperfecta, as well as muscle disorders like Duchenne muscular dystrophy. These models have provided significant insights into the molecular pathways involved in these diseases, helping to identify the key genetic and biochemical factors that contribute to their progression. These findings have also advanced our understanding of disease mechanisms and facilitated the development of potential therapeutic strategies for musculoskeletal disorders.

Effects of 12-week power training on bone in mobility-limited older adults: randomised controlled trial

This study examines how power training affects estimated bone strength, revealing that females benefit more than males, especially in the upper limbs (radius). These findings highlight the importance of designing sex-specific exercise programs to enhance bone health. Further research is needed to optimize training duration and address site-specific differences.

PURPOSE

This study aimed to compare the effects of 12-week of power training (PWT), an explosive form of strength training, on bone microarchitecture, estimated bone strength, and markers in mobility-limited (gait speed < 0.9 m/s) older adults.

METHODS

Fifty-seven older adults (83 ± 5 years) were randomly assigned to either a training group (TRAIN, n = 28, 15 females, 13 males) performing high-intensity PWT or a control group (CTRL, n = 29, 22 females, 7 males) maintaining their usual lifestyle. High-resolution peripheral quantitative computed tomography (HR-pQCT) assessed bone geometry, densities, microarchitecture (e.g. trabecular number (Tb.N) and thickness (Tb.Th)), and estimated bone strength (stiffness and failure load) at the tibia and radius. Blood markers for bone metabolism (PINP and CTX-1) and muscle strength (handgrip and leg press) were also measured.

RESULTS

Baseline sex differences showed females having lower stiffness (- 37.5%) and failure load (- 38%) at the radius compared with males. After PWT, females in the TRAIN group exhibited declines in Tb.N (- 4.4%) and improvements in Tb.Th (+ 6.0%), stiffness (+ 2.7%), and failure load (+ 2.4%) at the radius (p < 0.05). A time x group interaction indicated increases in leg press strength for the whole TRAIN group (+ 23%), and within females (+ 29%) and males (+ 19%) (p < 0.001). Baseline handgrip strength correlated with stiffness (r = 0.577) and failure load (r = 0.612) at the radius (p < 0.001). Females in the TRAIN group showed a reduction in PINP (- 25%), while males showed an increase in CTX-1 (+ 18%).

CONCLUSION

A 12-week PWT may enhance estimated bone strength in mobility-limited older adults, especially at sites less accustomed to daily loading (i.e. radius).

CLINICAL TRIAL REGISTRATION

NCT02051725.

Myokines and Microbiota: New Perspectives in the Endocrine Muscle-Gut Axis

This review explores the dual role of skeletal muscle as both a mechanical and endocrine organ, highlighting its contributions to overall health and its adaptability to various inputs such as nutrition, hormones, exercise, and injuries. In addition to its role in metabolism and energy conversion, skeletal muscle secretes signalling molecules called myokines (at rest) and exerkines (during/after physical exercise), which communicate with other organs like the brain, the cardiovascular system, and the immune system. Key molecules such as interleukins, irisin, and myostatin are discussed for their roles in mediating muscle health and inter-organ communication. This work also focuses on the muscle-gut axis, emphasising the bidirectional interaction between skeletal muscle and the gut microbiota, a complex ecosystem influencing immune defence, digestion, and metabolism. Muscle activity, particularly exercise, alters the gut microbial composition, promoting beneficial species, while gut-derived metabolites like short-chain fatty acids (SCFAs) impact muscle metabolism, mitochondrial function, and insulin sensitivity. Dysbiosis, or an imbalanced microbiota, can lead to muscle atrophy, inflammation, and metabolic dysfunction. This evidence highlights emerging research into myokines and exerkines as potential therapeutic targets for managing conditions like muscle decline, ageing, and metabolic diseases through muscle-gut interactions.

Modulation of Carnitine Palmitoyl Transferase 1b Expression and Activity in Muscle Pathophysiology in Osteoarthritis and Osteoporosis

In the pathophysiology of osteoarthritis and osteoporosis, articular cartilage and bone represent the target tissues, respectively, but muscle is also involved. Since many changes in energy metabolism occur in muscle with aging, the aim of the present work was to investigate the involvement of carnitine palmitoyl transferase 1b (Cpt1b) in the muscle pathophysiology of the two diseases. Healthy subjects (CTR, n = 5), osteoarthritic (OA, n = 10), and osteoporotic (OP, n = 10) patients were enrolled. Gene expression analysis conducted on muscle and myoblasts showed up-regulation of CPT1B in OA patients; this result was confirmed by immunohistochemical and immunofluorescence analyses and enzyme activity assay, which showed increased Cpt1b activity in OA muscle. In addition, CPT1B expression resulted down-regulated in cultured OP myoblasts. Given the potential involvement of Cpt1b in the modulation of oxidative stress, we investigated ROS levels, which were found to be lower in OA myoblasts, and gene expression of nicotinamide adenine dinucleotide phosphate hydrogen oxidase 4 (Nox4), which resulted up-regulated in OA cells. Finally, the immunofluorescence of BCL2/adenovirus E1B 19 kDa protein-interacting protein 3 (Bnip3) showed a decreased expression in OP myoblasts, with respect to CTR and OA. Contextually, through an ultrastructural analysis conducted by Transmission Electron Microscopy (TEM), the presence of aberrant mitochondria was observed in OP muscle. This study highlights the potential role of Cpt1b in the regulation of muscle homeostasis in both osteoarthritis and osteoporosis, allowing for the expansion of the current knowledge of what are the molecular biological pathways involved in the regulation of muscle physiology in both diseases.

Research Progress on the Effects of Different Exercise Modes on the Secretion of Exerkines After Spinal Cord Injury

Exercise training is a conventional treatment strategy throughout the entire treatment process for patients with spinal cord injury (SCI). Currently, exercise modalities for SCI patients primarily include aerobic exercise, endurance training, strength training, high-intensity interval training, and mind-body exercises. These exercises play a positive role in enhancing skeletal muscle function, inducing neuroprotection and regeneration, thereby influencing neural plasticity, reducing limb spasticity, and improving motor function and daily living abilities in SCI patients. However, the mechanism by which exercise training promotes functional recovery after SCI is still unclear, and there is no consensus on a unified and standardized exercise treatment plan. Different exercise methods may bring different benefits. After SCI, patients' physical activity levels decrease significantly due to factors such as motor dysfunction, which may be a key factor affecting changes in exerkines. The changes in exerkines of SCI patients caused by exercise training are an important and highly relevant and visual evaluation index, which may provide a new research direction for revealing the intrinsic mechanism by which exercise promotes functional recovery after SCI. Therefore, this article summarizes the changes in the expression of common exerkines (neurotrophic factors, inflammatory factors, myokines, bioactive peptides) after SCI, and intends to analyze the impact and role of different exercise methods on functional recovery after SCI from the perspective of exerkines mechanism. We hope to provide theoretical basis and data support for scientific exercise treatment programs after SCI.

Comparative Analysis of Myokines and Bone Metabolism Markers in Prepubertal Vegetarian and Omnivorous Children

The role of bone and muscle as endocrine organs may be important contributing factors for children's growth and development. Myokines, secreted by muscle cells, play a role in regulating bone metabolism, either directly or indirectly. Conversely, markers of bone metabolism, reflecting the balance between bone formation and bone resorption, can also influence myokine secretion. This study investigated a panel of serum myokines and their relationships with bone metabolism markers in children following vegetarian and omnivorous diets. A cohort of sixty-eight healthy prepubertal children, comprising 44 vegetarians and 24 omnivores, participated in this study. Anthropometric measurements, dietary assessments, and biochemical analyses were conducted. To evaluate the serum concentrations of bone markers and myokines, an enzyme-linked immunosorbent assay (ELISA) was used. The studied children did not differ regarding their serum myokine levels, except for a higher concentration of decorin in the vegetarian group (p = 0.020). The vegetarians demonstrated distinct pattern of bone metabolism markers compared to the omnivores, with lower levels of N-terminal propeptide of type I procollagen (P1NP) (p = 0.001) and elevated levels of C-terminal telopeptide of type I collagen (CTX-I) (p = 0.018). Consequently, the P1NP/CTX-I ratio was significantly decreased in the vegetarians. The children following a vegetarian diet showed impaired bone metabolism with reduced bone formation and increased bone resorption. Higher levels of decorin, a myokine involved in collagen fibrillogenesis and essential for tissue structure and function, may suggest a potential compensatory mechanism contributing to maintaining bone homeostasis in vegetarians. The observed significant positive correlations between myostatin and bone metabolism markers, including P1NP and soluble receptor activator of nuclear factor kappa-B ligand (sRANKL), suggest an interplay between muscle and bone metabolism, potentially through the RANK/RANKL/OPG signaling pathway.

Navigating the Intersection: Sarcopenia and Sarcopenic Obesity in Inflammatory Bowel Disease

Inflammatory bowel diseases (IBDs) are intricate systemic conditions that can extend beyond the gastrointestinal tract through both direct and indirect mechanisms. Sarcopenia, characterized by a reduction in muscle mass and strength, often emerges as a consequence of the clinical course of IBDs. Indeed, sarcopenia exhibits a high prevalence in Crohn's disease (52%) and ulcerative colitis (37%). While computed tomography and magnetic resonance imaging remain gold-standard methods for assessing muscle mass, ultrasound is gaining traction as a reliable, cost-effective, and widely available diagnostic method. Muscle strength serves as a key indicator of muscle function, with grip strength test emerging nowadays as the most reliable assessment method. In IBDs, sarcopenia may arise from factors such as inflammation, malnutrition, and gut dysbiosis, leading to the formulation of the 'gut-muscle axis' hypothesis. This condition determines an increased need for surgery with poorer post-surgical outcomes and a reduced response to biological treatments. Sarcopenia and its consequences lead to reduced quality of life (QoL), in addition to the already impaired QoL. Of emerging concern is sarcopenic obesity in IBDs, a challenging condition whose pathogenesis and management are still poorly understood. Resistance exercise and nutritional interventions, particularly those aimed at augmenting protein intake, have demonstrated efficacy in addressing sarcopenia in IBDs. Furthermore, anti-TNF biological therapies showed interesting outcomes in managing this condition. This review seeks to furnish a comprehensive overview of sarcopenia in IBDs, elucidating diagnostic methodologies, pathophysiological mechanisms, and clinical implications and management. Attention will also be paid to sarcopenic obesity, exploring the pathophysiology and possible treatment modalities of this condition.