The Gut-Muscle Axis in Sarcopenia: A Meta-Analysis of Microbiome Alterations and Their Correlation with Muscle Mass, Strength, and Physical Performance in Older Adults
Bibliographic record
Abstract
Introduction: Sarcopenia, the age-related loss of muscle mass, strength, and function, poses a significant global health challenge. The gut-muscle axis has emerged as a critical pathway in its pathogenesis, suggesting that alterations in the gut microbiome contribute to muscle decline. Observational studies have reported associations between microbial dysbiosis and sarcopenic parameters, but the magnitude and consistency of these correlations remain unquantified across the literature. This meta-analysis aimed to synthesize the evidence on the correlation between gut microbiome composition and the core components of sarcopenia in older adults. Methods: We conducted a systematic search of PubMed, Scopus, Web of Science, and Embase for observational studies published between January 2015 and July 2025. We included studies that assessed gut microbiome composition and at least one sarcopenia component (muscle mass, muscle strength, physical performance) in adults aged ≥60. Correlation coefficients (r) were extracted and pooled using a random-effects model. Heterogeneity was assessed using the I² statistic, and the Newcastle-Ottawa Scale (NOS) was used for quality assessment. Results: Six studies met the inclusion criteria, encompassing a total of 1,189 participants. The overall quality of the included studies was high, with a median NOS score of 8. The pooled analysis revealed a significant, albeit small, positive correlation between gut microbial alpha diversity (Shannon index) and muscle strength (handgrip strength) (pooled r = 0.19, 95% CI: 0.11-0.27, p < 0.001; I² = 41%). Furthermore, the relative abundance of the butyrate-producing genus Faecalibacterium was positively correlated with physical performance (gait speed) (pooled r = 0.24, 95% CI: 0.16-0.32, p < 0.001; I² = 28%). Conversely, a non-significant negative correlation was observed between the abundance of the family Enterobacteriaceae and appendicular skeletal muscle mass (pooled r = -0.14, 95% CI: -0.29-0.01, p = 0.07; I² = 62%). Conclusion: This meta-analysis provides quantitative evidence supporting a significant association between the gut microbiome and muscle health in older adults. Higher gut microbial diversity and an abundance of beneficial, short-chain fatty acid-producing bacteria are correlated with better muscle strength and physical performance. These findings underscore the importance of the gut-muscle axis in the pathophysiology of sarcopenia and highlight the gut microbiome as a potential target for therapeutic interventions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".