Circulating biomarkers of the brain-muscle-metabolic axis in primary sarcopenia: neudesin, nesfatin-1, and irisin
EUROPEAN GERIATRIC MEDICINE, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Publication Date: 2026
- Doi Number: 10.1007/s41999-026-01582-z
- Journal Name: EUROPEAN GERIATRIC MEDICINE
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Istanbul University Affiliated: Yes
Abstract
Purpose Sarcopenia is an age-related geriatric syndrome characterized by the progressive loss of skeletal muscle mass, strength, and physical performance. Although muscle-based assessments remain central to diagnosis, no specific circulating biomarker is currently available for early detection. Emerging evidence suggests that neudesin, nesfatin-1, and irisin are involved in muscle metabolism, energy homeostasis, and the regulation of inflammation. This study aimed to investigate the association of these biomarkers with primary sarcopenia in older adults and to evaluate their potential diagnostic utility. Methods This study included 88 participants aged >= 65 years (58 women, 30 men), excluding secondary sarcopenia. Diagnosis was based on EWGSOP2 criteria. Serum neudesin, nesfatin-1, and irisin levels were measured by enzyme-linked immunosorbent assay (ELISA). Sociodemographic characteristics, comorbidities, medication use, anthropometric parameters, and comprehensive geriatric assessment data were collected. Results Serum concentrations of neudesin, nesfatin-1, and irisin were significantly lower in individuals with sarcopenia compared to non-sarcopenic controls (p = 0.001, p < 0.001, and p < 0.001, respectively). After adjustment for body mass index (BMI), neudesin and nesfatin-1 remained independently associated with sarcopenia, whereas the association between irisin and sarcopenia was attenuated. All three biomarkers demonstrated good discriminatory ability for sarcopenia. Conclusion Reduced serum concentrations of neudesin, nesfatin-1, and irisin are significantly associated with primary sarcopenia in older adults. Nesfatin-1 and neudesin appear to be the most robust biomarker candidates, independent of adiposity. These results suggest that sarcopenia involves alterations in interconnected metabolic, endocrine, and neurotrophic pathways within the brain-muscle-metabolic axis. This study is the first to evaluate a combined neurotrophic, myokine, and metabolic biomarker panel in primary sarcopenia. Additional prospective studies are necessary to validate these findings and determine their clinical relevance.