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
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)…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,189 participants or records.
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