Current concepts of the pathogenesis of sarcopenia and the possibilities of prevention and correction in the context of anti-aging medicine
Svechnikova E.V., Morzhanaeva M.A., Arutyunyan G.B., Artemyeva N.O., Devyatova A.V., Lemytskaya V.E., Gladko E.V.
Sarcopenia is based on a complex, multifactorial pathophysiology. Key mechanisms include skeletal muscle anabolic resistance (a reduced ability of muscle tissue to respond with protein synthesis to amino acid intake and physical activity), chronic subclinical inflammation (inflammaging), dysregulation of the IGF-1, PI3K, Akt, and mTORC1 signaling axis, insulin resistance, increased proteolysis via the ubiquitin-proteasome and autophagy, mitochondrial dysfunction with impaired mitophagy, and degeneration of the neuromuscular junction. The contribution of these processes leads to a deterioration in the quality and quantity of muscle fibers with aging. Risk factors for sarcopenia are divided into primary (age-related changes) and secondary (comorbidities, sedentary lifestyle, protein and micronutrient deficiencies). Current research confirms that the best clinical outcomes are achieved with a combination of progressive strength training, adequate protein intake (rich in essential amino acids), and correction of nutrient deficiencies, combined with targeted interventions for sarcopenia-associated metabolic pathways.
HIFEM and HIFES hardware technologies deserve special attention in the prevention and correction of sarcopenia.
For citations: Svechnikova E.V., Morzhanaeva M.A., Arutyunyan G.B., Artemyeva N.O., Devyatova A.V., Lemytskaya V.E., Gladko E.V. Current concepts of the pathogenesis of sarcopenia and the possibilities of prevention and correction in the context of anti-aging medicine. Pharmateca. 2026;33(4):103-116. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.4.103-116
Authors’ contribution: All authors made an equivalent contribution to the preparation of the publication.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Keywords
sarcopenia
HIFEM
HIFES
RF
nutritional correction
mitochondrial dysfunction
microbiota
vitamin D
HMB
leucine
About the Authors
Elena V. Svechnikova, Dr. Sci. (Med.), Head of the Department of Dermatovenereology and Cosmetology, Polyclinic No. 1 of the Administrative Directorate of the President of the Russian Federation, Moscow; Professor, Department of Skin and Venereal Diseases, Russian Biotechnology University (ROSBIOTEKH), Moscow, Russia; ORCID: https://orcid.org/0000-0002-5885-4872, eLibrary SPIN: 5772-7930, AuthorID: 937449Maria A. Morzhanaeva, Cand.Sci. (Med.), Cosmetologist, Dermatologist, Medical Director of the Aesthetic Department, BTL LLC, Moscow, Russia; maria_morzhanaeva@mail.ru, ORCID: https://orcid.org/0000-0001-8657-9559, eLibrary SPIN: 5506-3811, AuthorID: 1257497 (corresponding author)
Grigory B. Arutyunyan, Senior Lecturer, Skripkin Department of Dermatovenereology, Institute of Microbiology and Microbiology, Pirogov Russian National Research Medical University, Moscow, Russia; arutyunyan.g82@mail.ru, ORCID: https://orcid.org/0000-0002-9454-0854
Natalya O. Artemyeva, Cand. Sci. (Med.), Nutritionist, Geneticist, OMNIUS Expert Multidisciplinary Clinic, Moscow, Russia;
natalya.artemeva.89@mail.ru, ORCID: https://orcid.org/0000-0002-5619-6757
Alena V. Devyatova, Dermatovenerologist, OMNIUS Expert Multidisciplinary Clinic, Moscow, Russia; alyona9va@mail.ru, ORCID:
https://orcid.org/0000-0003-0498-2673
Valentina E. Lemytskaya, Neurologist, Dermatovenerologist, Cosmetologist, Head of the Clinical Department, BTL LLC, Moscow, Russia; ORCID: https://orcid.org/0000-0001-5039-4691, eLibrary SPIN: 6232-3620, AuthorID: 1331096
Viktor V. Gladko, Dr. Sci. (Med.), Professor, Director, Head of the Department of Skin and Venereal Diseases with a Course in Cosmetology, Russian Biotechnological University (ROSBIOTECH), Moscow, Russia; dr.gladko@mgupp.ru, ORCID: https://orcid.org/0000-0003-3087-5038
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