In recent years, sarcopenic obesity (SO) has increasingly become one of the serious public health challenges due to the rapid increase in the number of obese people in the world, which has caused a heavy burden on patients' life and social medical care. Challenges and regarding the diagnosis and treatment of SO remain because of its complex pathogenesis and limitations. As a safe and effective way to promote body health, exercise may prevent and treat SO through multiple mechanisms. In this context, this paper systematically summarizes and discusses the possible mechanism of the benefit of SO via exercise, in order to provide novel ideas and theoretical support for the screening of SO therapeutic targets.

Meili Hao. Sarcopenic obesity: potential therapeutic targets based on exercise. Frontiers in Sport Research (2023) Vol. 5, Issue 8: 41-46. https://doi.org/10.25236/FSR.2023.050808.

[1] Morgan P T , Smeuninx B , Breen L(2020). Exploring the Impact of Obesity on Skeletal Muscle Function in Older Age. Front Nutr, 7: p. 569904.

[2] I keda, S.I., et al.(2016). Exercise-induced increase in IL-6 level enhances GLUT4 expression and insulin sensitivity in mouse skeletal muscle. Biochem Biophys Res Commun,473(4): pp. 947-952.

[3] Lipina, C. and H.S(2017). Hundal, Lipid modulation of skeletal muscle mass and function. J Cachexia Sarcopenia Muscle, 8(2): pp. 190-201. 

[4] Liu, S.H., et al(2019).Omega-3 Fatty Acids-Enriched Fish Oil Activates AMPK/PGC-1alpha Signaling and Prevents Obesity-Related Skeletal Muscle Wasting. Mar Drugs,17(6):p.10.

[5] Kurdiova, T., et al(2014). Effects of obesity, diabetes and exercise on Fndc5 gene expression and irisin release in human skeletal muscle and adipose tissue: in vivo and in vitro studies. J Physiol, 592(5):pp. 1091-107.

[6] Pincu, Y., et al(2015).The effects of high fat diet and moderate exercise on TGFbeta1 and collagen deposition in mouse skeletal muscle. Cytokine,73(01):p.23.

[7] Yoo, A., et al(2020).Chrysanthemi Zawadskii var. Latilobum Attenuates Obesity-Induced Skeletal Muscle Atrophy via Regulation of PRMTs in Skeletal Muscle of Mice. Int J Mol Sci, 21(8).

[8] Collins, K.H., et al(2016).High-fat high-sucrose diet leads to dynamic structural and inflammatory alterations in the rat vastus lateralis muscle. J Orthop Res, 34(12): p. 2069-2078. 

[9] Larsson, L., et al(2019). Sarcopenia: Aging-Related Loss of Muscle Mass and Function. Physiol Rev, 99(1): p. 427-511.

[10] Bae, J.Y.(2018). Aerobic Exercise Increases Meteorin-Like Protein in Muscle and Adipose Tissue of Chronic High-Fat Diet-Induced Obese Mice. Biomed Res Int, 2018.

[11] Jo, E., et al.(2012). Potential mechanisms underlying the role of chronic inflammation in age-related muscle wasting. Aging Clin Exp Res, 2012. 24(5): p. 412-422.

[12] Yang Y , Jemiolo B , Trappe S(2006). Trappe, Proteolytic mRNA expression in response to acute resistance exercise in human single skeletal muscle fibers. J Appl Physiol (1985),101(5): p. 1442-1450..

[13] Louis, E., et al.(2007).Time course of proteolytic, cytokine, and myostatin gene expression after acute exercise in human skeletal muscle. J Appl Physiol (1985),103(5): p. 1744-1751. 

[14] Deldicque, L., et al.(2008).Effects of resistance exercise with and without creatine supplementation on gene expression and cell signaling in human skeletal muscle. J Appl Physiol (1985), 104(2): p. 371-378.

[15] Liang, J., et al.(2021). Lifelong Aerobic Exercise Alleviates Sarcopenia by Activating Autophagy and Inhibiting Protein Degradation via the AMPK/PGC-1alpha Signaling Pathway. Metabolites, 11(5). . 

[16] Gielen, S., et al.(2012). Exercise training attenuates MuRF-1 expression in the skeletal muscle of patients with chronic heart failure independent of age: the randomized Leipzig Exercise Intervention in Chronic Heart Failure and Aging catabolism study. Circulation, 125(22): p. 2716-2727. 

[17] Fan, J., et al.(2017).Spermidine coupled with exercise rescues skeletal muscle atrophy from D-gal-induced aging rats through enhanced autophagy and reduced apoptosis via AMPK-FOXO3a signal pathway. Oncotarget,8(11): p. 17475-17490. 

[18] Lenhare, L., et al.(2017). Physical exercise increases Sestrin 2 protein levels and induces autophagy in the skeletal muscle of old mice. Exp Gerontol,97: p. 17-21. 

[19] Luo, L., et al.(2013). Chronic resistance training activates autophagy and reduces apoptosis of muscle cells by modulating IGF-1 and its receptors, Akt/mTOR and Akt/FOXO3a signaling in aged rats. Exp Gerontol, 48(4): p. 427-36.

[20] Matsakas, A., et al.(2012).Exercise training attenuates the hypermuscular phenotype and restores skeletal muscle function in the myostatin null mouse. Exp Physiol,97(1): p. 125-140.  

[21] White, Z., et al.(2016).Voluntary resistance wheel exercise from mid-life prevents sarcopenia and increases markers of mitochondrial function and autophagy in muscles of old male and female C57BL/6J mice. Skelet Muscle, 2016. 6(1): p. 45. 

[22] Kwon, I., et al.(2015). Effects of long-term resistance exercise training on autophagy in rat skeletal muscle of chloroquine-induced sporadic inclusion body myositis. J Exerc Nutrition Biochem, 19(3): p. 225-234.

[23] Pryde, K.R., et al.(2001) PINK1 disables the anti-fission machinery to segregate damaged mitochondria for mitophagy. J Cell Biol, 213(2): p. 163-71.

[24] Gibala, M.J.(2001).Regulation of skeletal muscle amino acid metabolism during exercise. Int J Sport Nutr Exerc Metab, 2001. 11(1): p. 87-108.

[25] Leger, B., et al.(2006).Akt signalling through GSK-3beta, mTOR and Foxo1 is involved in human skeletal muscle hypertrophy and atrophy. J Physiol, 2006. 576(Pt 3): p. 923-933. 

[26] Sumi, K., K. Ashida, and K. Nakazato(2020).Resistance exercise with anti-inflammatory foods attenuates skeletal muscle atrophy induced by chronic inflammation. J Appl Physiol (1985),128(1): p. 197-211.

[27] Kim, Y.A., et al.(2013). Autophagic response to exercise training in skeletal muscle with age. J Physiol Biochem, 2013. 69(4): p. 697-705.

[28] Pagano, A.F., et al.(2014). Autophagy and protein turnover signaling in slow-twitch muscle during exercise. Med Sci Sports Exerc,46(7): p. 1314-25.

[29] Ahn, N. and K. Kim(2020).Effects of Aerobic and Resistance Exercise on Myokines in High Fat Diet-Induced Middle-Aged Obese Rats. Int J Environ Res Public Health, 2020. 17(8). 

[30] Samaan, M.C., et al.(2014). Endurance interval training in obese mice reduces muscle inflammation and macrophage content independently of weight loss. Physiol Rep, 2014. 2(5). 

[31] Al-Nassan, S., et al.(2012). Chronic Exercise Training Down-Regulates TNF-alpha and Atrogin-1/MAFbx in Mouse Gastrocnemius Muscle Atrophy Induced by Hindlimb Unloading. Acta Histochem Cytochem, 45(6): p. 343-349.

[32] Bai, C.H., et al.(2020).Combination of exercise training and resveratrol attenuates obese sarcopenia in skeletal muscle atrophy. Chin J Physiol,63(3): p. 101-112. 

[33] Pedraza-Vazquez, G., et al.(2023). A low-intensity lifelong exercise routine changes miRNA expression in aging and prevents osteosarcopenic obesity by modulating inflammation. Arch Gerontol Geriatr, 2023. 105: p. 104856. 

[34] You, B., et al.(2021).The Treatment of Rhodiola Mimics Exercise to Resist High-Fat Diet-Induced Muscle Dysfunction via Sirtuin1-Dependent Mechanisms. Front Pharmacol, 2021. 12: p. 646489.

[35] Hansen, J., et al.(2011). Exercise induces a marked increase in plasma follistatin: evidence that follistatin is a contraction-induced hepatokine. Endocrinology,152(1): p. 164-171. 

[36] Lira, V.A., et al.(2013).Autophagy is required for exercise training-induced skeletal muscle adaptation and improvement of physical performance. FASEB J, 27(10): p. 4184-4193. 

[37] Heo, J.W., et al.(2018).Exercise Training Attenuates Obesity-Induced Skeletal Muscle Remodeling and Mitochondria-Mediated Apoptosis in the Skeletal Muscle. Int J Environ Res Public Health, 2018. 15(10).