Age-Related Changes in Insulin Signaling in the Development of Sarcopenia

Insulin signaling and IGF-1 is one of the more intensely studied portions of biochemistry, in mammals and lower animals, when it comes to the interaction between metabolism and pace of aging. Researchers here look at how changes in this signaling might contribute to sarcopenia, the age-related loss of muscle mass and strength. Sarcopenia is a condition with many, many contributing factors, and it is important to think about the chains of cause and effect when reading about them. Different processes operate upstream or downstream of one another, but nonetheless tend to be studied in isolation of the bigger picture. There are first causes and downstream, proximate causes, and changes in insulin signaling have the look of being a fair way downstream of the root causes of aging.

Sarcopenia is defined as the combined loss of skeletal muscle strength, function, and/or mass with aging. This degenerative loss of muscle mass is associated with poor quality of life and early mortality in humans. The loss of muscle mass occurs due to acute changes in daily muscle net protein balance (NPB). It is generally believed a poor NPB occurs due to reduced muscle protein synthetic responses to exercise, dietary amino acid availability, or an insensitivity of insulin to suppress breakdown. Hence, aging muscles appear to be resistant to the anabolic action of exercise and protein (amino acids or hormonal) when compared to their younger counterparts.

The mechanisms that underpin anabolic resistance to anabolic stimuli (protein and resistance exercise) are multifactorial and may be partly driven by poor lifestyle choices (increased sedentary time and reduced dietary protein intake) as well as an inherent dysregulated mechanism in old muscles irrespective of the environmental stimuli. The insulin like growth factor 1 (IGF-1), Akt/Protein Kinase B and mechanistic target of rapamycin (mTOR) pathway is the primary driver between mechanical contraction and protein synthesis and may be a site of dysregulation between old and younger people.

Therefore, our review aims to describe and summarize the differences seen in older muscle in this pathway in response to resistance exercise (RE) and describe approaches that researchers have sought out to maximize the response in muscle. Furthermore, this review will present the hypothesis that inositol hexakisphosphate kinase 1 (IP6K1) may be implicated in IGF-1 signaling and thus sarcopenia, based on recent evidence that IGF-1 and insulin share some intracellular bound signaling events and that IP6K1 has been implicated in skeletal muscle insulin resistance.


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