Precise resistance training alleviates osteosarcopenia via the GLP-1/myostatin path: a 32-week randomized controlled trial and molecular mechanism study.

BACKGROUND: With the ageing of the global population, osteoporosis poses a serious challenge to elderly health. PURPOSE: The aim is to explore the intervention effect and molecular mechanism of resistance training (RT) based on precise mechanical load monitoring on patients with primary osteoporosis complicated with muscle atrophy. METHODS: Recruiting 98 elderly patients, they were randomly divided into an intervention group (n = 49) and a control group (n = 49). Molecular level studies have confirmed that the increase in endogenous GLP-1 secretion induced by RT (+46.9%) is significantly correlated with the downregulation of MSTN expression (-41.7%). RESULTS: In vitro experiments further elucidated that MSTN mature peptides inhibit muscle regeneration by inducing G2/M phase blockade in myoblasts, and the GLP-1 mediated signalling pathway can effectively alleviate this blockade effect. CONCLUSION: Precise resistance training has synergistically improved the musculoskeletal structure and function of elderly patients through the "GLP-1/MSTN axis", providing important biological evidence for clinical precision intervention in skeletal muscle atrophy.