The interaction mechanisms between sarcopenia and gut microbiota based on the gut-muscle axis

Advances in high-throughput sequencing and metagenomics have improved our understanding of the gut microbiota and its associations with disease development and treatment response. The relationship between the gut microbiota and sarcopenia has attracted increasing attention in recent years. In this narrative review, we searched PubMed, Web of Science, Embase, CNKI, Wanfang Data, and VIP through April 2,026 and synthesized 29 human studies included in the narrative analysis together with relevant preclinical evidence. We summarize reported alterations in microbial diversity, taxonomic composition, functional potential, and microbiota-related metabolites in community-based or age-related sarcopenia, disease-associated sarcopenia, and related muscle phenotypes. This narrative review aims to provide a mechanistic framework for understanding the gut-muscle axis and to identify potential directions for the prevention and management of sarcopenia.