Maturitas. 2026 Mar 4;208:108900. doi: 10.1016/j.maturitas.2026.108900. Online ahead of print.
ABSTRACT
BACKGROUND: Population aging has intensified interest in identifying physiological determinants of biological age beyond chronological age. Muscle loss and bone deterioration are key features of age-related decline, yet their individual, joint, and sex-specific contributions to biological age acceleration remain insufficiently characterized in Asian populations.
METHODS: A total of 29,437 adults aged 20-80 years from the China National Health Survey conducted in 2023-2024 were included. Appendicular skeletal muscle mass was assessed by bioelectrical impedance analysis, handgrip strength by dynamometer, and bone mineral density by quantitative ultrasound. Biological age acceleration was estimated using the Klemera-Doubal method based on sex-specific biomarker panels. Logistic regression models evaluated associations of low muscle mass, low muscle strength, and sarcopenia with elevated biological age acceleration. Additive and multiplicative interactions between muscle indicators and bone mineral density were examined. Population-attributable fractions were calculated to quantify the contributions of muscle- and bone-related deficits.
RESULTS: Lower muscle mass and lower muscle strength were strongly and inversely associated with biological age acceleration in both sexes (all P < 0.0001). Individuals with low muscle mass, low muscle strength, or sarcopenia had approximately 30% to 80% higher odds of accelerated aging. Bone mineral density showed modest and sex-dependent associations, with a weak inverse relationship observed in men but no clear association in women. Joint effects of low bone mineral density and muscle deficits were observed in men and in postmenopausal women with osteoporosis defined as a T-score below -2.5. Population-attributable fraction analysis indicated that muscle-related deficits contributed substantially more to the risk of accelerated aging than low bone mineral density.
CONCLUSIONS: Muscle-related indicators are strongly associated with biological age acceleration, whereas the influence of bone mineral density is weaker. Clear combined effects were observed in men and in postmenopausal women with osteoporosis. Muscle-related deficits accounted for a substantially greater proportion of the risk of accelerated aging than low bone mineral density in both sexes.
PMID:41795347 | DOI:10.1016/j.maturitas.2026.108900
