Journal of Cachexia, Sarcopenia and Muscle

Blood protein linked to risk of muscle loss and weakness

Higher levels were linked to a lower risk of muscle loss and weakness over four years, with a hazard ratio of 0.64 per standard-deviation increase.

Paper by Ming-Qing He, Xue-Ning Dai, Mian Zhang, +10 more authorsWei Qiang Gao · Department of Geriatrics The First Affiliated Hospital of Soochow University Suzhou China

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Among 1,370 community-dwelling adults aged 65 or older in Jiangsu Province, China, researchers measured blood tsukushi in a four-year observational cohort study. Participants averaged 76 years of age, and 55% were men. Tsukushi is a protein released by the liver. The team assessed sarcopenia—low muscle mass combined with weak grip or slow walking—using muscle measurements, grip tests and walking speed.

Higher starting tsukushi levels were associated with lower risk of developing sarcopenia after accounting for other factors. The hazard ratio, a comparison of rates over time, was 0.64 per standard-deviation increase, a measure based on the spread of protein levels. The association appeared more evident in women than men. The authors suggested tsukushi may be a candidate blood marker for identifying people at risk early.

Why it matters

Sarcopenia is an age-related condition linked to disability and death. Identifying an early blood marker may help flag older adults at risk before muscle-related function declines.

Caveats

The observational follow-up could not rule out that tsukushi marked underlying muscle or metabolic health rather than affecting later sarcopenia. The cohort excluded people unable to move independently and those with cancer or severe kidney or liver disease.

From the paper

Participants

A total of 1370 participants (mean age 76 ± 7 years; 55% men) were included and categorized into tertiles of serum TSK (Table 1 and Figure 2A).

Results, 3.1 Baseline Characteristics

Follow-up

A total of 1370 community-dwelling individuals aged ≥ 65 years were followed for 4 years.

Methods

Result

In multivariable analyses, higher TSK levels were associated with a lower risk of incident sarcopenia (hazard ratio per SD increase = 0.64, 95% CI = 0.53–0.76, p < 0.001).

Results

Limitation

First, this was a single-centre cohort study, which may limit the generalizability of the findings to other populations.

5 Study Limitations

Quoted word for word from the full text on onlinelibrary.wiley.com.

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The paper

Circulating Tsukushi Predicts Incident Sarcopenia and Functional Decline in Older Adults: A Prospective Cohort Study

Department of Geriatrics The First Affiliated Hospital of Soochow University Suzhou China; Nantong First People's Hospital Southeast University Nantong China

Journal of Cachexia, Sarcopenia and Muscle, Nov 8, 2026, Open access, CC BY

doi.org/10.1002/jcsm.70423PubMed 43000212