Codonopsis lanceolata ameliorates sarcopenic obesity via recovering PI3K/Akt pathway and lipid metabolism in skeletal muscle.

Background: The incidence of sarcopenic obesity, muscle atrophy induced by obesity, has steadily increased and is emerging as a health problem. Although the anti-obesity effect of Codonopsis lanceolata (CL) is known, its efficacy against sarcopenic obesity has not been studied.

Purpose: We aimed to investigate the effect of CL on sarcopenic obesity and the changes in the related mechanisms to confirm the potential of CL as an effective natural therapeutic agent for sarcopenic obesity.

Methods: C57BL/6 mice were fed a high-fat diet (HFD) for 9 weeks, and CL was administered for 6 weeks with HFD feeding. Body weight and grip strength were measured twice a week. After sacrifice, muscle fiber histological analysis, blood lipid analysis, muscle triglyceride extraction, western blot, and real-time PCR were performed. High-performance liquid chromatography (HPLC)-electrospray ionization (ESI)-mass spectrometry (MS) analysis and in vitro experiments using C2C12 cells were performed to verify the main and active compounds of CL. Confluent C2C12 cells were differentiated for 4 days, and then the main compound of CL was co-treated with palmitic acid for 24 h.

Results: CL reduced body weight, mass of three fat tissues (epididymal fat, mesenteric fat, and perirenal fat), adipocyte cross-sectional area (CSA), and improved insulin signaling. Simultaneously, CL improved grip strength, mass of three muscle tissues (quadriceps, gastrocnemius, and soleus), and muscle fiber CSA. These results were due to the recovery of both the phosphatidylinositol-3-kinase (PI3K)/ protein kinase B (Akt) signaling pathway and lipid metabolisms in skeletal muscle. Lipids accumulated in skeletal muscle interrupt the PI3K/Akt pathway, but CL reduced intramyocellular triglyceride concentration by restoring gene expression of factors related to triglyceride synthesis and fatty acid oxidation. Therefore, the activated PI3K/Akt pathway enhanced muscle protein synthesis by increasing phosphorylation of ribosomal protein S6 kinase 1 and eIF4E-binding protein 1 and suppressed muscle protein degradation by decreasing expression of muscle ring finger-1 and muscle atrophy F-box protein. In addition, tangshenoside I (TS) was verified as the main compound of CL by HPLC-ESI-MS analysis, and its efficacy of inhibiting myotube atrophy and lipid accumulation in myotubes was confirmed, verifying that TS is an active compound.

Conclusion: CL is an effective natural material for sarcopenic obesity that suppresses muscle atrophy by inhibiting the accumulation of lipids in skeletal muscle through restoration of impaired PI3K/Akt pathway and lipid metabolism.