# Mito-Modulatory Medication Use and Skeletal Muscle Bioenergetics Among Older Men and Women: The Study of Muscle, Mobility, and Aging

**Authors:** Howard J Phang, Jaclyn Bergstrom, Rabia S Atayee, Laura A Hart, Peggy M Cawthon, Terri Blackwell, Philip A Kramer, Giovanna Distefano, Erin E Kershaw, Steven R Cummings, Anthony J A Molina

PMC · DOI: 10.1093/gerona/glaf063 · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · 2025-03-23

## TL;DR

This study explores how common medications that affect mitochondria impact muscle energy production in older adults, finding gender-specific effects in men.

## Contribution

The study reveals gender-specific associations between mito-modulatory medications and skeletal muscle bioenergetics in older adults.

## Key findings

- Mito-modulatory medication use was linked to lower muscle bioenergetic capacity in men but not in women.
- Higher medication load correlated with reduced mitochondrial function metrics like Max OXPHOS and ATP production.
- Results highlight the need for clinical trials to assess these medications' effects on mitochondrial health.

## Abstract

The potential impacts of drug-induced modulation of mitochondrial function in humans remain unclear despite the high prevalence of “mito-modulatory” medication use among older adults. Although these medications, such as statins and metformin, have undergone extensive characterization of their effects on mitochondrial function in vitro, the effects in humans are far more complex and poorly understood.

This study uses data from the Study of Muscle, Mobility, and Aging (SOMMA) to evaluate how mito-modulatory medication use is related to skeletal muscle bioenergetic capacity, measured by ex vivo high-resolution respirometry and in vivo phosphorus magnetic resonance spectroscopy in healthy older adults.

We found that mito-modulatory medication use was related to lower maximal complex I & II supported oxidative phosphorylation (Max OXPHOS), maximal electron transfer system capacity (Max ETS), and maximal ATP production capacity (ATP Max) in men, but not in women. We also found this to be dependent on the number of medications used, in which higher mito-modulatory medication load was associated with lower Max OXPHOS, Max ETS, and ATP Max.

Our results provide greater insight into the potential clinical effects of mito-modulatory medication use and highlight the need to test the impact of these medications on mitochondrial function in randomized trials.

## Linked entities

- **Chemicals:** metformin (PubChem CID 4091)

## Full-text entities

- **Chemicals:** phosphorus (MESH:D010758), Mito (-), metformin (MESH:D008687), ATP (MESH:D000255)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

92 references — full list in the complete paper: https://tomesphere.com/paper/PMC12128851/full.md

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Source: https://tomesphere.com/paper/PMC12128851