NFE2L2 and obesity due to melanocortin 4 receptor deficiency: The underlying causes of sarcopenia are multifactorial and include various mechanisms, including malnutrition, obesity, inflammation, oxidative stress, mitochondrial dysfunction, and apoptosis.78, 79, 80, 81 Multiple investigations have demonstrated that the impairment of the NRF2-ARE pathway is linked to muscle atrophy.