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肌肉减少症的健康结局:一项系统评价与荟萃分析

Health Outcomes of Sarcopenia: A Systematic Review and Meta-Analysis.

作者信息

Beaudart Charlotte, Zaaria Myriam, Pasleau Françoise, Reginster Jean-Yves, Bruyère Olivier

机构信息

Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.

Aix-Marseille University, School of Medicine, Marseille, France.

出版信息

PLoS One. 2017 Jan 17;12(1):e0169548. doi: 10.1371/journal.pone.0169548. eCollection 2017.

Abstract

OBJECTIVE

The purpose of this study was to perform a systematic review to assess the short-, middle- and long-term consequences of sarcopenia.

METHODS

Prospective studies assessing the consequences of sarcopenia were searched across different electronic databases (MEDLINE, EMBASE, EBM Reviews, Cochrane Database of Systematic Reviews, EBM Reviews ACP Journal Club, EBM Reviews DARE and AMED). Only studies that used the definition of the European Working Group on Sarcopenia in Older People to diagnose sarcopenia were included. Study selection and data extraction were performed by two independent reviewers. For outcomes reported by three or more studies, a meta-analysis was performed. The study results are expressed as odds ratios (OR) with 95% CI.

RESULTS

Of the 772 references identified through the database search, 17 were included in this systematic review. The number of participants in the included studies ranged from 99 to 6658, and the duration of follow-up varied from 3 months to 9.8 years. Eleven out of 12 studies assessed the impact of sarcopenia on mortality. The results showed a higher rate of mortality among sarcopenic subjects (pooled OR of 3.596 (95% CI 2.96-4.37)). The effect was higher in people aged 79 years or older compared with younger subjects (p = 0.02). Sarcopenia is also associated with functional decline (pooled OR of 6 studies 3.03 (95% CI 1.80-5.12)), a higher rate of falls (2/2 studies found a significant association) and a higher incidence of hospitalizations (1/1 study). The impact of sarcopenia on the incidence of fractures and the length of hospital stay was less clear (only 1/2 studies showed an association for both outcomes).

CONCLUSION

Sarcopenia is associated with several harmful outcomes, making this geriatric syndrome a real public health burden.

摘要

目的

本研究旨在进行一项系统评价,以评估肌肉减少症的短期、中期和长期后果。

方法

在不同的电子数据库(MEDLINE、EMBASE、循证医学评论、Cochrane系统评价数据库、循证医学评论美国医师协会杂志俱乐部、循证医学评论DARE和AMED)中检索评估肌肉减少症后果的前瞻性研究。仅纳入使用老年人肌肉减少症欧洲工作组定义来诊断肌肉减少症的研究。研究选择和数据提取由两名独立的评审员进行。对于三项或更多研究报告的结果,进行荟萃分析。研究结果以95%置信区间的比值比(OR)表示。

结果

通过数据库检索确定的772篇参考文献中,有17篇纳入了本系统评价。纳入研究的参与者数量从99人到6658人不等,随访时间从3个月到9.8年不等。12项研究中的11项评估了肌肉减少症对死亡率的影响。结果显示,肌肉减少症患者的死亡率较高(汇总OR为3.596(95%CI 2.96 - 4.37))。与年轻受试者相比,79岁及以上人群的影响更高(p = 0.02)。肌肉减少症还与功能下降相关(6项研究的汇总OR为3.03(95%CI 1.80 - 5.12))、跌倒发生率较高(2/2项研究发现有显著关联)以及住院率较高(1/1项研究)。肌肉减少症对骨折发生率和住院时间的影响不太明确(仅1/2项研究显示这两个结果均有关联)。

结论

肌肉减少症与多种有害后果相关,使这种老年综合征成为真正的公共卫生负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5722/5240970/fc51475f3442/pone.0169548.g001.jpg

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