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肌肉减少症是否与全因死亡率和功能残疾风险增加有关?

Is sarcopenia associated with an increased risk of all-cause mortality and functional disability?

作者信息

Kelley George A, Kelley Kristi S

机构信息

Department of Biostatistics, West Virginia University, Morgantown, WV, United States.

出版信息

Exp Gerontol. 2017 Oct 1;96:100-103. doi: 10.1016/j.exger.2017.06.008. Epub 2017 Jun 21.

Abstract

BACKGROUND

While a recent meta-analysis of observational studies reported a statistically significant association between sarcopenia and both all-cause mortality and functional decline, a recently developed inverse heterogeneity (IVhet) model has been shown to be more valid than the traditional random-effects model used.

OBJECTIVE

The objective of this short report was to use a previous meta-analysis to compare the two approaches.

METHODS

Aggregate data meta-analysis of prospective observational studies conducted in any setting. Men and women 60years of age and older in which all-cause mortality (12 studies, 14,169 participants) or functional decline (6 studies, 8561 participants) was assessed. Using the IVhet model, pooling of previous studies regarding the association between sarcopenia and all-cause mortality as well as functional decline. Absolute and relative differences between IVhet and random-effects results were also calculated as well as influence analysis with each study deleted once. Non-overlapping 95% confidence intervals (CI) for odds ratios (OR) were considered statistically significant.

RESULTS

Sarcopenia was associated with an increased risk for all-cause mortality (OR=3.64, 95% CI=2.94 to 4.51) and functional decline (OR=2.58, 95% CI=1.33 to 4.99). Compared to the random-effects model, the OR was slightly higher (0.04 or 1.1%) but with wider CI (0.16 or 11.3%) for all-cause mortality and 0.45 (14.9%) lower with a CI that was 0.34 (10.2%) wider for functional decline. With each study deleted from the model once, results remained statistically significant for both all-cause mortality and functional decline.

CONCLUSION

These results provide additional and more accurate evidence in support of an association between sarcopenia and an increased risk for both all-cause mortality and functional decline.

摘要

背景

尽管最近一项观察性研究的荟萃分析报告称,肌肉减少症与全因死亡率和功能衰退之间存在统计学上的显著关联,但一种新开发的逆异质性(IVhet)模型已被证明比所使用的传统随机效应模型更有效。

目的

本简短报告的目的是利用先前的一项荟萃分析来比较这两种方法。

方法

对在任何环境中进行的前瞻性观察性研究进行汇总数据荟萃分析。评估了60岁及以上男性和女性的全因死亡率(12项研究,14169名参与者)或功能衰退(6项研究,8561名参与者)。使用IVhet模型,汇总先前关于肌肉减少症与全因死亡率以及功能衰退之间关联的研究。还计算了IVhet和随机效应结果之间的绝对和相对差异,以及每次删除一项研究后的影响分析。比值比(OR)的非重叠95%置信区间(CI)被认为具有统计学意义。

结果

肌肉减少症与全因死亡率增加风险(OR=3.64,95%CI=2.94至4.51)和功能衰退(OR=2.58,95%CI=1.33至4.99)相关。与随机效应模型相比,全因死亡率的OR略高(0.04或1.1%),但CI更宽(0.16或11.3%);功能衰退的OR低0.45(14.9%),CI宽0.34(10.2%)。每次从模型中删除一项研究后,全因死亡率和功能衰退的结果仍具有统计学意义。

结论

这些结果提供了更多且更准确的证据,支持肌肉减少症与全因死亡率和功能衰退增加风险之间的关联。

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