Liu Ping, Hao Qiukui, Hai Shan, Wang Hui, Cao Li, Dong Birong
The Center of Gerontology Geriatrics, West China Hospital, Sichuan University, China.
The Center of Gerontology Geriatrics, West China Hospital, Sichuan University, China.
Maturitas. 2017 Sep;103:16-22. doi: 10.1016/j.maturitas.2017.04.007. Epub 2017 Apr 11.
The aim of this systematic review and meta-analysis was to examine the association between sarcopenia and all-cause mortality among community-dwelling older people. A systematic review was performed using three electronic databases (EMBASE, MEDLINE and the Cochrane Library) to identify prospective cohort studies from January 2009 to February 2017 examining sarcopenia as a predictor of all-cause mortality among community-dwelling older people. We conducted a pooled analysis of mortality associated with sarcopenia, and subgroup analyses based on measurements of muscle mass and length of follow-up by employing a random-effects model. Sensitivity analyses were performed evaluate the cause of high heterogeneity. In addition, methodological quality, heterogeneity and publication bias were evaluated. Of 1703 studies identified, 6 studies incorporating 7367 individuals were included in the meta-analysis for all-cause mortality. The pooled hazard ratios (HRs) of all-cause mortality from the combination of included studies suggested participants with sarcopenia had a significantly higher rate of mortality (pooled HR 1.60, 95%CI 1.24-2.06, I=27.8%, p=0.216) than participants without sarcopenia. The subgroup analysis for length of follow-up suggested studies with a follow-up period of less than 5 years found a higher risk of all-cause mortality (pooled HR 2.09, 95%CI 1.21-3.60) than studies with a follow-up period of 5 years or more (pooled HR 1.52, 95%CI 1.14-2.01). A subgroup of anthropometric measures was found to identify higher mortality risks (pooled HR 2.26, 95%CI 1.30-3.92) than a subgroup of dual-energy x-ray (DXA) absorptiometry (pooled HR 1.82, 95%CI 1.04-3.18) factors or a subgroup of bioelectrical impedance analysis (BIA) factors (pooled HR 1.31, 95%CI 1.15-1.49). Sarcopenia is a predictor of all-cause mortality among community-dwelling older people. Therefore, it is important to diagnose sarcopenia and to intervene, in order to reduce mortality rates in the elderly.
本系统评价和荟萃分析的目的是研究社区居住老年人中肌肉减少症与全因死亡率之间的关联。使用三个电子数据库（EMBASE、MEDLINE和Cochrane图书馆）进行系统评价，以识别2009年1月至2017年2月期间将肌肉减少症作为社区居住老年人全因死亡率预测因素的前瞻性队列研究。我们对与肌肉减少症相关的死亡率进行了汇总分析，并采用随机效应模型，基于肌肉质量测量和随访时间进行亚组分析。进行敏感性分析以评估高异质性的原因。此外，还评估了方法学质量、异质性和发表偏倚。在识别出的1703项研究中，纳入荟萃分析的6项研究共7367名个体用于全因死亡率分析。纳入研究综合得出的全因死亡率合并风险比（HRs）表明，肌肉减少症患者的死亡率显著高于无肌肉减少症患者（合并HR 1.60，95%CI 1.24 - 2.06，I = 27.8%，p = 0.216）。随访时间的亚组分析表明，随访期少于5年的研究中全因死亡率风险高于随访期为5年或更长时间的研究（合并HR 2.09，95%CI 1.21 - 3.60）。发现人体测量指标亚组识别出的死亡风险高于双能X线吸收法（DXA）因素亚组（合并HR 1.82，95%CI 1.04 - 3.18）或生物电阻抗分析（BIA）因素亚组（合并HR 1.31，95%CI 1.15 - 1.49）。肌肉减少症是社区居住老年人全因死亡率的预测因素。因此，诊断和干预肌肉减少症对于降低老年人死亡率很重要。
