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心力衰竭中的肌肉减少症:一项系统评价和荟萃分析。

Sarcopenia in heart failure: a systematic review and meta-analysis.

作者信息

Zhang Yan, Zhang Jia, Ni Wenqing, Yuan Xueli, Zhang Hongmin, Li Ping, Xu Jian, Zhao Zhiguang

机构信息

Department of Elderly Health Management, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, 518020, China.

Administration Office, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, 518020, China.

出版信息

ESC Heart Fail. 2021 Apr;8(2):1007-1017. doi: 10.1002/ehf2.13255. Epub 2021 Feb 11.

Abstract

AIMS

Sarcopenia has been found to be frequently associated with co-morbidity among patients with heart failure (HF). However, there remain insufficient data to accurately estimate the global prevalence of sarcopenia in HF. Therefore, the purpose of this research was to conduct a systematic review and meta-analysis to estimate the current overall prevalence of sarcopenia in patients with HF.

METHODS AND RESULTS

We searched relevant databases for studies published up to 13 July 2020, assessing sarcopenia in vpatients with HF. After careful screening, data of included articles were extracted with a predesigned Excel form. Then the pooled prevalence of sarcopenia in patients with HF was calculated using the random-effects model. The Q test was used to assess the heterogeneity, and I statistic was calculated to quantify and evaluate the heterogeneity. Subgroup analyses were conducted to determine potential sources of heterogeneity. A total of 2852 articles were initially identified, and after removing duplicate publications and applying the selection criteria, we reviewed 79 full-text articles. Finally, 11 articles (n = 1742 patients with HF) were included in this systematic review and meta-analysis. The pooled prevalence of sarcopenia in patients with HF was 34% [95% confidence interval (CI): 22-47%, I  = 96.59%] and ranged from 10% to 69%. However, substantial heterogeneity between studies (I  = 96.59%, P < 0.001) was observed. There was no significant heterogeneity between subgroups by sex (P = 0.803) or the method used to define sarcopenia (P = 0.307). While the heterogeneity between subgroups by population setting was statistically significant (P < 0.001), the pooled prevalence of sarcopenia was 55% (95% CI: 43-66%) for hospitalized patients with HF and 26% (95% CI: 16-37%) for ambulatory patients.

CONCLUSIONS

Sarcopenia was a common condition in patients with HF, and the prevalence of hospitalized patients was higher than for ambulatory patients. Early detection of sarcopenia was therefore important in patients with HF, and it was important to implement interventions so that physical therapists or managerial dieticians can easily be introduced into clinical practice.

摘要

目的

已发现肌肉减少症在心力衰竭(HF)患者中常与合并症相关。然而,仍缺乏足够数据来准确估计HF患者中肌肉减少症的全球患病率。因此,本研究的目的是进行系统评价和荟萃分析,以估计目前HF患者中肌肉减少症的总体患病率。

方法与结果

我们检索了相关数据库,查找截至2020年7月13日发表的评估HF患者肌肉减少症的研究。经过仔细筛选,使用预先设计的Excel表格提取纳入文章的数据。然后使用随机效应模型计算HF患者中肌肉减少症的合并患病率。采用Q检验评估异质性,并计算I统计量以量化和评估异质性。进行亚组分析以确定异质性的潜在来源。最初共识别出2852篇文章,在去除重复出版物并应用选择标准后,我们审阅了79篇全文文章。最后,11篇文章(n = 1742例HF患者)纳入本系统评价和荟萃分析。HF患者中肌肉减少症的合并患病率为34%[95%置信区间(CI):22 - 47%,I = 96.59%],范围为10%至69%。然而,观察到各研究之间存在显著异质性(I = 96.59%,P < 0.001)。按性别(P = 0.803)或用于定义肌肉减少症的方法(P = 0.307)划分的亚组之间无显著异质性。虽然按人群设置划分的亚组之间的异质性具有统计学意义(P < 0.001),但HF住院患者中肌肉减少症的合并患病率为55%(95%CI:43 - 66%),门诊患者为26%(95%CI:16 - 37%)。

结论

肌肉减少症在HF患者中是一种常见情况,住院患者的患病率高于门诊患者。因此,早期发现HF患者的肌肉减少症很重要,实施干预措施以便物理治疗师或管理营养师能够轻松引入临床实践也很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/323f/8006658/94b5db2f0789/EHF2-8-1007-g001.jpg

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