Guimarães Nathalia Sernizon, Raposo Mariana Amaral, Greco Dirceu, Tupinambás Unaí, Premaor Melissa Orlandin
Department of Nutrition, Federal University of Ouro Preto, Ouro Preto, Brazil.
PG Fisiopatologia Medica, Universidade Estadual de Campinas, Campinas, Brazil.
J Clin Densitom. 2022 Jan-Mar;25(1):113-123. doi: 10.1016/j.jocd.2021.03.004. Epub 2021 Mar 7.
This systematic review aims to estimate the prevalence of sarcopenia in people living with HIV (PLHIV) and to assess whether there is a difference between the muscle mass of PLHIV and people living without HIV. A systematic review of randomized controlled trials, cohort studies, cross-sectional and case-control studies was carried out. PLHIV over 18 years of age and that had their muscle mass evaluated by dual-energy X-ray absorptiometry were included. Overall, 4,376 studies were found, of which 118 had their full texts evaluated. A total of 5,532 people living with HIV and 2,986 people living without HIV were identified in 41 studies. The frequency of sarcopenia defined by low muscle mass (Baumgartner's operational definition) alone was 30.3% (95%CI 24.3%, 37.1%) and the frequency of sarcopenia defined by low muscle mass with low muscle strength (EWGSOP definition) was 4.5% (95%CI 1.3%, 13.9%), p-value = 0.0006. The standardized mean differences of muscle mass between PLHIV and controls was -0.211 units of standard deviation (95%CI -0.419, -0.003). In the meta-regression analysis muscle mass mean difference was associated with BMI, CD4, percentage of subjects on ART, and study design. PLHIV have a lower muscle mass when compared to people living without HIV. This difference appears to be attenuated by higher BMI, CD4 levels, and the percentage of subjects using ART. Furthermore, the frequencies of sarcopenia assessed by the operational definition of Baumgartner and the EWGSOP are not comparable and cannot be interchanged in PLHIV.
本系统评价旨在估计艾滋病毒感染者（PLHIV）中肌肉减少症的患病率，并评估PLHIV与未感染艾滋病毒者的肌肉质量是否存在差异。我们对随机对照试验、队列研究、横断面研究和病例对照研究进行了系统评价。纳入了年龄超过18岁且通过双能X线吸收法评估了肌肉质量的PLHIV。总体而言，共检索到4376项研究，其中118项研究的全文进行了评估。41项研究共纳入了5532名艾滋病毒感染者和2986名未感染艾滋病毒者。仅根据低肌肉质量（鲍姆加特纳操作定义）定义的肌肉减少症发生率为30.3%（95%CI 24.3%，37.1%），而根据低肌肉质量合并低肌肉力量（EWGSOP定义）定义的肌肉减少症发生率为4.5%（95%CI 1.3%，13.9%），p值 = 0.0006。PLHIV与对照组之间肌肉质量的标准化平均差异为-0.211个标准差单位（95%CI -0.419，-0.003）。在meta回归分析中，肌肉质量平均差异与BMI、CD4、接受抗逆转录病毒治疗（ART）的受试者百分比以及研究设计相关。与未感染艾滋病毒者相比，PLHIV的肌肉质量较低。较高的BMI、CD4水平以及使用ART的受试者百分比似乎会减弱这种差异。此外，根据鲍姆加特纳操作定义和EWGSOP评估的肌肉减少症发生率不可比，在PLHIV中不能相互转换。
