不同测量方式在瘦体重与死亡率关联中的作用：一项系统评价和荟萃分析。
The effect of different measurement modalities in the association of lean mass with mortality: A systematic review and meta-analysis.
作者信息
Li Gloria Hoi-Yee, Lee Grace Koon-Yee, Au Philip Chun-Ming, Chan Marcus, Li Hang-Long, Cheung Bernard Man-Yung, Wong Ian Chi-Kei, Lee Victor Ho-Fun, Mok James, Yip Benjamin Hon-Kei, Cheng Kenneth King-Yip, Wu Chih-Hsing, Cheung Ching-Lung
机构信息
Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong.
Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
出版信息
Osteoporos Sarcopenia. 2021 Mar;7(Suppl 1):S13-S18. doi: 10.1016/j.afos.2021.02.004. Epub 2021 Mar 12.
OBJECTIVES
Lean mass is commonly measured by 3 modalities, dual energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), and computerized tomography (CT). CT is considered the most accurate, while lean mass measured by DXA and BIA often consists of non-muscle compartment, and hence considered less accurate when compared with CT. It remains unclear if the association of lean mass with mortality would differ using different measurement modalities.
METHODS
A systematic review and meta-analysis of lean mass and mortality was conducted. The analysis was stratified by different measurement modalities and health conditions. Pooled hazard ratios were estimated using a random effects model.
RESULTS
This meta-analysis included 188 studies with 98 468 participants. Reduced lean mass measured by BIA, DXA, and CT, was associated with increased risk of mortality with a hazard ratio (HR) of 1.35 (95% CI, 1.21-1.49), 1.18 (95% CI, 1.06-1.30), and 1.44 (95% CI, 1.32-1.57), respectively. Similarly, low lean mass defined by BIA-, DXA-, and CT-measurement was associated with increased risk of mortality, with an HR of 1.81 (95% CI, 1.56-2.10), 1.44 (95% CI, 1.29-1.60), and 1.78 (95% CI, 1.64-1.93).
CONCLUSIONS
Reduced and low lean mass were robustly associated with increased mortality in studies using different measurement modalities.
目的
瘦体重通常通过三种方式测量，即双能X线吸收法（DXA）、生物电阻抗分析（BIA）和计算机断层扫描（CT）。CT被认为是最准确的，而通过DXA和BIA测量的瘦体重通常包含非肌肉部分，因此与CT相比被认为准确性较低。使用不同测量方式时，瘦体重与死亡率之间的关联是否会有所不同仍不清楚。
方法
对瘦体重与死亡率进行了系统评价和荟萃分析。分析按不同测量方式和健康状况进行分层。使用随机效应模型估计合并风险比。
结果
该荟萃分析纳入了188项研究，共98468名参与者。通过BIA、DXA和CT测量的瘦体重降低与死亡风险增加相关，风险比（HR）分别为1.35（95%CI，1.21-1.49）、1.18（95%CI，1.06-1.30）和1.44（95%CI，1.32-1.57）。同样，通过BIA、DXA和CT测量定义的低瘦体重与死亡风险增加相关，HR分别为1.81（95%CI，1.56-2.10）、1.44（95%CI，1.29-1.60）和1.78（95%CI，1.64-1.93）。
结论
在使用不同测量方式的研究中，瘦体重降低和低瘦体重与死亡率增加密切相关。
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