Lin Taiping, Dai Miao, Xu Ping, Sun Luwei, Shu Xiaoyu, Xia Xin, Zhao Yanli, Song Quhong, Guo Duan, Deng Chuanyao, Yue Jirong
Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Department of Biomedical Engineering, Sichuan University Library, Chengdu, Sichuan, China.
J Am Med Dir Assoc. 2022 May;23(5):902.e1-902.e20. doi: 10.1016/j.jamda.2022.02.005. Epub 2022 Mar 23.
Sarcopenia is a generalized and progressive skeletal muscle disorder and has been proven to be associated with many diseases; however, the correlation between sarcopenia and pain has not yet been systematically clarified. This review aimed to investigate the prevalence of sarcopenia in patients with pain and to ascertain whether pain is independently associated with sarcopenia.
Systematic review and meta-analysis.
A systematic literature search was performed from the Cochrane Central Register of Controlled Trials, Embase, MEDLINE and Epub Ahead of Print, In-Process, In-Data-Review, and Other Non-Indexed Citations, Daily and Versions for observational studies from inception until February 2021, and our search was updated on December 31, 2021.
Sarcopenia prevalence was calculated according to the corresponding number of patients with sarcopenia and pain. We performed meta-analyses with random effects models to calculate the pooled prevalence of sarcopenia in pain and its correlations. Subgroup analyses were also performed based on pain classification, pain location, and diagnostic criteria for sarcopenia. Heterogeneity between the studies was described using the I statistic.
Fourteen observational studies (13,953 participants, 44% women, and mean age from 40.1 to 76.6 years) were included. Study quality was rated moderate to high. The overall sarcopenia prevalence in patients with pain was 0.11 (95% CI 0.07-0.15, P < .001; I = 92.3%). People with pain were independently associated with a higher risk of sarcopenia than those without pain [odds ratio (OR) 1.35; 95% CI 1.17-1.56; P = .025; I = 51.1%]. Subgroup analyses showed that the cumulative prevalence and effect measures of sarcopenia were increased when individuals suffered secondary musculoskeletal pain (Prevalence = 12%; OR 1.45; 95% CI 1.19-1.78) and low back pain (Prevalence = 21%; OR 1.95; 95% CI 1.22-3.12).
The prevalence of sarcopenia in patients with pain is relatively high, and pain is significantly associated with sarcopenia in older adults. Attention is needed to screen sarcopenia among patients with pain and optimize its early detection and management in clinical practice.
肌肉减少症是一种全身性、进行性骨骼肌疾病，已被证明与多种疾病相关；然而，肌肉减少症与疼痛之间的相关性尚未得到系统阐明。本综述旨在调查疼痛患者中肌肉减少症的患病率，并确定疼痛是否与肌肉减少症独立相关。
系统评价和荟萃分析。
从Cochrane对照试验中央注册库、Embase、MEDLINE以及Epub Ahead of Print、In-Process、In-Data-Review和其他非索引引文、每日版和版本中进行系统文献检索，检索起始至2021年2月的观察性研究，检索于2021年12月31日更新。
根据肌肉减少症和疼痛患者的相应数量计算肌肉减少症患病率。我们使用随机效应模型进行荟萃分析，以计算疼痛患者中肌肉减少症的合并患病率及其相关性。还根据疼痛分类、疼痛部位和肌肉减少症诊断标准进行亚组分析。使用I统计量描述研究之间的异质性。
纳入14项观察性研究（13953名参与者，44%为女性，平均年龄40.1至76.6岁）。研究质量评定为中到高。疼痛患者中肌肉减少症的总体患病率为0.11（95%CI 0.07-0.15，P<.001；I=92.3%）。与无疼痛者相比，疼痛患者发生肌肉减少症的风险更高[优势比（OR）1.35；95%CI 1.17-1.56；P=.025；I=51.1%]。亚组分析表明，当个体患有继发性肌肉骨骼疼痛（患病率=12%；OR 1.45；95%CI 1.19-1.78）和腰痛（患病率=21%；OR 1.95；95%CI 1.22-3.12）时，肌肉减少症的累积患病率和效应量会增加。
疼痛患者中肌肉减少症的患病率相对较高，且疼痛与老年人肌肉减少症显著相关。在临床实践中，需要关注疼痛患者中肌肉减少症的筛查，并优化其早期检测和管理。
