特发性肺纤维化患者肌肉减少症的患病率及危险因素：一项系统评价和荟萃分析
Prevalence and risk factors of sarcopenia in idiopathic pulmonary fibrosis: a systematic review and meta-analysis.
作者信息
Li Jiaye, Lu Ye, Deng Mingming, Tong Run, Zhang Qin, Bian Yiding, Miao Jinrui, Wang Zilin, Zhou Xiaoming, Hou Gang
机构信息
Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China.
Department of Respiratory and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
出版信息
Front Med (Lausanne). 2023 Jun 8;10:1187760. doi: 10.3389/fmed.2023.1187760. eCollection 2023.
BACKGROUND
Sarcopenia often occurs as a comorbidity in many diseases which ultimately affects patient prognosis. However, it has received little attention in patients with idiopathic pulmonary fibrosis (IPF). This systematic review and meta-analysis aimed at determining the prevalence and risk factors of sarcopenia in patients with IPF.
METHODS
Embase, MEDLINE, Web of Science, and Cochrane databases were searched using relevant MeSH terms until December 31, 2022. The Newcastle-Ottawa Scale (NOS) was used for quality assessment and data analysis were performed using Stata MP 17.0 (Texas, USA). A random effects model was adopted to account for differences between articles, and the statistic was used to describe statistical heterogeneities. Overall pooled estimates obtained from a random effects model were estimated using the metan command. Forest plots were generated to graphically represent the data of the meta-analysis. Meta-regression analysis was used for count or continuous variables. Egger test was used to evaluate publication bias and, if publication bias was observed, the trim and fill method was used.
MAIN RESULTS
The search results showed 154 studies, and five studies (three cross-section and two cohort studies) with 477 participants were finally included. No significant heterogeneity was observed among studies included in the meta-analysis ( = 16.00%) and our study's publication bias is low (Egger test, = 0.266). The prevalence of sarcopenia in patients with IPF was 26% (95% CI, 0.22-0.31). The risk factors for sarcopenia in patients with IPF were age ( = 0.0131), BMI ( = 0.001), FVC% ( < 0.001), FEV1% ( = 0.006), DLco% ( ≤ 0.001), and GAP score ( = 0.003).
CONCLUSIONS
The pooled prevalence of sarcopenia in patients with IPF was 26%. The risk factors for sarcopenia in IPF patients were age, BMI, FVC%, FEV1%, DLco%, and GAP score. It is important to identify these risk factors as early as possible to improve the life quality of patients with IPF.
背景
肌肉减少症常作为多种疾病的合并症出现，最终影响患者预后。然而，在特发性肺纤维化（IPF）患者中，它很少受到关注。本系统评价和荟萃分析旨在确定IPF患者中肌肉减少症的患病率和危险因素。
方法
使用相关医学主题词检索Embase、MEDLINE、Web of Science和Cochrane数据库，检索截至2022年12月31日。采用纽卡斯尔-渥太华量表（NOS）进行质量评估，并使用Stata MP 17.0（美国德克萨斯州）进行数据分析。采用随机效应模型来考虑各文章之间的差异，并用 统计量描述统计异质性。使用metan命令估计从随机效应模型获得的总体合并估计值。生成森林图以直观呈现荟萃分析的数据。荟萃回归分析用于计数或连续变量。采用Egger检验评估发表偏倚，若观察到发表偏倚，则使用修剪和填充法。
主要结果
检索结果显示有154项研究，最终纳入了5项研究（3项横断面研究和2项队列研究），共477名参与者。荟萃分析纳入的研究之间未观察到显著异质性（ = 16.00%），且本研究的发表偏倚较低（Egger检验， = 0.266）。IPF患者中肌肉减少症的患病率为26%（95%CI，0.22 - 0.31）。IPF患者肌肉减少症的危险因素为年龄（ = 0.0131）、体重指数（BMI）（ = 0.001）、用力肺活量百分比（FVC%）（ < 0.001）、第1秒用力呼气容积百分比（FEV1%）（ = 0.006）、一氧化碳弥散量百分比（DLco%）（ ≤ 0.001）和GAP评分（ = 0.003）。
结论
IPF患者中肌肉减少症的合并患病率为26%。IPF患者肌肉减少症的危险因素为年龄、BMI、FVC%、FEV1%、DLco%和GAP评分。尽早识别这些危险因素对于提高IPF患者的生活质量很重要。
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