School of Nursing, Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang, China.
Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, Sichuan, China; Clinical Medical College of Chengdu Medical College, Chengdu 610500, Sichuan, China.
Clin Nutr. 2024 Sep;43(9):2005-2016. doi: 10.1016/j.clnu.2024.07.006. Epub 2024 Jul 20.
Sarcopenia is a common complication in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). However, the prevalence and its impact on the survival of sarcopenia in patients with MASLD is unknown. In this study, we aimed to assess the prevalence and effects of sarcopenia in patients with MASLD.
Systematic review and meta-analysis of full texts of relevant studies were searched from inception until June 12, 2024 in five databases (PubMed, Cochrane Library, Embase, Web of Science, and the China National Knowledge Infrastructure). Next, we assessed the prevalence of sarcopenia in MASLD, and calculated the ORs and HRs between sarcopenia and MASLD based on the adjusted data from individual studies. Statistical analyses were performed using Stata 11.0.
Of the 2984 records considered, 29 studies recruiting 63,330 patients were included. The pooled prevalence of sarcopenia in patients with MASLD was 23.5% overall (95% CI; 19.1%-27.9%, I = 99.6%), and was higher in Asian patients, male, cross-sectional studies, when BIA were employed to measure muscle mass, one criterion of diagnosis sarcopenia, MASLD was diagnosed employing MRI, and moderate-quality studies. Sarcopenia was associated with MASLD patients (adjusted odds ratio [aOR] 2.08, 95% CI 1.58-2.74, I = 93.6%) with similar findings in subgroups stratified by age, study design, methods for measuring muscle mass, assessment method to detect sarcopenia, and study quality. The association between all-cause mortality further supports the association between sarcopenia and poor prognosis with MASLD (aHR 1.59, 95% CI 1.33-1.91, I = 0%).
Sarcopenia was strongly associated with MASLD progression and was a risk factor not only for MASLD pathogenesis but was also markedly correlated with MASLD-associated mortality.
肌肉减少症是代谢功能障碍相关脂肪性肝病（MASLD）患者的常见并发症。然而，MASLD 患者中肌肉减少症的患病率及其对生存的影响尚不清楚。本研究旨在评估 MASLD 患者中肌肉减少症的患病率及其影响。
从建库至 2024 年 6 月 12 日，在 5 个数据库（PubMed、Cochrane Library、Embase、Web of Science 和中国知网）中系统地检索了相关研究的全文，并进行了综述和荟萃分析。然后，我们评估了 MASLD 患者中肌肉减少症的患病率，并根据来自个体研究的调整数据计算了肌肉减少症与 MASLD 之间的比值比（ORs）和风险比（HRs）。统计分析使用 Stata 11.0 进行。
在考虑的 2984 条记录中，有 29 项研究纳入了 63330 名患者。总体而言，MASLD 患者肌肉减少症的患病率为 23.5%（95%CI：19.1%-27.9%，I=99.6%），在亚洲患者、男性、横断面研究中，当使用 BIA 测量肌肉质量、诊断肌肉减少症的一个标准、采用 MRI 诊断 MASLD 以及研究质量为中等时，肌肉减少症的患病率更高。肌肉减少症与 MASLD 患者相关（调整后的比值比[aOR] 2.08，95%CI 1.58-2.74，I=93.6%），在按年龄、研究设计、测量肌肉质量的方法、检测肌肉减少症的评估方法和研究质量分层的亚组中也有类似的发现。全因死亡率的相关性进一步支持了肌肉减少症与 MASLD 不良预后之间的相关性（调整后的风险比[aHR] 1.59，95%CI 1.33-1.91，I=0%）。
肌肉减少症与 MASLD 进展密切相关，不仅是 MASLD 发病机制的一个危险因素，而且与 MASLD 相关死亡率显著相关。
