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性别差异、蛋白质稳态和线粒体功能对与中风相关的肌肉减少症的影响:系统评价和荟萃分析。

Sex difference, proteostasis and mitochondrial function impact stroke-related sarcopenia-A systematic review and meta-analysis.

机构信息

Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung 404328, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taichung 404333, Taiwan.

Graduate Institute of Integrated Medicine, China Medical University, Taichung 404333, Taiwan; Department of Medical Genetics and Medical Research, China Medical University Hospital, Taichung 404328, Taiwan; Drug Development Center, China Medical University, Taichung 404333, Taiwan.

出版信息

Ageing Res Rev. 2024 Nov;101:102484. doi: 10.1016/j.arr.2024.102484. Epub 2024 Aug 30.

Abstract

BACKGROUND

The prevalence of stroke-related sarcopenia has been noted; however, epidemiological data and interventions that increase or reduce the incidence of stroke-related sarcopenia remain lacking.

METHODS

Studies on stroke-related sarcopenia were included in association or interventional analyses. All analyses were performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two evaluators independently extracted the data.

RESULTS

Female stroke patients had a higher preference for sarcopenia than male patients (pooled odds ratio [OR] = 0.670, 95 % CI 0.533-0.842, p = 0.001). Although stroke patients without drug use have improved skeletal muscle mass index (SMI) (MD = 0.272, 95 % CI 0.087-0.457, p = 0.004), handgrip strength (HGS) was not significantly altered (MD = -0.068, 95 % CI -0.221-0.076, p = 0.354). Stroke patients with nutrient interventions have improved SMI (MD = -0.354, 95 % CI -0.635- -0.073, p = 0.014) and HGS (MD = -0.394, 95 % CI -0.678- -0.111, p = 0.006); the synergistic effect of rehabilitation exercise has not been ruled out. Whether a sex difference exists in these interventions remains to be investigated. The underlying pathological mechanisms and potential therapeutic strategies for this disease are discussed.

CONCLUSION

Sex difference, proteostasis, and mitochondrial function may impact the incidence of stroke-related sarcopenia. Understanding the underlying pathological mechanisms and potential therapeutic targets for this disease will provide new insights into disease treatment, prevention, and drug development.

摘要

背景

已有研究报道与中风相关的肌肉减少症的流行情况;然而,缺乏关于增加或减少中风相关肌肉减少症发病率的流行病学数据和干预措施。

方法

本研究纳入了与中风相关的肌肉减少症的相关性或干预性分析研究。所有分析均按照系统评价和荟萃分析的首选报告项目(PRISMA)指南进行。两位评估员独立提取数据。

结果

女性中风患者比男性患者更易出现肌肉减少症(汇总优势比 [OR] = 0.670,95%置信区间 [CI] 0.533-0.842,p = 0.001)。尽管未使用药物治疗的中风患者骨骼肌质量指数(SMI)有所改善(MD = 0.272,95%CI 0.087-0.457,p = 0.004),但握力(HGS)并未显著改变(MD = -0.068,95%CI -0.221-0.076,p = 0.354)。接受营养干预的中风患者的 SMI(MD = -0.354,95%CI -0.635- -0.073,p = 0.014)和 HGS(MD = -0.394,95%CI -0.678- -0.111,p = 0.006)均有改善;但不能排除康复运动的协同作用。这些干预措施是否存在性别差异仍有待研究。本文还讨论了这种疾病的潜在病理机制和潜在治疗策略。

结论

性别差异、蛋白质平衡和线粒体功能可能会影响中风相关肌肉减少症的发病率。了解这种疾病的潜在病理机制和潜在治疗靶点将为疾病治疗、预防和药物开发提供新的思路。

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