Brzeszczyński Filip, Hamilton David, Bończak Oktawiusz, Brzeszczyńska Joanna
Department of Trauma, Orthopaedics and Musculoskeletal Oncology, Copernicus Memorial Hospital, Pabianicka 62, 93-513 Łódź, Poland.
Research Centre for Health, Glasgow Caledonian University, Govan Mbeki Building, Cowcaddens Road, Glasgow G4 0BA, UK.
Int J Mol Sci. 2024 Dec 15;25(24):13433. doi: 10.3390/ijms252413433.
Hip fractures are associated with high morbidity and mortality. Sarcopenia is a significant factor contributing to poor prognosis; however, the clinical diagnosis of sarcopenia remains difficult in surgical patients. This systematic review aims to identify the biomarkers of sarcopenia as diagnostic and predictive tools in patients admitted for hip fracture surgery. A systematic search was conducted in the MEDLINE, EMBASE, and Google Scholar databases according to the PRISMA guidelines. Biomarker study quality was assessed using the BIOCROSS score. A total of 7 studies met the inclusion criteria and 515 patients were included, of whom 402 (78%) were female and 113 (22%) were male. The mean age of the participants was 83.1 years (SD: 5.9). Skeletal muscle biopsies were used for biomarker assessment in 14% (1/7) of studies and venous blood samples were used in the remaining 86% (6/7). The highlighted sarcopenia biomarkers included the low expression of insulin-like growth factor (IGF-I) and tumor necrosis factor-α (TNF-α), along with high serum myostatin and low serum vitamin D levels. Overall, the BIOCROSS score was satisfactory, with all studies obtaining at least a score of 13/20. The orthopedic literature is limited; however, the highlighted biomarkers in this review could be used as adjuncts in the diagnosis of sarcopenia in surgical patients.
髋部骨折与高发病率和死亡率相关。肌肉减少症是导致预后不良的一个重要因素；然而，在外科手术患者中，肌肉减少症的临床诊断仍然困难。本系统评价旨在确定肌肉减少症的生物标志物，作为髋部骨折手术患者的诊断和预测工具。根据PRISMA指南，在MEDLINE、EMBASE和谷歌学术数据库中进行了系统检索。使用BIOCROSS评分评估生物标志物研究的质量。共有7项研究符合纳入标准，纳入了515例患者，其中402例（78%）为女性，113例（22%）为男性。参与者的平均年龄为83.1岁（标准差：5.9）。14%（1/7）的研究使用骨骼肌活检进行生物标志物评估，其余86%（6/7）使用静脉血样本。突出的肌肉减少症生物标志物包括胰岛素样生长因子（IGF-I）和肿瘤坏死因子-α（TNF-α）的低表达，以及血清肌生成抑制素水平升高和血清维生素D水平降低。总体而言，BIOCROSS评分令人满意，所有研究至少获得13/20的评分。骨科文献有限；然而，本综述中突出的生物标志物可作为外科手术患者肌肉减少症诊断的辅助手段。
