Prokopidis Konstantinos, Testa Giuseppe Dario, Giannaki Christoforos D, Stavrinou Pinelopi, Kelaiditi Eirini, Hoogendijk Emiel O, Veronese Nicola
Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom.
Department of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, Florence, Italy.
Adv Nutr. 2025 May;16(5):100428. doi: 10.1016/j.advnut.2025.100428. Epub 2025 Apr 11.
Malnutrition is a common phenomenon, particularly in those at an increased risk of muscle mass and function losses. In this systematic review and meta-analysis, we aimed to explore the association of malnutrition with sarcopenia in middle-aged and older adults and the prognostic association of malnutrition and sarcopenia compared with sarcopenia alone on all-cause mortality. PubMed, Scopus, Web of Science, and Cochrane Library were searched from inception until January 2024. A meta-analysis using a random-effect model was employed, utilizing the Mini Nutritional Assessment malnutrition tool as a continuous and categorical variable. The study protocol was registered in the International Prospective Register of Systematic Reviews (CRD42024501521). Malnutrition was significantly associated with a greater risk of sarcopenia [continuous: k = 12, odds ratio (OR): 1.38, 95% confidence interval (CI): 1.18, 1.61, I = 94.8%, P < 0.01; categorical: k = 37, OR: 2.99, 95% CI: 2.26, 3.96, I = 78.3%, P < 0.01]. Sarcopenia and malnutrition were associated with a higher risk of mortality compared with sarcopenia alone (k = 5, hazard ratio: 4.04, 95% CI: 1.36, 11.94, I = 92.8%, P < 0.01). Metaregression showed age, sex, and number of adjustments did not explain heterogeneity among studies. The included studies had a moderate risk of bias. Malnutrition is associated with higher odds of sarcopenia and their combined presence is a better predictor of all-cause mortality compared with sarcopenia alone, further highlighting the importance of applying interventions to counteract these two closely related phenomena.
营养不良是一种常见现象，尤其在肌肉量和功能丧失风险增加的人群中。在这项系统评价和荟萃分析中，我们旨在探讨中老年人营养不良与肌肉减少症之间的关联，以及与仅肌肉减少症相比，营养不良和肌肉减少症对全因死亡率的预后关联。检索了PubMed、Scopus、科学网和考科蓝图书馆，检索时间从建库至2024年1月。采用随机效应模型进行荟萃分析，将微型营养评定法营养不良工具作为连续变量和分类变量使用。该研究方案已在国际前瞻性系统评价注册库（注册号：CRD42024501521）中注册。营养不良与肌肉减少症风险增加显著相关[连续变量：k = 12，优势比（OR）：1.38，95%置信区间（CI）：1.18，1.61，I² = 94.8%，P < 0.01；分类变量：k = 37，OR：2.99，95% CI：2.26，3.96，I² = 78.3%，P < 0.01]。与仅肌肉减少症相比，肌肉减少症和营养不良与更高的死亡风险相关（k = 5，风险比：4.04，95% CI：1.36，11.94，I² = 92.8%，P < 0.01）。元回归分析显示，年龄、性别和调整数量并不能解释研究之间的异质性。纳入的研究存在中度偏倚风险。营养不良与肌肉减少症的发生几率较高相关，与仅肌肉减少症相比，二者共同存在是全因死亡率的更好预测指标，这进一步凸显了采取干预措施应对这两种密切相关现象的重要性。
