Le Khang Duy Ricky, Patel Harsh, Downie Emma
Department of General Surgical Specialties, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Geelong Clinical School, Deakin University, Geelong, Victoria, Australia.
PLoS One. 2025 Apr 29;20(4):e0322409. doi: 10.1371/journal.pone.0322409. eCollection 2025.
Sarcopenia is a known risk factor for poor prognosis in chronic pancreatitis, however the impact of sarcopenia in acute pancreatitis (AP) is unknown. This systematic review examines the prognostic impact of sarcopenia on clinical outcomes in patients with acute pancreatitis.
A systematic literature of Medline, EMBASE, Cochrane, and the World Health Organisation International Clinical Trials Registry Platform was undertaken to identify articles relating to sarcopenia, AP, and computed tomography imaging. Data collected was related to studies' demographic population, presence of sarcopenia, sarcopenia assessment methodology, obesity, pancreatitis severity, and short- and long-term complications of AP.
A total of four out of 114 unique peer-review articles were included in this review, encompassing 947 patients in total. Of the analysable data, 200 patients had sarcopenia and 640 did not. There was marked heterogeneity in the determination of the presence of sarcopenia between studies. No significant association was found between sarcopenia and pancreatic necrosis, organ failure, venous thromboembolism, recurrent acute pancreatitis, or mortality.
Sarcopenia remains highly prevalent in patients suffering from acute pancreatitis. There is insufficient evidence to suggest sarcopenia is associated with poorer outcomes in patients with acute pancreatitis. More high-powered studies are required to further characterise the impact of sarcopenia on patients with acute pancreatitis.
肌肉减少症是慢性胰腺炎预后不良的已知危险因素,然而,肌肉减少症在急性胰腺炎(AP)中的影响尚不清楚。本系统评价旨在研究肌肉减少症对急性胰腺炎患者临床结局的预后影响。
对Medline、EMBASE、Cochrane以及世界卫生组织国际临床试验注册平台进行系统文献检索,以确定与肌肉减少症、急性胰腺炎和计算机断层扫描成像相关的文章。收集的数据涉及研究的人口统计学特征、肌肉减少症的存在情况、肌肉减少症评估方法、肥胖、胰腺炎严重程度以及急性胰腺炎的短期和长期并发症。
本评价共纳入114篇经同行评审的独特文章中的4篇,共涉及947例患者。在可分析的数据中,200例患者存在肌肉减少症,640例患者不存在。各研究之间在肌肉减少症存在情况的判定上存在明显异质性。未发现肌肉减少症与胰腺坏死、器官衰竭、静脉血栓栓塞、复发性急性胰腺炎或死亡率之间存在显著关联。
肌肉减少症在急性胰腺炎患者中仍然非常普遍。没有足够的证据表明肌肉减少症与急性胰腺炎患者的较差结局相关。需要更多有说服力的研究来进一步描述肌肉减少症对急性胰腺炎患者的影响。