Zheng Hejie, Wang Tianhong, Li Zhuoyang, Lu Huimin
Department of Urology, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Sciences, University of Electronic Science and Technology of China, Chengdu, 610072, China.
Department of Clinical Research, West China Hospital, Sichuan University, Chengdu, 610041, China.
BMC Musculoskelet Disord. 2025 Jun 6;26(1):566. doi: 10.1186/s12891-025-08775-w.
Currently, the prevalence of sarcopenia is on the rise. Sarcopenia may significantly affect the prognosis of fracture patients by increasing postoperative complications, diminishing quality of life, and raising mortality rates. This studyaims to investigate the impact of sarcopenia on the prognosis of fractures.
A systematic search was carried out in PubMed, Embase, Cochrane Library, and Web of Science using the keywords "sarcopenia" and "fracture" from the inception of each database to January 14, 2025. The logarithm and its standard error of the odds ratio (OR) were calculated to assess the effect size. Sensitivity analysis was conducted using a one-by-one exclusion approach. Publication bias was evaluated through funnel plots, Egger's test, Begg's test, and the trim and fill method.
Our pooled analysis of data from 30 studies, comprising 32 datasets, demonstrated that sarcopenia significantly elevated the risk of poor prognosis in fracture patients (OR 1.51, 95% CI 1.24-1.85), particularly, the risk of refracture (OR 1.66, 95% CI 1.36-2.03). In hip fractures, sarcopenia similarly increased the risk of poor prognosis (OR 1.43, 95% CI 1.17-1.76), refracture (OR 1.54, 95% CI 1.21-1.96) and poor functional recovery (OR 2.13, 95% CI 1.41-3.21).
Sarcopenia plays a crucial role as a risk factor for poor prognosis in patients with fractures, including both an elevated risk of mortality, refracture and poor functional recovery. This necessitates that clinical workers place greater emphasis on the identification and diagnosis of sarcopenia in practice, deliver enhanced clinical care tailored to fracture patients, conduct more prospective studies, and advocate for the global standardization of sarcopenia diagnostic criteria in the future.
目前，肌肉减少症的患病率正在上升。肌肉减少症可能通过增加术后并发症、降低生活质量和提高死亡率，显著影响骨折患者的预后。本研究旨在探讨肌肉减少症对骨折预后的影响。
从每个数据库建立之初至2025年1月14日，在PubMed、Embase、Cochrane图书馆和Web of Science中使用关键词“肌肉减少症”和“骨折”进行系统检索。计算比值比（OR）的对数及其标准误以评估效应大小。采用逐一排除法进行敏感性分析。通过漏斗图、Egger检验、Begg检验和修剪填充法评估发表偏倚。
我们对30项研究（包括32个数据集）的数据进行的汇总分析表明，肌肉减少症显著增加了骨折患者预后不良的风险（OR 1.51，95%CI 1.24-1.85），特别是再次骨折的风险（OR 1.66，95%CI 1.36-2.03）。在髋部骨折中，肌肉减少症同样增加了预后不良的风险（OR 1.43，95%CI 1.17-1.76）、再次骨折的风险（OR 1.54，95%CI 1.21-1.96）和功能恢复不良的风险（OR 2.13，95%CI 1.41-3.21）。
肌肉减少症作为骨折患者预后不良的危险因素起着关键作用，包括死亡率升高、再次骨折和功能恢复不良的风险增加。这就要求临床工作者在实践中更加重视肌肉减少症的识别和诊断，为骨折患者提供强化的临床护理，开展更多前瞻性研究，并在未来倡导肌肉减少症诊断标准的全球标准化。
