Sarcopenia and adverse health-related outcomes: An umbrella review of meta-analyses of observational studies

Lin Xia, Rui Zhao, Qianyi Wan, Yutao Wu, Yong Zhou, Yong Wang, Yaping Cui, Xiaoding Shen, Xiaoting Wu, Lin Xia, Rui Zhao, Qianyi Wan, Yutao Wu, Yong Zhou, Yong Wang, Yaping Cui, Xiaoding Shen, Xiaoting Wu

Abstract

Objective: The purpose of this umbrella review was to assess the associations between sarcopenia and adverse health-related outcomes.

Design: An umbrella review of meta-analyses of observational studies.

Setting and participants: Patients with sarcopenia and controls without sarcopenia were included.

Measures: The PubMed, Web of Science and Embase were searched for relevant systematic review and meta-analysis. AMSTAR and GRADE system were used for methodological quality and evidence quality assessments, respectively.

Results: Totally 54 outcomes extracted from 30 meta-analyses were analyzed. Twenty out of 21 prognostic outcomes indicated that sarcopenia was significantly associated with poorer prognosis of gastric cancer, hepatocellular cancer, urothelial cancer, head and neck cancer, hematological malignancy, pancreatic cancer, breast cancer, colorectal cancer, lung cancer, esophageal cancer, and ovarian cancer. Besides, 10 out of 16 postoperative outcomes suggested that sarcopenia significantly increased the risk of multiple postoperative complications and prolonged the length of hospitalization of patients with digestive cancer. In age-related outcomes, sarcopenia significantly increased the risk of dysphagia, cognitive impairment, fractures, falls, hospitalization, and all-cause mortality of elderly populations. Moreover, sarcopenia was also associated with higher level of albuminuria, risk of depression, and several metabolic diseases.

Conclusions and implications: Sarcopenia significantly affected a wide range of adverse health-related outcomes, particularly in patients of tumor and elderly populations. Because evidences of most outcomes were rated as "low" and "very low," more prospective cohort studies are required in the future.

Keywords: AMSTAR; GRADE; health-related outcomes; sarcopenia; umbrella review.

Conflict of interest statement

There was no conflict of interest.

© 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Figures

FIGURE 1
FIGURE 1
Forest plot of prognostic outcomes of tumor having significant associations with sarcopenia
FIGURE 2
FIGURE 2
Forest plot of postoperative outcomes having significant associations with sarcopenia
FIGURE 3
FIGURE 3
Forest plot of age‐related outcomes having significant associations with sarcopenia
FIGURE 4
FIGURE 4
Forest plot of metabolic outcomes having significant associations with sarcopenia

References

    1. Cruz‐Jentoft AJ, Sayer AA. Sarcopenia. Lancet. 2019;393(10191):2636‐2646.
    1. Cruz‐Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16‐31.
    1. Shafiee G, Keshtkar A, Soltani A, Ahadi Z, Larijani B, Heshmat R. Prevalence of sarcopenia in the world: a systematic review and meta‐analysis of general population studies. J Diabetes Metab Disord. 2017;16:21.
    1. Mayhew AJ, Amog K, Phillips S, et al. The prevalence of sarcopenia in community‐dwelling older adults, an exploration of differences between studies and within definitions: a systematic review and meta‐analyses. Age Ageing. 2019;48(1):48‐56.
    1. Martone AM, Bianchi L, Abete P, et al. The incidence of sarcopenia among hospitalized older patients: results from the Glisten study. J Cachexia Sarcopeni. 2017;8(6):907‐914.
    1. Pamoukdjian F, Bouillet T, Levy V, Soussan M, Zelek L, Paillaud E. Prevalence and predictive value of pre‐therapeutic sarcopenia in cancer patients: a systematic review. Clin Nutr. 2018;37(4):1101‐1113.
    1. Shen YJ, Chen J, Chen XY, Hou LS, Lin XF, Yang M. Prevalence and associated factors of sarcopenia in nursing home residents: a systematic review and meta‐analysis. J Am Med Directors Ass. 2019;20(1):5‐13.
    1. Beaudart C, Zaaria M, Pasleau F, Reginster JY, Bruyere O. Health outcomes of sarcopenia: a systematic review and meta‐analysis. PLoS One. 2017;12(1):e0169548.
    1. Zhang G, Meng S, Li R, Ye J, Zhao L. Clinical significance of sarcopenia in the treatment of patients with primary hepatic malignancies, a systematic review and meta‐analysis. Oncotarget. 2017;8(60):102474‐102485.
    1. Simonsen C, de Heer P, Bjerre ED, et al. Sarcopenia and postoperative complication risk in gastrointestinal surgical oncology: a meta‐analysis. Ann Surg. 2018;268(1):58‐69.
    1. Veronese N, Demurtas J, Soysal P, et al. Sarcopenia and health‐related outcomes: an umbrella review of observational studies. Eur Geriatr Med. 2019;10(6):853‐862.
    1. Aromataris E, Fernandez R, Godfrey CM, Holly C, Khalil H, Tungpunkom P. Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach. Int J Evid Based Healthc. 2015;13(3):132‐140.
    1. Ioannidis JP. Integration of evidence from multiple meta‐analyses: a primer on umbrella reviews, treatment networks and multiple treatments meta‐analyses. CMAJ. 2009;181(8):488‐493.
    1. Shea BJ, Hamel C, Wells GA, et al. AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. J Clin Epidemiol. 2009;62(10):1013‐1020.
    1. Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol. 2007;7:10.
    1. Guyatt G, Oxman AD, Akl EA, et al. GRADE guidelines: 1. Introduction‐GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383‐394.
    1. Veronese N, Demurtas J, Celotto S, et al. Is chocolate consumption associated with health outcomes? An umbrella review of systematic reviews and meta‐analyses. Clin Nutr. 2018.
    1. Solmi M, Köhler CA, Stubbs B, et al. Environmental risk factors and nonpharmacological and nonsurgical interventions for obesity: an umbrella review of meta‐analyses of cohort studies and randomized controlled trials. Eur J Clin Invest. 2018;48(12):e12982.
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ. 2003;327(7414):557‐560.
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629‐634.
    1. Belbasis L, Bellou V, Evangelou E, Ioannidis JP, Tzoulaki I. Environmental risk factors and multiple sclerosis: an umbrella review of systematic reviews and meta‐analyses. Lancet Neurol. 2015;14(3):263‐273.
    1. Zhang XM, Dou QL, Zeng Y, Yang Y, Cheng ASK, Zhang WW. Sarcopenia as a predictor of mortality in women with breast cancer: a meta‐analysis and systematic review. BMC Cancer. 2020;20(1):172.
    1. Wong A, Zhu D, Kraus D, Tham T. Radiologically defined sarcopenia affects survival in head and neck cancer: a meta‐analysis. Laryngoscope. 2020.
    1. Ubachs J, Ziemons J, Minis‐Rutten IJG, et al. Sarcopenia and ovarian cancer survival: a systematic review and meta‐analysis. J Cachexia Sarcopenia Muscle. 2019;10(6):1165‐1174.
    1. Sun G, Li Y, Peng Y, et al. Can sarcopenia be a predictor of prognosis for patients with non‐metastatic colorectal cancer? A systematic review and meta‐analysis. Int J Colorectal Dis. 2018;33(10):1419‐1427.
    1. Su H, Ruan J, Chen T, Lin E, Shi L. CT‐assessed sarcopenia is a predictive factor for both long‐term and short‐term outcomes in gastrointestinal oncology patients: a systematic review and meta‐analysis. Cancer Imaging. 2019;19(1):82.
    1. Kamarajah SK, Bundred J, Tan BHL. Body composition assessment and sarcopenia in patients with gastric cancer: a systematic review and meta‐analysis. Gastric Cancer. 2019;22(1):10‐22.
    1. Jia S, Qiao R, Xiao Y, et al. Prognostic value of sarcopenia in survivors of hematological malignances undergoing a hematopoietic stem cell transplantation: a systematic review and meta‐analysis. Support Care Cancer. 2020;28(8):3533‐3542.
    1. Hu X, Dou WC, Shao YX, et al. The prognostic value of sarcopenia in patients with surgically treated urothelial carcinoma: a systematic review and meta‐analysis. Eur J Surg Oncol. 2019;45(5):747‐754.
    1. Deng HY, Zha P, Peng L, Hou L, Huang KL, Li XY. Preoperative sarcopenia is a predictor of poor prognosis of esophageal cancer after esophagectomy: a comprehensive systematic review and meta‐analysis. Dis Esophagus. 2019;32(3).
    1. Deng HY, Hou L, Zha P, Huang KL, Peng L. Sarcopenia is an independent unfavorable prognostic factor of non‐small cell lung cancer after surgical resection: a comprehensive systematic review and meta‐analysis. Eur J Surg Oncol. 2019;45(5):728‐735.
    1. Chang KV, Chen JD, Wu WT, Huang KC, Hsu CT, Han DS. Association between loss of skeletal muscle mass and mortality and tumor recurrence in hepatocellular carcinoma: a systematic review and meta‐analysis. Liver Cancer. 2018;7(1):90‐103.
    1. Yang Z, Zhou X, Ma B, Xing Y, Jiang X, Wang Z. Predictive value of preoperative sarcopenia in patients with gastric cancer: a meta‐analysis and systematic review. J Gastrointest Surg. 2018;22(11):1890‐1902.
    1. Wang PY, Xu LD, Chen XK, et al. Sarcopenia and short‐term outcomes after esophagectomy: a meta‐analysis. Ann Surg Oncol. 2020;27(8):3041‐3051.
    1. Hua H, Xu X, Tang Y, Ren Z, Xu Q, Chen L. Effect of sarcopenia on clinical outcomes following digestive carcinoma surgery: a meta‐analysis. Support Care Cancer. 2019;27(7):2385‐2394.
    1. Bundred J, Kamarajah SK, Roberts KJ. Body composition assessment and sarcopenia in patients with pancreatic cancer: a systematic review and meta‐analysis. HPB (Oxford). 2019;21(12):1603‐1612.
    1. Zhao Y, Zhang Y, Hao Q, Ge M, Dong B. Sarcopenia and hospital‐related outcomes in the old people: a systematic review and meta‐analysis. Aging Clin Exp Res. 2019;31(1):5‐15.
    1. Zhao WT, Yang M, Wu HM, Yang L, Zhang XM, Huang Y. Systematic review and meta‐analysis of the association between sarcopenia and dysphagia. J Nutr Health Aging. 2018;22(8):1003‐1009.
    1. Zhang X, Wang C, Dou Q, Zhang W, Yang Y, Xie X. Sarcopenia as a predictor of all‐cause mortality among older nursing home residents: a systematic review and meta‐analysis. BMJ Open. 2018;8(11):e021252.
    1. Zhang X, Huang P, Dou Q, et al. Falls among older adults with sarcopenia dwelling in nursing home or community: a meta‐analysis. Clin Nutr. 2019.
    1. Yeung SSY, Reijnierse EM, Pham VK, et al. Sarcopenia and its association with falls and fractures in older adults: a systematic review and meta‐analysis. J Cachexia Sarcopenia Muscle. 2019;10(3):485‐500.
    1. Liu P, Hao Q, Hai S, Wang H, Cao L, Dong B. Sarcopenia as a predictor of all‐cause mortality among community‐dwelling older people: a systematic review and meta‐analysis. Maturitas. 2017;103:16‐22.
    1. Cabett Cipolli G, Sanches Yassuda M, Aprahamian I. Sarcopenia is associated with cognitive impairment in older adults: a systematic review and meta‐analysis. J Nutr Health Aging. 2019;23(6):525‐531.
    1. Zhang H, Lin S, Gao T, et al. Association between sarcopenia and metabolic syndrome in middle‐aged and older non‐obese adults: a systematic review and meta‐analysis. Nutrients. 2018;10(3).
    1. Yu R, Shi Q, Liu L, Chen L. Relationship of sarcopenia with steatohepatitis and advanced liver fibrosis in non‐alcoholic fatty liver disease: a meta‐analysis. BMC Gastroenterol. 2018;18(1):51.
    1. Pan X, Han Y, Zou T, et al. Sarcopenia contributes to the progression of nonalcoholic fatty liver disease‐ related fibrosis: a meta‐analysis. Dig Dis. 2018;36(6):427‐436.
    1. Kim G, Kang SH, Kim MY, Baik SK. Prognostic value of sarcopenia in patients with liver cirrhosis: a systematic review and meta‐analysis. PLoS One. 2017;12(10):e0186990.
    1. Chang KV, Chen JD, Wu WT, Huang KC, Lin HY, Han DS. Is sarcopenia associated with hepatic encephalopathy in liver cirrhosis? A systematic review and meta‐analysis. J Formos Med Assoc. 2019;118(4):833‐842.
    1. Ida S, Kaneko R, Imataka K, Murata K. Association between sarcopenia and renal function in patients with diabetes: a systematic review and meta‐analysis. J Diabetes Res. 2019;2019:1365189.
    1. Chang KV, Hsu TH, Wu WT, Huang KC, Han DS. Is sarcopenia associated with depression? A systematic review and meta‐analysis of observational studies. Age Ageing. 2017;46(5):738‐746.
    1. Prado CMM, Baracos VE, McCargar LJ, et al. Sarcopenia as a determinant of chemotherapy toxicity and time to tumor progression in metastatic breast cancer patients receiving capecitabine treatment. Clin Cancer Res. 2009;15(8):2920‐2926.
    1. Nishioka N, Uchino J, Hirai S, et al. Association of sarcopenia with and efficacy of Anti‐PD‐1/PD‐L1 therapy in non‐small‐cell lung cancer. J Clin Med. 2019;8(4).
    1. Souza ABF, Nascimento DAC, Rodrigues IJM, et al. Association between sarcopenia and diabetes in community dwelling elderly in the Amazon region ‐ Viver Mais Project. Arch Gerontol Geriat. 2019;83:121‐125.
    1. Peball M, Mahlknecht P, Werkmann M, et al. Prevalence and associated factors of sarcopenia and frailty in Parkinson's disease: a cross‐sectional study. Gerontology. 2019;65(3):216‐228.
    1. Hayashi M, Abe K, Fujita M, Okai K, Takahashi A, Ohira H. Association between sarcopenia and osteoporosis in chronic liver disease. Hepatol Res. 2018;48(11):893‐904.
    1. de Blasio F, Di Gregorio A, de Blasio F, Bianco A, Bellofiore B, Scalfi L. Malnutrition and sarcopenia assessment in patients with chronic obstructive pulmonary disease according to international diagnostic criteria, and evaluation of raw BIA variables. Resp Med. 2018;134:1‐5.
    1. Choi YI, Park DK, Chung JW, Kim JH. Sarcopenia is independently associated with an increased risk of peptic ulcer disease. Gastroenterology. 2019;156(6):S751.
    1. Skov‐Jensen C, Skovbro M, Flint A, Helge JW, Dela F. Contraction‐mediated glucose uptake is increased in men with impaired glucose tolerance. Appl Physiol Nutr Me. 2007;32(1):115‐124.
    1. Lee SW, Youm Y, Lee WJ, et al. Appendicular skeletal muscle mass and insulin resistance in an elderly Korean population: the Korean social life, health and aging project‐health examination cohort. Diabetes Metab J. 2015;39(1):37‐45.
    1. Polyzos SA, Kountouras J, Zavos C. Nonalcoholic fatty liver disease: the pathogenetic roles of insulin resistance and adipocytokines. Curr Mol Med. 2009;9(3):299‐314.
    1. Ten Haaf DSM, Eijsvogels TMH, Bongers C, et al. Protein supplementation improves lean body mass in physically active older adults: a randomized placebo‐controlled trial. J Cachexia Sarcopenia Muscle. 2019;10(2):298‐310.
    1. Smith GI, Julliand S, Reeds DN, Sinacore DR, Klein S, Mittendorfer B. Fish oil‐derived n‐3 PUFA therapy increases muscle mass and function in healthy older adults. Am J Clin Nutr. 2015;102(1):115‐122.
    1. Liao CD, Tsauo JY, Wu YT, et al. Effects of protein supplementation combined with resistance exercise on body composition and physical function in older adults: a systematic review and meta‐analysis. Am J Clin Nutr. 2017;106(4):1078‐1091.
    1. Coelho‐Junior HJ, Milano‐Teixeira L, Rodrigues B, Bacurau R, Marzetti E, Uchida M. Relative protein intake and physical function in older adults: a systematic review and meta‐analysis of observational studies. Nutrients. 2018;10(9).
    1. Antoniak AE, Greig CA. The effect of combined resistance exercise training and vitamin D3 supplementation on musculoskeletal health and function in older adults: a systematic review and meta‐analysis. BMJ Open. 2017;7(7):e014619.
    1. Wright J, Baldwin C. Oral nutritional support with or without exercise in the management of malnutrition in nutritionally vulnerable older people: A systematic review and meta‐analysis. Clin Nutr. 2018;37(6):1879‐1891.
    1. Sim M, Lewis JR, Blekkenhorst LC, et al. Higher dietary nitrate intake is associated with better muscle function in older women. J Cachexia Sarcopenia Muscle. 2019.
    1. Velho S, Moço S, Ferreira A, et al. Dietary patterns and their relationships to sarcopenia in Portuguese patients with gastrointestinal cancer: an exploratory study. Nutrition. 2019;63–64:193‐199.
    1. Hanach NI, McCullough F, Avery A. The impact of dairy protein intake on muscle mass, muscle strength, and physical performance in middle‐aged to older adults with or without existing sarcopenia: a systematic review and meta‐analysis. Adv Nutr. 2019;10(1):59‐69.
    1. Beckwee D, Delaere A, Aelbrecht S, et al. Exercise interventions for the prevention and treatment of sarcopenia. a systematic umbrella review. J Nutr Health Aging. 2019;23(6):494‐502.
    1. Bear DE, Langan A, Dimidi E, et al. beta‐Hydroxy‐beta‐methylbutyrate and its impact on skeletal muscle mass and physical function in clinical practice: a systematic review and meta‐analysis. Am J Clin Nutr. 2019;109(4):1119‐1132.
    1. Morley JE. Treatment of sarcopenia: the road to the future. J Cachexia Sarcopeni. 2018;9(7):1196‐1199.
    1. Rooks D, Praestgaard J, Hariry S, et al. Treatment of sarcopenia with bimagrumab: results from a Phase II, randomized, controlled. Proof‐of‐concept study. J Am Geriatr Soc. 2017;65(9):1988‐1995.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する