A Meta-analysis Of Prevalence And Clinical Impact Of Sarcopenia In Patients With COPD

Objective: We conducted a statistical analysis on the prevalence of sarcopenia in patients with chronic obstructive pulmonary disease(COPD)at home and abroad,and obtained the reference value of the prevalence of sarcopenia in COPD patients based on a large sample size,and evaluated the clinical impact of sarcopenia on COPD.Methods: According to the inclusion and exclusion criteria,Thorough information retrieval was conducted using the following database: CN KI database,Wanfang database,Embase,Pub Med,Cochrane library and Web O f science with the deadline to January,2021,and the references listed in all papers were also retrieved.Two researchers independently screened the study literature,extracted the st udy data and evaluated the study quality.Stata12.0 was used for the Meta-analysis of prevalence,Revman5.3 was used for the Meta-analysis of clinical effects,forest maps were drawn,and sensitivity analysis and bias evaluation were performed.Results:(1)The incidence of sarcopenia in COPD patients was reported in 21 studies involving 5,043 COPD patients,of whom 1,235 patients had sarcopenia.Meta-analysis using a random-effects model showed that the overall prevalence of sarcopenia among COPD patients was 28% [95%CI(0.23,0.34),I2=95.5%,P<0.0001].(2)Among the 21 included studies,11 reported the FEV1% predicted value of COPD patients with and without sarcopenia.Meta-analysis showed that the FEV1%predicted value of COPD patients with sarcopenia was lower than that of patients without sarcopenia,the difference was statistically significant [MD=-8.35,95%CI(-12.77,-3.93),I2=86.4%,P<0.00001].Five studies reported the results of 6-minute walk test in COPD patients with and without sarcopenia.Meta-analysis showed that the results of 6-minute walk test in COPD patients with sarcopenia were significantly lower than those in patients without sarcopenia,with statistically significant differences [MD=-69.06,95%CI(-97.00,-47.13),I2=53%,P<0.00001].Four studies reported the MMRC scale scores of COPD patients with and without sarcopenia.Meta-analysis showed that the MMRC scale scores of COPD patients with sarcopenia were significantly higher than those of patients without sarcopenia,the difference was statistically significant [MD=0.06,95%CI(0.34,0.99),I2=68%,P<0.00001].Three studies reported the BO DE score of COPD patients with and without sarcopenia,and Meta-analysis showed that the BODE score of COPD patients with sarcopenia was significantly higher than that of COPD patients without sarcopenia,the difference was statistically significant [MD=1.81,95%CI(1.36,2.27),I2=0%,P<0.00001].Conclusion: The incidence of sarcopenia in COPD patients is about 28%,and race,people with different disease severity,different consensus criteria for sarcopenia,and muscle measurement methods all have influence on the prevalence of sarcopenia.Sarcopenia has a negative effect on pulmonary function(FEV1%),motor ability,dyspnea,quality of life and prognosis of COPD patients.