Is sarcopenia associated with an increased risk of all-cause mortality and functional disability?
Is sarcopenia associated with an increased risk of all-cause mortality and functional disability?
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DOI：
10.1016/j.exger.2017.06.008
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发表时间：
2017-10-01
影响因子：
3.9
通讯作者：
Kelley, Kristi S.
中科院分区：
文献类型：
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作者：
Kelley, George A.;Kelley, Kristi S.
背景：虽然最近的一项观察性研究的荟萃分析报告了石棺减少与全因死亡率和功能衰退之间具有统计学意义的相关性，但最近发展的反向异质性(WHET)模型被证明比传统的随机效应模型更有效。目的：这篇简短报告的目的是使用先前的荟萃分析来比较这两种方法。方法：对在任何环境下进行的前瞻性观察研究进行汇总数据的荟萃分析。对60岁及以上的男性和女性进行全因死亡(12项研究，14,169名参与者)或功能衰退(6项研究，8561名参与者)的评估。使用IVhet模型，汇集了以前关于石棺减少与全因死亡率和功能衰退之间的关联的研究。也计算了随机效应和随机效应结果之间绝对差异和相对差异，以及影响分析，每个研究都被删除一次。结果：骨质疏松症与全因死亡率(OR=3.64，95%CI=2.94~4.51)和功能衰退(OR=2.58，95%CI=1.33~4.99)的风险增加有关。与随机效应模型相比，全因死亡率的OR略高(0.04或1.1%)，但CI较宽(0.16或11.3%)，而功能下降的CI较低0.45(14.9%)，CI较宽(10.2%)。随着每项研究从模型中删除一次，结果仍然具有统计学意义，全原因死亡率和功能衰退。结论：这些结果提供了更多和更准确的证据，支持石棺减少与全原因死亡率和功能衰退风险增加之间的关联。(C)2017 Elsevier Inc.保留所有权利。
Background: While a recent meta-analysis of observational studies reported a statistically significant association between sarcopenia and both all-cause mortality and functional decline, a recently developed inverse heterogeneity (Whet) model has been shown to be more valid than the traditional random-effects model used.Objective: The objective of this short report was to use a previous meta-analysis to compare the two approaches.Methods: Aggregate data meta-analysis of prospective observational studies conducted in any setting. Men and women 60 years of age and older in which all-cause mortality (12 studies, 14,169 participants) or functional decline (6 studies, 8561 participants) was assessed. Using the IVhet model, pooling of previous studies regarding the association between sarcopenia and all-cause mortality as well as functional decline. Absolute and relative differences between Whet and random-effects results were also calculated as well as influence analysis with each study deleted once. Non-overlapping 95% confidence intervals (CI) for odds ratios (OR) were considered statistically significant.Results: Sarcopenia was associated with an increased risk for all-cause mortality (OR = 3.64, 95% CI = 2.94 to 4.51) and functional decline (OR = 2.58, 95% CI = 1.33 to 4.99). Compared to the random-effects model, the OR was slightly higher (0.04 or 1.1%) but with wider CI (0.16 or 11.3%) for all-cause mortality and 0.45 (14.9%) lower with a CI that was 0.34 (10.2%) wider for functional decline. With each study deleted from the model once, results remained statistically significant for both all-cause mortality and functional decline.Conclusion: These results provide additional and more accurate evidence in support of an association between sarcopenia and an increased risk for both all-cause mortality and functional decline. (C) 2017 Elsevier Inc. All rights reserved.