Prevalence and risk factors of sarcopenia in idiopathic pulmonary fibrosis: a systematic review and meta-analysis

Jiaye Li; Ye Lu; Mingming Deng; Run Tong; Qin Zhang; Yiding Bian; Jinrui Miao; Zilin Wang; Xiaoming Zhou; Gang Hou

doi:10.3389/fmed.2023.1187760

Prevalence and risk factors of sarcopenia in idiopathic pulmonary fibrosis: a systematic review and meta-analysis

Front Med (Lausanne). 2023 Jun 8:10:1187760. doi: 10.3389/fmed.2023.1187760. eCollection 2023.

Authors

Jiaye Li^#¹, Ye Lu^#², Mingming Deng¹, Run Tong¹, Qin Zhang¹, Yiding Bian¹, Jinrui Miao¹, Zilin Wang¹, Xiaoming Zhou³, Gang Hou¹

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China.
² Department of Respiratory and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
³ Center for Diagnosis and Management of Pulmonary Vascular Diseases, Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences (CAMS) and Perceiving, Beijing, China.

^# Contributed equally.

Abstract

Background: Sarcopenia often occurs as a comorbidity in many diseases which ultimately affects patient prognosis. However, it has received little attention in patients with idiopathic pulmonary fibrosis (IPF). This systematic review and meta-analysis aimed at determining the prevalence and risk factors of sarcopenia in patients with IPF.

Methods: Embase, MEDLINE, Web of Science, and Cochrane databases were searched using relevant MeSH terms until December 31, 2022. The Newcastle-Ottawa Scale (NOS) was used for quality assessment and data analysis were performed using Stata MP 17.0 (Texas, USA). A random effects model was adopted to account for differences between articles, and the I² statistic was used to describe statistical heterogeneities. Overall pooled estimates obtained from a random effects model were estimated using the metan command. Forest plots were generated to graphically represent the data of the meta-analysis. Meta-regression analysis was used for count or continuous variables. Egger test was used to evaluate publication bias and, if publication bias was observed, the trim and fill method was used.

Main results: The search results showed 154 studies, and five studies (three cross-section and two cohort studies) with 477 participants were finally included. No significant heterogeneity was observed among studies included in the meta-analysis (I² = 16.00%) and our study's publication bias is low (Egger test, p = 0.266). The prevalence of sarcopenia in patients with IPF was 26% (95% CI, 0.22-0.31). The risk factors for sarcopenia in patients with IPF were age (p = 0.0131), BMI (p = 0.001), FVC% (p < 0.001), FEV1% (p = 0.006), DLco% (p ≤ 0.001), and GAP score (p = 0.003).

Conclusions: The pooled prevalence of sarcopenia in patients with IPF was 26%. The risk factors for sarcopenia in IPF patients were age, BMI, FVC%, FEV1%, DLco%, and GAP score. It is important to identify these risk factors as early as possible to improve the life quality of patients with IPF.

Keywords: IPF; meta-analysis; review; risk factors; sarcopenia.

Publication types

Systematic Review

Grants and funding

This study was supported by National High Level Hospital Clinical Research Funding (2022-NHLHCRF-LX-01), the Elite Medical Professionals Project of China-Japan Friendship Hospital (No. ZRJY2021-BJ08), and the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (No. 2020-PT320-001). Funding information for this article has been deposited with the Crossref Funder Registry.