各种干预措施对肌少症患者炎症因子影响的meta分析

Effects of various interventions on inflammatory cytokines in patients with sarcopenia:A meta-analysis

目的 通过分析肌少症患者在施行不同干预措施前后各项炎症因子的变化趋势,探讨肌少症与各种炎症因子的相关性。方法 通过对PubMed、Ovid、Cochrane Library和中国知网、万方数据库的检索,搜索了建库至2022年8月30日发表的肌少症与炎症指标相关的文献,符合纳入与排除标准的文献共6篇,共产生7组数据,累计纳入样本量402例,其中包含干预组232例,对照组170例。通过RevMan5.3对纳入的研究进行质量评估,使用Stata15.0软件进行数据分析,根据文献原始数据资料,计算各项指标的均值、标准差,使用随机效应模型及固定效应模型分析C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)在不同干预措施下的变化趋势。结果 各种积极的干预措施对肌少症患者的CRP水平有降低作用,差异有统计学意义[标准均数差(SMD)=-0.61,95%可信区间(95%CI)-0.91~-0.31,P<0.001],但IL-6和TNF-α水平在干预前后无明显变化(WMD=-0.39,95%CI-0.88~0.09,P=0.113;WMD=-0.56,95%CI-1.95~0.84,P=0.437)。结论 各种干预措施对肌少症患者的IL-6及TNF-α水平影响较小,但均可降低CRP水平,一定程度上,CRP可预测干预措施的效果。

Objective To explore the correlation between sarcopenia and inflammatory cytokines by analyzing the variation tendency of inflammatory cytokines in patients with sarcopenia before and after various interventions.Methods By searching PubMed,Ovid,Cochrane Library,China National Knowledge Infrastructure,Wanfang database,the literatures related to sarcopenia and inflammation indexes published from the establishment of the database to August 30,2022 were searched,and there were six literatures that met the inclusion and exclusion criteria,resulting in seven groups of data,with a total of 402 cases,including 232 cases in the experimental group and 170 cases in the control group.The quality of the included literatures was evaluated by RevMan5.3,and the data was analyzed by Stata 15.0.According to the original data of the article,the mean and standard deviation of each index were calculated.The random effect model and fixed effect model were used to analyze the variation tendency of C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)under the intervention measures.Results Various active interventions could reduce the CRP level of patients with sarcopenia,and the difference was statistically significant(SMD=-0.61,95%CI-0.91--0.31,P<0.001),but the levels of IL-6 and TNF-αshowed no statistical difference(WMD=-0.39,95%CI-0.88-0.09,P=0.113;WMD=-0.56,95%CI-1.95-0.84,P=0.437).Conclusion Various interventi ons have little effect on the levels of IL-6 and TNF-αin patients with sarcopenia,but they can reduce the level of CRP.To some extent,CRP can predict the effect of interventions.