相位角与肌少症及相关诊断指标的Meta分析

Meta-analysis of the correlation between phase angle and sarcopenia and its diagnostic indexes

目的:系统评价相位角与肌少症及相关诊断指标的相关性。方法:计算机检索PubMed、EMbase、Cochrane Library、Web of Science、中国知网、万方、维普和SinoMed数据库,收集关于相位角与肌少症及相关诊断指标相关的临床研究,检索时限均为各数据库建库至2024-05-08。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险。采用RevMan 5.3和Stata 14.0软件进行Meta分析。结果:经筛选共纳入50篇合格文献。Meta分析结果显示,与非肌少症人群对比,肌少症患者的相位角显著降低[SMD=-0.99,95%CI(-1.09,-0.90),P<0.00001]。亚组分析结果表明,重度肌少症以及亚洲肌少症患者相位角差值更加显著,并且伴有肌少症的恶性肿瘤和呼吸系统疾病患者的相位角降低更加明显。相位角与骨骼肌质量指数(Pearson’s r=0.565,P<0.00001)、握力(Pearson’s r=0.446,P<0.00001)、步速(Pearson’s r=0.405,P<0.00001)均呈中等正相关,但与四肢骨骼肌质量指数呈极弱正相关(Pearson’s r=0.139,P=0.02)。结论:与非肌少症人群对比,相位角在肌少症人群具有显著差异性,且与肌少症诊断指标均存在不同程度相关性,提示相位角在肌少症的客观诊断中具有一定的临床价值,但其结果可能受到肌少症严重程度、相位角检测仪器等因素的影响,且因受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。

OBJECTIVE:To systematically evaluate the correlation between phase angle and sarcopenia and its diagnostic indexes.METHODS:The PubMed,EMbase,Cochrane Library,Web of Science,CNKI,WanFang Data,VIP and SinoMed databases were electronically searched to collect studies on the correlation between phase angle and sarcopenia and its diagnostic indexes from database inception to May 8,2024.Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies.Meta-analysis was then performed using RevMan 5.3 and Stata 14.0 software.RESULTS:A total of 50 eligible articles were included.Meta-analysis results showed that compared with the non-sarcopenic population,the phase angle was significantly reduced in sarcopenic patients[standardized mean difference(SMD)=-0.99,95%confidence interval(CI)(-1.09,-0.90),P<0.00001].The results of subgroup analysis indicated that the difference of phase angle was more significant in patients with severe sarcopenia and Asian sarcopenia.Moreover,reduction in the phase angle was more obvious in patients with malignant tumors and respiratory diseases with sarcopenia.And skeletal muscle mass index(Pearson’s r=0.565,P<0.00001),grip strength(Pearson’s r=0.446,P<0.00001),and gait speed(Pearson’s r=0.405,P<0.00001)all showed a moderate positive correlation with phase angle.However,appendicular skeletal muscle mass index showed a very weak positive correlation with phase angle(Pearson’s r=0.139,P=0.02).CONCLUSION:Phase angle has a significant difference between sarcopenia and non-sarcopenia population,and it is correlated with the diagnostic indexes of sarcopenia to different extents.It suggests that phase angle has some clinical values in the objective diagnosis of sarcopenia.However,the results may be influenced by some factors such as sarcopenia severity and detection instruments of phase angle.Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.