Risk of secondary sarcopenia in Europeans with fibromyalgia according to the EWGSOP2 guidelines: systematic review and meta-analysis.

IF 3.3 3区 医学 Q1 REHABILITATION
Laura Rodríguez-Lumbreras, Juan D Ruiz-Cárdenas, María A Murcia-González
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引用次数: 0

Abstract

Introduction: Fibromyalgia is characterized by chronic widespread pain accompanied by reduced levels of physical activity and associated comorbidities such as overweight and obesity which have been associated to sarcopenia development. The aim of this systematic review is to ascertain whether Europeans with fibromyalgia show a reduction in sarcopenia determinants compared to apparently-healthy controls and to determine the risk of sarcopenia and its possible risk factors (PROSPERO: CRD42023439839).

Evidence acquisition: Systematic searches were conducted on six databases (Academic-Search-Ultimate, CENTRAL, PubMed, SciELO, WOS-Core Collection, and ClinicalTrials.gov last-search February-2024) looking for original studies developed in European countries which assessed any of the sarcopenia determinants proposed by the EWGSOP2-guidelines (handgrip strength, five sit-to-stand, appendicular skeletal mass [ASM], skeletal muscle index [SMI]) and included fibromyalgia and healthy-control individuals. Studies mixing fibromyalgia with other diagnoses were excluded. Random-effects meta-analyses and meta-regressions were used to analyze possible differences and associated risk factors. The risk of bias was assessed using the Cochrane-Rob tool and the Quality Assessment Tool for Observational Studies, and the certainty of the evidence using GRADE-approach.

Evidence synthesis: A total of 25 studies (6393 individuals; 97% women; 20-65 years) were included. Fibromyalgia individuals showed reduced muscle strength ([handgrip] SMD: -1.16 [-1.29, -1.03]; high-certainty; [five sit-to-stand] not-assessed) and muscle quantity ([ASM] mean-difference: -0.83 kg [-1.41, -0.37]; [SMI] mean-difference: -0.26 kg/m2 [-0.41, -0.10]; both low-certainty) compared to healthy-controls. Fibromyalgia individuals had nine-times greater risk for probable sarcopenia (OR: 9.23 [6.85, 12.45]; high-certainty), but not for confirmed sarcopenia ([ASM] OR: 0.91 [0.49, 1.67]; [SMI] OR: 0.67 [0.19, 2.33]; both low-certainty) according to the EWGSOP2 cut-off points. Reduced muscle strength was strongly associated to fibromyalgia-severity (β=-0.953 [-0.069, -0.038]). Studies were rated as high-risk of bias overall because did not account for some potential confounders (physical activity, sedentary time, Body Mass Index) which could influence the estimated effect.

Conclusions: Europeans with fibromyalgia have a large reduction in muscle strength and may have a reduction in muscle quantity. The risk of probable sarcopenia according to the EWGSOP2 cut-off points was nine-times higher, but may have no difference in risk of reduced muscle quantity relative to healthy-controls. Muscle strength was strongly associated to disease severity.

根据 EWGSOP2 指南,欧洲纤维肌痛患者继发性肌肉疏松症的风险:系统回顾与荟萃分析。
引言纤维肌痛的特点是慢性广泛性疼痛,同时伴有体力活动减少以及超重和肥胖等相关并发症,这些都与肌肉疏松症的发生有关。本系统性综述旨在确定与表面健康的对照组相比,患有纤维肌痛的欧洲人肌肉疏松症的决定因素是否有所减少,并确定肌肉疏松症的风险及其可能的风险因素(PROSPERO:CRD42023439839):我们在六个数据库(Academic-Search-Ultimate、CENTRAL、PubMed、SciELO、WOS-Core Collection 和 ClinicalTrials.gov,最后搜索日期为 2 月至 2024 年)中进行了系统性检索,以寻找在欧洲国家开展的原始研究,这些研究评估了 EWGSOP2- 指南提出的任何一项肌肉疏松症决定因素(手握力、五次坐立、附着骨骼质量 [ASM]、骨骼肌指数 [SMI]),并纳入了纤维肌痛患者和健康对照者。将纤维肌痛与其他诊断混合的研究被排除在外。随机效应荟萃分析和荟萃回归用于分析可能存在的差异和相关风险因素。使用 Cochrane-Rob 工具和观察性研究质量评估工具评估了偏倚风险,并使用 GRADE 方法评估了证据的确定性:共纳入 25 项研究(6393 人;97% 为女性;20-65 岁)。纤维肌痛患者的肌力([手握] SMD:-1.16 [-1.29, -1.03]; 高确定性;[五次坐立]未评估)和肌肉量([ASM] 平均差异:-0.83 kg [-1.03]; 高确定性;[五次坐立]未评估)均有所下降:-0.83千克 [-1.41,-0.37];[SMI]平均差:-0.26 kg/m2 [-0.41, -0.10];均为低确定性)。根据 EWGSOP2 临界点,纤维肌痛患者患可能肌少症(OR:9.23 [6.85, 12.45];高确定性)的风险高出九倍,但患确诊肌少症([ASM] OR:0.91 [0.49, 1.67];[SMI] OR:0.67 [0.19, 2.33];均为低确定性)的风险却没有高出九倍。肌力下降与纤维肌痛严重程度密切相关(β=-0.953 [-0.069, -0.038])。由于没有考虑一些可能影响估计效果的潜在混杂因素(体力活动、久坐时间、体重指数),研究总体上被评为偏倚风险较高:结论:患有纤维肌痛的欧洲人肌肉力量大幅下降,肌肉数量也可能减少。根据 EWGSOP2 临界点,可能患肌少症的风险高出九倍,但与健康对照组相比,肌肉数量减少的风险可能没有差异。肌肉力量与疾病严重程度密切相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.50
自引率
4.40%
发文量
162
审稿时长
6-12 weeks
期刊介绍: The European Journal of Physical and Rehabilitation Medicine publishes papers of clinical interest in physical and rehabilitation medicine.
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