肌肉减少型肥胖对非转移性结直肠癌患病率和预后的影响：一项系统综述和荟萃分析。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-07-31 DOI:10.1016/j.clnesp.2025.07.1127

Wanping Wang , Fang Fang , Tianxiu Wang , Xinyi Chen , Lu Zhao , Chunmei Wang , Yujia Tang , Qin Li , Dong Tang , Jingqiu Zhang

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引用次数: 0

摘要

背景与目的：肌少性肥胖（SO）在非转移性结直肠癌（nmCRC）患者中的患病率及其对预后的影响仍存在争议。该荟萃分析评估了nmCRC患者的SO患病率及其与生存和术后结局的关系。方法：检索截至2025年1月的PubMed、EMBASE、CINAHL、OVID、Web of Science和Cochrane Library。观察性研究报告了nmCRC中SO患病率或其预后影响。在R.4.5.1中使用随机/固定效应模型合并数据。结果：共纳入18项研究，涉及11283例nmCRC患者。nmCRC患者的总SO患病率为13% （95% CI: 07%-22%）。SO显著降低总生存率（HR=1.52, 95% CI:1.26-1.82， P=0.000）、无病生存率(HR=1.72；95%置信区间:1.27—-2.32;P = 0.000)。增加了总并发症的风险(OR=2.23；95%置信区间:1.05—-4.73;P=0.037)，吻合口瘘(OR=2.56；95% ci: 1.30-5.05；P=0.007)，死亡率(OR=1.89；95%置信区间:1.38—-2.59;P = 0.000)。癌症特异性生存率无统计学意义(HR=1.50；95%可信区间= 0.86 - -2.63;P=0.154)，无复发生存率(HR=1.60；95%可信区间= 0.64 - -4.04;P=0.318)或住院时间(or =3.74；95%可信区间= 0.74 - -18.98;P = 0.111)。结论：SO与较差的生存率和较高的术后并发症有关。常规的身体成分评估可能有助于早期SO的识别和干预。需要标准化的诊断标准和前瞻性研究来完善预后评估。

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The impact of sarcopenic obesity on the prevalence and prognosis of non-metastatic colorectal cancer: A systematic review and meta-analysis

Background & aims

The prevalence of sarcopenic obesity (SO) and its impact on prognosis in patients with non-metastatic colorectal cancer (nmCRC) remain controversial. This meta-analysis evaluated SO prevalence and its associations with survival and postoperative outcomes in nmCRC patients.

Methods

PubMed, EMBASE, CINAHL, OVID, Web of Science, and the Cochrane Library were searched up to January 2025. Observational studies reporting SO prevalence or its prognostic impact in nmCRC were included. Data were pooled using random/fixed-effects models in R.4.5.1.

Results

A total of 18 studies involving 11283 nmCRC patients were included. The pooled SO prevalence in patients with nmCRC was 13% (95%CI: 7%–22%). SO significantly decreased overall survival (HR = 1.52; 95%CI: 1.26–1.82; P = 0.000), disease-free survival (HR = 1.72; 95%CI: 1.27–2.32;P = 0.000). It increased risks of total complications (OR = 2.23; 95%CI: 1.05–4.73; P = 0.037), anastomotic leakage (OR = 2.56; 95%CI: 1.30–5.05; P = 0.007), and mortality (OR = 1.87; 95%CI: 1.34–2.62; P = 0.000). No statistically significant association was observed for cancer-specific survival (HR = 1.50; 95%CI: 0.86–2.63; P = 0.154), recurrence-free survival (HR = 1.60; 95%CI: 0.64–4.04; P = 0.318), or length of stay (OR = 3.74; 95%CI: 0.74–18.98; P = 0.111).

Conclusion

SO is linked to poorer survival and higher postoperative complications. Routine body composition assessments may aid early SO identification and intervention. Standardized diagnostic criteria and prospective studies are needed to refine prognostic evaluations.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.