肌少症与肌少性肥胖生物标志物的系统综述和荟萃分析。
完整摘要 · 中文译文
目的：肌少症和肌少性肥胖（SO）是以骨骼肌质量减少和肌肉力量受损为特征的老年综合征，其特异性生物标志物及潜在机制尚不明确。本研究旨在通过收集过去15年的相关文献，对生物标志物与肌少症/肌少性肥胖之间的关联进行荟萃分析和文献综述。我们旨在进一步识别这些疾病的共有和差异性生物标志物，从而揭示其不同的病理生理过程，并为精准诊断和靶向干预提供依据。 方法：在PubMed和Embase数据库中对2010年12月至2025年12月的所有文献进行了全面检索。我们纳入了描述血清生物标志物与肌少症/肌少性肥胖之间关联的英文文章，包括横断面研究、前瞻性队列研究和回顾性病例研究，不限制种族、人群或样本量。文献筛选按照预先设定的纳入和排除标准进行。提取相关研究数据，并评估纳入研究的质量。采用均数差和95%置信区间计算合并效应量。 结果：最终共纳入43篇探讨生物标志物与肌少症/肌少性肥胖关联的英文文章。与非肌少症患者相比，肌少症患者的血清C反应蛋白（CRP）、白细胞介素、肿瘤坏死因子、胱抑素C、血 尿素氮和高密度脂蛋白胆固醇（HDL-C）。相反，血清维生素D、丙氨酸转氨酶、白蛋白、血红蛋白、甘油三酯、尿酸、血糖和空腹胰岛素水平较高与肌少症发生率较低相关。在肌少症患者与非肌少症患者之间，白细胞计数、血小板计数、天冬氨酸转氨酶、碱性磷酸酶、胆红素、总胆固醇（TC）、肌酐、红细胞沉降率、低密度脂蛋白胆固醇（LDL-C）或促甲状腺激素水平未观察到显著差异。与健康个体相比，肥胖合并肌少症（SO）患者血清CRP、LDL-C、TC、TG、白细胞、肌酐、尿酸、空腹血糖和空腹胰岛素水平较高，而HDL-C和维生素D水平较高与SO风险较低相关。SO患者的TG水平低于单纯肥胖患者，两组间CRP、HDL-C、LDL-C、TC、维生素D、血糖或白细胞介素-6水平无显著差异。
完整摘要 · 英文原文
OBJECTIVE: Sarcopenia and sarcopenic obesity (SO) are geriatric syndromes characterized by reduced skeletal muscle mass and impaired muscle strength, whose specific biomarkers and underlying mechanisms remain unclear. This study aimed to conduct a meta-analysis and literature review on the associations between biomarkers and sarcopenia/SO by collecting relevant publications over the past 15 years. We intended to further identify the shared and differential biomarkers of these disorders, thereby revealing their distinct pathophysiological processes and providing a basis for precise diagnosis and targeted intervention. METHODS: A comprehensive literature search was performed in PubMed, Embase databases for all publications from December 2010 to December 2025. We included English articles describing the associations between serum biomarkers and sarcopenia/SO, including cross-sectional studies, prospective cohort studies, and retrospective case studies, with no restrictions on race, population, or sample size. Literature screening was conducted in accordance with predefined inclusion and exclusion criteria. Relevant study data were extracted, and the quality of included studies was assessed. The mean difference and 95% confidence interval were used to calculate the pooled effect size. RESULTS: A total of 43 English articles investigating the associations between biomarkers and sarcopenia/SO were finally included. Compared with non-sarcopenic patients, sarcopenic patients had elevated serum levels of C-reactive protein (CRP), interleukins, tumor necrosis factor, cystatin C, blood urea nitrogen, and high-density lipoprotein cholesterol (HDL-C). In contrast, higher serum levels of vitamin D, alanine transaminase, albumin, hemoglobin, TG, uric acid, blood glucose, and fasting insulin were associated with a lower incidence of sarcopenia. No significant differences were observed in WBC count, platelet count, aspartate transaminase, alkaline phosphatase, bilirubin, total cholesterol (TC), creatinine, erythrocyte sedimentation rate, low-density lipoprotein cholesterol (LDL-C), or thyroid-stimulating hormone levels between sarcopenic and non-sarcopenic patients. Compared with healthy individuals, SO patients had higher serum levels of CRP, LDL-C, TC, TG, WBC, creatinine, uric acid, fasting blood glucose, and fasting insulin, while higher levels of HDL-C and vitamin D were associated with a lower risk of SO. SO patients had lower TG levels than patients with simple obesity, with no significant differences in CRP, HDL-C, LDL-C, TC, vitamin D, blood glucose, or interleukin-6 levels between the 2 groups.