PDF(Pubmed)
Abstract：
Low skeletal muscle mass is known to be associated with poor morbidity and mortality outcomes in cancer, but evidence of its impact on health-related quality of life (HRQOL) is less established. This systematic review and meta-analysis was performed to investigate the relationship between skeletal muscle mass and HRQOL in adults with cancer. Five databases (Ovid MEDLINE, Embase via Ovid, CINAHL plus, Scopus, and PsycInfo) were systematically searched from 1 January 2007 until 2 September 2020. Studies reporting on the association between measures of skeletal muscle (mass and/or radiodensity) derived from analysis of computed tomography imaging, and a validated measure of HRQOL in adults with cancer, were considered for inclusion. Studies classifying skeletal muscle mass as a categorical variable (low or normal) were combined in a meta-analysis to investigate cross-sectional association with HRQOL. Studies reporting skeletal muscle as a continuous variable were qualitatively synthesized. A total of 14 studies involving 2776 participants were eligible for inclusion. Skeletal muscle mass classified as low or normal was used to dichotomize participants in 10 studies (n = 1375). Five different cut points were used for classification across the 10 studies, with low muscle mass attributed to 58% of participants. Low muscle mass was associated with poorer global HRQOL scores [n = 985 from seven studies, standardized mean difference -0.27, 95% confidence interval (CI) -0.40 to -0.14, P < 0.0001], and poorer physical functioning domain HRQOL scores (n = 507 from five studies, standardized mean difference -0.40, 95% CI -0.74 to -0.05, P = 0.02), but not social, role, emotional, or cognitive functioning domain scores (all P > 0.05). Five studies examined the cross-sectional relationship between HRQOL and skeletal muscle mass as a continuous variable and found little evidence of an association unless non-linear analysis was used. Two studies investigated the relationship between longitudinal changes in both skeletal muscle and HRQOL, reporting that an association exists across several HRQOL domains. Low muscle mass may be associated with lower global and physical functioning HRQOL scores in adults with cancer. The interpretation of this relationship is limited by the varied classification of low muscle mass between studies. There is a need for prospective, longitudinal studies examining the interplay between skeletal muscle mass and HRQOL over time, and data should be made accessible to enable reanalysis according to different cut points. Further research is needed to elucidate the causal pathways between these outcomes.
摘要：
众所周知，低骨骼肌质量与癌症的低发病率和低死亡率相关。但其对健康相关生活质量(HRQOL)影响的证据尚不明确.这项系统评价和荟萃分析旨在研究成人癌症患者骨骼肌质量与HRQOL之间的关系。五个数据库(OvidMEDLINE，Embase通过Ovid,CINAHLplus,Scopus,和PsycInfo）从2007年1月1日至2020年9月2日进行了系统搜索。报告来自计算机断层扫描成像分析的骨骼肌测量（质量和/或放射密度）之间的关联的研究，以及成人癌症患者HRQOL的有效测量，被考虑纳入。将骨骼肌质量分类为分类变量（低或正常）的研究在荟萃分析中进行组合，以研究与HRQOL的横截面关联。定性合成了将骨骼肌报告为连续变量的研究。共有14项研究纳入2776名参与者。在10项研究（n=1375）中，使用分类为低或正常的骨骼肌质量对参与者进行二分法。在这10项研究中，使用了5个不同的切点进行分类，与低肌肉质量归因于58％的参与者。低肌肉质量与较差的全球HRQOL评分相关[来自七项研究的n=985，标准化平均差-0.27，95%置信区间(CI)-0.40至-0.14，P<0.0001]，和较差的身体功能领域HRQOL得分(来自五项研究的n=507，标准化平均差-0.40，95%CI-0.74至-0.05，P=0.02)，但不是社交，角色,情感,或认知功能域评分(均P>0.05)。五项研究将HRQOL与骨骼肌质量之间的横截面关系作为连续变量，除非使用非线性分析，否则几乎没有发现关联的证据。两项研究调查了骨骼肌纵向变化与HRQOL之间的关系，报告多个HRQOL域之间存在关联。在患有癌症的成年人中,低肌肉质量可能与较低的整体和身体功能HRQOL评分相关。对这种关系的解释受到研究之间低肌肉质量分类的限制。有前瞻性的需要，纵向研究检查骨骼肌质量和HRQOL之间的相互作用随着时间的推移，和数据应该是可访问的，以便根据不同的切点进行重新分析。需要进一步的研究来阐明这些结果之间的因果途径。
