目的:衰弱和低蛋白血症在老年人中很常见。尽管有证据表明虚弱和低蛋白血症之间存在相关性,住院/危重患者和老年社区居民的虚弱和低蛋白血症之间的关系尚未明确.因此,我们的荟萃分析的目的是评估不同类型患者的虚弱与低蛋白血症之间的关联.
方法:对PubMed上发表的文章进行系统检索,Embase,Medline,WebofScience,科克伦,万方,从建立到2024年4月的CNKI数据库被用来搜索关于老年人体弱多病严重程度和低蛋白血症之间关联的研究.纽卡斯尔-渥太华量表和医疗保健研究与质量量表用于评估研究质量。
结果:纳入了22项研究,包括90,351名虚弱的老年人。荟萃分析显示,虚弱或早弱与低蛋白血症之间存在关联(OR=2.37,95%CI:1.47,3.83;OR=1.62,95%CI:1.23,2.15),重度衰弱患者与轻度或中度衰弱患者的低蛋白血症风险无显著差异(OR=0.62,95%CI:0.44,0.87).衰弱对低蛋白血症发生的影响在住院患者/危重患者中比在手术患者中更明显(OR=3.75,95%CI:2.36,5.96),其次是老年社区居民(OR=2.30,95%CI:1.18,4.49)。
结论:脆弱与手术患者的低蛋白血症有关,住院老年患者和老年社区居民。未来的研究应集中在白蛋白补充在预防或减轻虚弱和相关结局方面的益处。
OBJECTIVE: Frailty and hypoproteinaemia are common in older individuals. Although there is evidence of a correlation between frailty and hypoproteinaemia, the relationship between frailty and hypoproteinaemia in hospitalized/critically ill and older community residents has not been clarified. Therefore, the aim of our meta-analysis was to evaluate the associations between frailty and hypoproteinaemia in different types of patients.
METHODS: A systematic retrieval of articles published in the PubMed, Embase, Medline, Web of Science, Cochrane, Wanfang, and CNKI databases from their establishment to April 2024 was performed to search for studies on the associations between severity of frailty or prefrailty and hypoproteinaemia in older adults. The Newcastle‒Ottawa Scale and the Agency for Healthcare Research and Quality Scale were used to assess study quality.
RESULTS: Twenty-two studies were included including 90,351 frail older people were included. Meta-analysis revealed an association between frailty or prefrailty and hypoproteinaemia (OR = 2.37, 95% CI: 1.47, 3.83; OR = 1.62, 95% CI: 1.23, 2.15), there was no significant difference in the risk of hypoproteinaemia between patients with severe frailty and those with low or moderate frailty (OR = 0.62, 95% CI:0.44, 0.87). The effect of frailty on the occurrence of hypoproteinaemia was more obvious in hospitalized patients/critically ill patients than in surgical patients (OR = 3.75, 95% CI: 2.36, 5.96), followed by older community residents (OR = 2.30, 95% CI: 1.18, 4.49).
CONCLUSIONS: Frailty is associated with hypoproteinaemia in surgical patients, hospitalized older patients and older community residents. Future studies should focus on the benefits of albumin supplementation in preventing or alleviating frailty and related outcomes in the future.