Risk Factors of Stroke-related Sarcopenia: a Systematic Review and Meta-analysis

Overview

Journal Front Aging

Specialty Geriatrics

Date 2025 Feb 19

PMID 39967995

Authors

Huan Yan

Juan Li

Lihong Xian

Yujie Li

Simin Li

Qinghua Wen

Affiliations

Soon will be listed here.

Abstract

Background: The presence of sarcopenia at the time of stroke may deteriorate the rehabilitation and functional outcomes. There is no consensus on the factors associated with stroke-related sarcopenia because previous studies produced inconsistent and disputed results. Therefore, we screened the possible risk factors by meta-analysis.

Methods: Studies published before March 2024 on risk factors with stroke-related sarcopenia were searched through PubMed, Embase, Web of Science, CINAHL, Cochrane Library, CNKI, Wan Fang, CBM, and VIP library databases. Two researchers independently screened the articles to extract the information and to evaluate their quality. Meta-analysis was then performed using Revman 5.4 software to determine the significant risk factors for patients with stroke-related sarcopenia.

Results: A total of 14 studies (n = 3,113) were selected to determine the following factors that were statistically significant in patients with stroke-related sarcopenia: Age (OR = 1.04; 95% CI: 1.02, 1.06; < 0.0001), tube feeding (OR = 3.98; 95% CI: 2.12, 7.47; < 0.0001), pre-stroke sarcopenia (OR = 1.84; 95% CI: 1.39, 2.43; < 0.0001), atrial fibrillation (OR = 1.53; 95% CI: 1.15, 2.02; = 0.003), NIHSS score (OR = 1.48; 95% CI: 1.21, 1.81; = 0.0001), and osteoporosis (OR = 1.801; 95% CI: 58, 2.04; < 0.00001). BMI ( = 0.71), FOIS ( = 0.80), time since stroke ( = 0.34), and calf circumference reduction ( = 0.48) were not identified as risk or protective factors after stroke ( < 0.05).

Conclusion: Our results identified various risk factors for stroke-related sarcopenia which should be considered and studied by healthcare organizations and professionals to improve the health of stroke patients.

Systematic Review Registration: PROSPERO, Identifier CRD42024545757.

References

Mas M, Gonzalez J, Frontera W . Stroke and sarcopenia. Curr Phys Med Rehabil Rep. 2021; 8(4):452-460. PMC: 7990034. DOI: 10.1007/s40141-020-00284-2. View

Tanaka S, Yamauchi K, Hayashi Y, Kumagae K, Goto K, Harayama E . Factors influencing the reduction in quadriceps muscle thickness in the paretic limbs of patients with acute stroke. Clin Nutr ESPEN. 2024; 60:173-178. DOI: 10.1016/j.clnesp.2024.01.019. View

Nozoe M, Kanai M, Kubo H, Yamamoto M, Shimada S, Mase K . Prestroke Sarcopenia and Stroke Severity in Elderly Patients with Acute Stroke. J Stroke Cerebrovasc Dis. 2019; 28(8):2228-2231. DOI: 10.1016/j.jstrokecerebrovasdis.2019.05.001. View

Aydin T, Kesiktas F, Oren M, Erdogan T, Ahisha Y, Kizilkurt T . Sarcopenia in patients following stroke: an overlooked problem. Int J Rehabil Res. 2021; 44(3):269-275. DOI: 10.1097/MRR.0000000000000487. View

Imamura M, Nozoe M, Kubo H, Shimada S . Association between premorbid sarcopenia and neurological deterioration in patients with acute ischemic stroke. Clin Neurol Neurosurg. 2022; 224:107527. DOI: 10.1016/j.clineuro.2022.107527. View

Kim Y, Choi Y . Prevalence and risk factors of possible sarcopenia in patients with subacute stroke. PLoS One. 2023; 18(9):e0291452. PMC: 10508606. DOI: 10.1371/journal.pone.0291452. View

Sato R, Akiyama E, Konishi M, Matsuzawa Y, Suzuki H, Kawashima C . Decreased Appendicular Skeletal Muscle Mass is Associated with Poor Outcomes after ST-Segment Elevation Myocardial Infarction. J Atheroscler Thromb. 2020; 27(12):1278-1287. PMC: 7840163. DOI: 10.5551/jat.52282. View

Arnold M, Liesirova K, Broeg-Morvay A, Meisterernst J, Schlager M, Mono M . Dysphagia in Acute Stroke: Incidence, Burden and Impact on Clinical Outcome. PLoS One. 2016; 11(2):e0148424. PMC: 4749248. DOI: 10.1371/journal.pone.0148424. View

Li S, Gonzalez-Buonomo J, Ghuman J, Huang X, Malik A, Yozbatiran N . Aging after stroke: how to define post-stroke sarcopenia and what are its risk factors?. Eur J Phys Rehabil Med. 2022; 58(5):683-692. PMC: 10022455. DOI: 10.23736/S1973-9087.22.07514-1. View

10.

Hughes V, Frontera W, Wood M, Evans W, Dallal G, Roubenoff R . Longitudinal muscle strength changes in older adults: influence of muscle mass, physical activity, and health. J Gerontol A Biol Sci Med Sci. 2001; 56(5):B209-17. DOI: 10.1093/gerona/56.5.b209. View

11.

Clark B, Manini T . Functional consequences of sarcopenia and dynapenia in the elderly. Curr Opin Clin Nutr Metab Care. 2010; 13(3):271-6. PMC: 2895460. DOI: 10.1097/MCO.0b013e328337819e. View

12.

Proietti M, Romiti G, Raparelli V, Diemberger I, Boriani G, Dalla Vecchia L . Frailty prevalence and impact on outcomes in patients with atrial fibrillation: A systematic review and meta-analysis of 1,187,000 patients. Ageing Res Rev. 2022; 79:101652. DOI: 10.1016/j.arr.2022.101652. View

13.

Fang P, Zhou J, Xiao X, Yang Y, Luan S, Liang Z . The prognostic value of sarcopenia in oesophageal cancer: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2022; 14(1):3-16. PMC: 9891912. DOI: 10.1002/jcsm.13126. View

14.

Li X, Shin H, Zhou P, Niu X, Liu J, Rymer W . Power spectral analysis of surface electromyography (EMG) at matched contraction levels of the first dorsal interosseous muscle in stroke survivors. Clin Neurophysiol. 2013; 125(5):988-94. DOI: 10.1016/j.clinph.2013.09.044. View

15.

Lisco G, Disoteo O, De Tullio A, De Geronimo V, Giagulli V, Monzani F . Sarcopenia and Diabetes: A Detrimental Liaison of Advancing Age. Nutrients. 2024; 16(1). PMC: 10780932. DOI: 10.3390/nu16010063. View

16.

Laurent M, Dubois V, Claessens F, Verschueren S, Vanderschueren D, Gielen E . Muscle-bone interactions: From experimental models to the clinic? A critical update. Mol Cell Endocrinol. 2015; 432:14-36. DOI: 10.1016/j.mce.2015.10.017. View

17.

Kawao N, Kaji H . Interactions between muscle tissues and bone metabolism. J Cell Biochem. 2014; 116(5):687-95. DOI: 10.1002/jcb.25040. View

18.

Ochi M, Kohara K, Tabara Y, Kido T, Uetani E, Ochi N . Arterial stiffness is associated with low thigh muscle mass in middle-aged to elderly men. Atherosclerosis. 2010; 212(1):327-32. DOI: 10.1016/j.atherosclerosis.2010.05.026. View

19.

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. PMC: 8005924. DOI: 10.1136/bmj.n71. View

20.

Garcia-Hermoso A, Cavero-Redondo I, Ramirez-Velez R, Ruiz J, Ortega F, Lee D . Muscular Strength as a Predictor of All-Cause Mortality in an Apparently Healthy Population: A Systematic Review and Meta-Analysis of Data From Approximately 2 Million Men and Women. Arch Phys Med Rehabil. 2018; 99(10):2100-2113.e5. DOI: 10.1016/j.apmr.2018.01.008. View