Systematic review and meta-analysis of lean mass and mortality: Rationale and study description

doi:10.1016/j.afos.2021.01.001

. 2021 Mar;7(Suppl 1):S3-S12.

doi: 10.1016/j.afos.2021.01.001. Epub 2021 Feb 11.

Systematic review and meta-analysis of lean mass and mortality: Rationale and study description

Affiliations

¹ Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
² Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
³ Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
⁴ Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
⁵ JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
⁶ Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
⁷ Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁸ Institute of Geriatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

PMID: 33997303
PMCID: PMC8088993
DOI: 10.1016/j.afos.2021.01.001

Systematic review and meta-analysis of lean mass and mortality: Rationale and study description

Ching-Lung Cheung et al. Osteoporos Sarcopenia. 2021 Mar.

. 2021 Mar;7(Suppl 1):S3-S12.

doi: 10.1016/j.afos.2021.01.001. Epub 2021 Feb 11.

Affiliations

¹ Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
² Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
³ Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
⁴ Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
⁵ JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
⁶ Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
⁷ Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁸ Institute of Geriatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

PMID: 33997303
PMCID: PMC8088993
DOI: 10.1016/j.afos.2021.01.001

Abstract

Objectives: Muscle mass is one of the key components in defining sarcopenia and is known to be important for locomotion and body homeostasis. Lean mass is commonly used as a surrogate of muscle mass and has been shown to be associated with increased mortality. However, the relationship of lean mass with mortality may be affected by different clinical conditions, modalities used, cut-off point to define low or normal lean mass, and even types of cancer among cancer patients. Thus, we aim to perform a comprehensive meta-analysis of lean mass with mortality by considering all these factors.

Methods: Systematic search was done in PubMed, Cochrane Library and Embase for articles related to lean mass and mortality. Lean mass measured by dual X-ray absorptiometry, bioelectrical impedance analysis, and computerized tomography were included.

Results: The number of relevant studies has increased continuously since 2002. A total of 188 studies with 98 468 people were included in the meta-analysis. The association of lean mass with mortality was most studied in cancer patients, followed by people with renal diseases, liver diseases, elderly, people with cardiovascular disease, lung diseases, and other diseases. The meta-analysis can be further conducted in subgroups based on measurement modalities, site of measurements, definition of low lean mass adopted, and types of cancer for studies conducted in cancer patients.

Conclusions: This series of meta-analysis provided insight and evidence on the relationship between lean mass and mortality in all directions, which may be useful for further study and guideline development.

Keywords: Lean mass; Meta-analysis; Mortality; Sarcopenia; Systematic review.

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Conflict of interest statement

The authors declare no competing interests.

Figures

**Fig. 2**
Number of studies by publication year included in the meta-analysis.

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References

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1. Cheung C.L., Lam K.S., Cheung B.M. Evaluation of cutpoints for low lean mass and slow gait speed in predicting death in the National Health and Nutrition Examination Survey 1999-2004. J Gerontol A Biol Sci Med Sci. 2016;71:90–95. - PubMed
1. Lee D.H., Keum N., Hu F.B., Orav E.J., Rimm E.B., Willett W.C. Predicted lean body mass, fat mass, and all cause and cause specific mortality in men: prospective US cohort study. BMJ. 2018:362. - PMC - PubMed
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[1] Schnyder S., Handschin C. Skeletal muscle as an endocrine organ: PGC-1α, myokines and exercise. Bone. 2015;80:115–125. - PMC - PubMed

[2] Schnyder S., Handschin C. Skeletal muscle as an endocrine organ: PGC-1α, myokines and exercise. Bone. 2015;80:115–125. - PMC - PubMed

[3] Cheung C.L., Lam K.S., Cheung B.M. Evaluation of cutpoints for low lean mass and slow gait speed in predicting death in the National Health and Nutrition Examination Survey 1999-2004. J Gerontol A Biol Sci Med Sci. 2016;71:90–95. - PubMed

[4] Cheung C.L., Lam K.S., Cheung B.M. Evaluation of cutpoints for low lean mass and slow gait speed in predicting death in the National Health and Nutrition Examination Survey 1999-2004. J Gerontol A Biol Sci Med Sci. 2016;71:90–95. - PubMed

[5] Lee D.H., Keum N., Hu F.B., Orav E.J., Rimm E.B., Willett W.C. Predicted lean body mass, fat mass, and all cause and cause specific mortality in men: prospective US cohort study. BMJ. 2018:362. - PMC - PubMed

[6] Lee D.H., Keum N., Hu F.B., Orav E.J., Rimm E.B., Willett W.C. Predicted lean body mass, fat mass, and all cause and cause specific mortality in men: prospective US cohort study. BMJ. 2018:362. - PMC - PubMed

[7] Chen L.K., Liu L.K., Woo J., Assantachai P., Auyeung T.W., Bahyah K.S. Sarcopenia in Asia: consensus report of the Asian working group for sarcopenia. J Am Med Dir Assoc. 2014;15:95–101. - PubMed

[8] Chen L.K., Liu L.K., Woo J., Assantachai P., Auyeung T.W., Bahyah K.S. Sarcopenia in Asia: consensus report of the Asian working group for sarcopenia. J Am Med Dir Assoc. 2014;15:95–101. - PubMed

[9] Cruz-Jentoft A.J., Baeyens J.P., Bauer J.M., Boirie Y., Cederholm T., Landi F. Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people. Age Ageing. 2010;39:412–423. - PMC - PubMed

[10] Cruz-Jentoft A.J., Baeyens J.P., Bauer J.M., Boirie Y., Cederholm T., Landi F. Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people. Age Ageing. 2010;39:412–423. - PMC - PubMed

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Systematic review and meta-analysis of lean mass and mortality: Rationale and study description

Affiliations

Systematic review and meta-analysis of lean mass and mortality: Rationale and study description

Authors

Affiliations

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