Differences in Circulating Inflammatory Markers in Older Adults With and Without Sarcopenia: A Systematic Review and Meta-Analysis

Journal of the American Medical Directors Association, vol. 27, pp. 106312

Abstract

Objectives In this systematic review and meta-analysis, mean differences among high-sensitivity C-reactive protein (CRP), CRP, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), the most common markers used in clinical practice, between older adults with and without sarcopenia based on established consensus were explored. Design A random-effects model meta-analysis was used to estimate the pooled effects of the included studies (CRD42024503466). Heterogeneity was assessed via meta-regressions, whereas publication bias was evaluated through Egger's test and funnel plots. Setting and Participants Forty-four studies with cross-sectional baseline data were included in this study. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, a systematic literature search of studies was conducted using PubMed, Cochrane Library, Web of Science, and Scopus. Results Sarcopenia exhibited a significant higher inflammatory profile compared with those without sarcopenia (CRP: standardized mean difference [SMD], 0.27; 95% CI, 0.14-0.40; I 2 = 82%; P < .01), (high-sensitivity CRP: SMD, 0.40; 95% CI, 0.20-0.60; I 2 = 79%; P < .01), (IL-6: SMD, 0.34; 95% CI, 0.12-0.56; I 2 = 72%; P < .01), (tumor necrosis factor-alpha: SMD, 0.78; 95% CI, 0.25-1.32; I 2 = 92%; P < .01). Overall, the quality of the studies was considered low. Publication bias was found in relation to IL-6, for which, following trim of 6 studies, an insignificant effect between groups was observed (SMD, 0.12; 95% CI, −0.38 to 0.61). Conclusions and Implications This meta-analysis showed a higher level of inflammation in sarcopenia vs nonsarcopenia. Longitudinal studies controlling for reported comorbidities and infections are needed to establish causality.

Authors 6

1. Konstantinos Prokopidis corresponding

   University of Liverpool

   Affiliation as printed

   Department of Musculoskeletal Ageing and Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom. Electronic address: k.prokopidis@liverpool.ac.uk

2. Collin Jc Exmann

   Amsterdam UMC Location Vrije Universiteit Amsterdam · Amsterdam Public Health

   Affiliation as printed

   Department of General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Aging and Later Life Program, Amsterdam, The Netherlands

3. Jordi Morwani‐Mangnani Aachen

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Centre, Leiden, The Netherlands

4. Mary Ní Lochlainn

   King's College London

   Affiliation as printed

   Centre for Ageing Resilience in a Changing Environment (CARICE), King's College London, London, United Kingdom

5. Emiel O. Hoogendijk

   Amsterdam UMC Location Vrije Universiteit Amsterdam · Amsterdam Public Health

   Affiliation as printed

   Department of General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Aging and Later Life Program, Amsterdam, The Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

6. Nicola Veronese

   University of Palermo

   Affiliation as printed

   Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy