Clinical characteristics and mortality risk of sarcopenia in interstitial lung disease: a systematic review and meta-analysis.
5 affiliations
- 1Department of Pulmonary and Critical Care Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
- 2Department of Nursing, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
- 3School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
- 4Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
- 5State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, China.
Abstract
Objective
Sarcopenia, prevalent in interstitial lung disease (ILD), increases the risk of poor outcomes. This study aimed to define the clinical characteristics of ILD patients with sarcopenia (ILD-S) and quantify sarcopenia's impact on mortality.Methods
We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and Scopus for English studies up to 1 September 2026 reporting clinical variables (mean ± SD) in ILD vs. ILD-S groups and adjusted hazard ratios with 95% confidence intervals (CI) for mortality risk. Subgroup analyses were stratified by sarcopenia diagnostic criteria, ILD subtype, and survival time. Heterogeneity was assessed using Cochran's Q and I² statistics. Sensitivity analyses (leave-one-out) and publication bias assessments (Egger's test, trim-and-fill method) were performed.Results
Fourteen studies comprising 1,546 participants (628 with ILD-S) were included. Compared with ILD patients without sarcopenia, those with ILD-S were significantly older (WMD = 3.03, 95% CI: 2.12-3.93), had higher Gender-Age-Physiology (GAP) scores (WMD = 0.43, 95% CI: 0.15 to 0.71), and a higher FEV₁/FVC ratio (WMD = 1.97, 95% CI: 0.21 to 3.73, P = 0.03). Conversely, the ILD-S group showed lower values for FEV₁% predicted (WMD = -6.95, 95% CI: -9.80 to -4.09), FVC% predicted (WMD = -9.46, 95% CI: -12.04 to -6.88), DLCO% predicted (WMD = -5.87, 95% CI: -11.68 to -0.06), body mass index (WMD = -1.35, 95% CI: -1.89 to -0.82), handgrip strength (WMD = -12.80, 95% CI: -17.02 to -8.58), 6-minute walk distance (WMD = -31.01, 95% CI: -60.05 to -1.97), and appendicular skeletal muscle index (WMD = -1.45, 95% CI: -2.15 to -0.76). No significant difference was observed in smoking history. Sarcopenia was strongly associated with increased mortality risk (HR = 2.02, 95% CI: 1.67 to 2.45), and this association remained stable across different follow-up periods. Sensitivity and publication bias analyses confirmed the robustness of the findings.Conclusion
Patients with ILD-S exhibit a distinctive profile characterized by older age, higher GAP scores, poorer pulmonary function, lower BMI, reduced muscle strength and mass, and significantly elevated mortality. Systematic recognition of these clinical features may facilitate early identification of ILD-S and inform the development of targeted interventions to improve patient outcomes.Systematic review registration
https://inplasy.com/, INPLASY202570030.
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BibTeX
@article{zhou2026clinical,
title = {{Clinical characteristics and mortality risk of sarcopenia in interstitial lung disease: a systematic review and meta-analysis.}},
author = {Lijuan Zhou and Xuan Wang and Weiwei Yuan and Yahui Yang and Ting Lu and Lu Guo and Xing He},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1955396},
url = {https://europepmc.org/article/MED/42898471},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clinical characteristics and mortality risk of sarcopenia in interstitial lung disease: a systematic review and meta-analysis.
AU - Lijuan Zhou
AU - Xuan Wang
AU - Weiwei Yuan
AU - Yahui Yang
AU - Ting Lu
AU - Lu Guo
AU - Xing He
PY - 2026
DA - 2026/10/05
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1955396
UR - https://europepmc.org/article/MED/42898471
AB - Objective Sarcopenia, prevalent in interstitial lung disease (ILD), increases the risk of poor outcomes. This study aimed to define the clinical characteristics of ILD patients with sarcopenia (ILD-S) and quantify sarcopenia's impact on mortality.Methods We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and Scopus for English studies up to 1 September 2026 reporting clinical variables (mean ± SD) in ILD vs. ILD-S groups and adjusted hazard ratios with 95% confidence intervals (CI) for mortality risk. Subgroup analyses were stratified by sarcopenia diagnostic criteria, ILD subtype, and survival time. Heterogeneity was assessed using Cochran's Q and I² statistics. Sensitivity analyses (leave-one-out) and publication bias assessments (Egger's test, trim-and-fill method) were performed.Results Fourteen studies comprising 1,546 participants (628 with ILD-S) were included. Compared with ILD patients without sarcopenia, those with ILD-S were significantly older (WMD = 3.03, 95% CI: 2.12-3.93), had higher Gender-Age-Physiology (GAP) scores (WMD = 0.43, 95% CI: 0.15 to 0.71), and a higher FEV₁/FVC ratio (WMD = 1.97, 95% CI: 0.21 to 3.73, P = 0.03). Conversely, the ILD-S group showed lower values for FEV₁% predicted (WMD = -6.95, 95% CI: -9.80 to -4.09), FVC% predicted (WMD = -9.46, 95% CI: -12.04 to -6.88), DLCO% predicted (WMD = -5.87, 95% CI: -11.68 to -0.06), body mass index (WMD = -1.35, 95% CI: -1.89 to -0.82), handgrip strength (WMD = -12.80, 95% CI: -17.02 to -8.58), 6-minute walk distance (WMD = -31.01, 95% CI: -60.05 to -1.97), and appendicular skeletal muscle index (WMD = -1.45, 95% CI: -2.15 to -0.76). No significant difference was observed in smoking history. Sarcopenia was strongly associated with increased mortality risk (HR = 2.02, 95% CI: 1.67 to 2.45), and this association remained stable across different follow-up periods. Sensitivity and publication bias analyses confirmed the robustness of the findings.Conclusion Patients with ILD-S exhibit a distinctive profile characterized by older age, higher GAP scores, poorer pulmonary function, lower BMI, reduced muscle strength and mass, and significantly elevated mortality. Systematic recognition of these clinical features may facilitate early identification of ILD-S and inform the development of targeted interventions to improve patient outcomes.Systematic review registration https://inplasy.com/, INPLASY202570030.
SN - 2296-858X
ER -