Abstract

RATIONALE: Sarcopenia has recently been studied in individuals with chronic obstructive pulmonary disease (COPD) due to its higher prevalence and negative impact on clinical outcomes in this disease. However, until now, there is no evidence on the criteria used to identify sarcopenia, its true prevalence and clinical impact on individuals with COPD. For this reason, we developed the first systematic review with meta-analysis to identify the current criteria used to diagnose sarcopenia, its prevalence and impact on health outcomes in individuals with COPD. METHODS: Five biomedical electronic databases including PubMed, LILACS, EMBASE, Cochrane Library and Scielo, were searched between database inception and August 31 st, 2018 to identify studies relating to sarcopenia in individuals with COPD. Studies that classified sarcopenia according to any criteria (provided it was stated in the methodology) were included. Health-related quality of life, muscle strength, exercise capacity, gait sped, physical activity levels, pulmonary function, inflammatory/oxidative stress biomarkers and mortality were assessed in studies with comparisons between individuals with and without sarcopenia. This review was registered in PROSPERO (University of York) (CRD42018092576). RESULTS: 23 studies were selected for analysis. The prevalence of sarcopenia varied from 33% to 14% when using only muscle mass versus when it is combined with physical function (p < 0.0001). Sarcopenia is associated with worse pulmonary function (FEV1%pred: MD=-7.06; 95% CI= -9, - 5.11; I 2= 83%), aerobic capacity (Std. MD -0.35; 95% CI= -0.44, -0.26; I 2= 96%) and quality of life (Std. MD= 0.26; 95% IC= 0.16, 035; I 2= 85%) in COPD. CONCLUSION: Sarcopenia is prevalent in a significant proportion of patients with COPD and imposes negative impacts upon a range of clinically important health outcomes. Future strategies may need to be considered to aid with early detection and management. Keywords: COPD, sarcopenia, aging, functionality