Sarcopenia and mortality in different clinical conditions: A meta-analysis

Grace Koon-Yee Lee, Philip Chun-Ming Au, Gloria Hoi-Yee Li, Marcus Chan, Hang-Long Li, Bernard Man-Yung Cheung, Ian Chi-Kei Wong, Victor Ho-Fun Lee, James Mok, Benjamin Hon-Kei Yip, Kenneth King-Yip Cheng, Chih-Hsing Wu, Ching-Lung Cheung

Research output: Journal article publicationJournal articleAcademic researchpeer-review


Sarcopenia is recognized to be a health problem which is as serious as obesity, but its relevance to mortality is unclear. We conducted a meta-analysis of cohort studies on lean mass and mortality in populations with different health conditions. In this study, a systematic search of PubMed, Cochrane Library and Embase was performed for cohort studies published before Dec 20, 2017 which examined the relationship between lean mass and mortality. We included studies reporting lean mass measurement by dual-energy X-ray absorptiometry, bioimpedance analysis or computed tomography, as continuous (per standard deviation [SD] decrease) or binary variables (using sarcopenia cutoffs). We excluded studies which used muscle mass surrogates, anthropometric measurement of muscle, rate of change in muscle mass, and sarcopenia defined by composite criteria. The primary study outcome was all-cause mortality. Pooled hazard ratio estimates were calculated using a random effects model. A total of 9602 articles were identified from the systematic search, and 188 studies with 98 468 participants from 34 countries were included in the meta-analysis. Of the 68 studies included in the present meta-analysis, the pooled HR was 1.36 and 1.74 for every SD decrease in lean mass and in people with low lean mass (cutoffs), respectively. Significant associations were also observed in elderly and all disease subgroups, irrespective of the measurement modalities. Lower lean mass is robustly associated with increased mortality, regardless of health conditions and lean mass measurement modalities. This meta-analysis highlighted low lean mass as a key public health issue.
Original languageEnglish
Pages (from-to)S19-S27
JournalOsteoporosis and Sarcopenia
Issue numberSuppl 1
Early online date11 Mar 2021
Publication statusPublished - Mar 2021


  • Chronic diseases
  • Sarcopenia
  • Systematic review
  • Mortality
  • Meta-analysis
  • Original


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