Sex difference, proteostasis and mitochondrial function impact stroke-related sarcopenia—A systematic review and meta-analysis

Abstract

BackgroundThe prevalence of stroke-related sarcopenia has been noted; however, epidemiological data and interventions that increase or reduce the incidence of stroke-related sarcopenia remain lacking. MethodsStudies on stroke-related sarcopenia were included in association or interventional analyses. All analyses were performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two evaluators independently extracted the data. ResultsFemale stroke patients had a higher preference for sarcopenia than male patients (pooled odds ratio [OR] = 0.670, 95 % CI 0.533–0.842, p = 0.001). Although stroke patients without drug use have improved skeletal muscle mass index (SMI) (MD = 0.272, 95 % CI 0.087–0.457, p = 0.004), handgrip strength (HGS) was not significantly altered (MD = −0.068, 95 % CI −0.221–0.076, p = 0.354). Stroke patients with nutrient interventions have improved SMI (MD = −0.354, 95 % CI −0.635- −0.073, p = 0.014) and HGS (MD = −0.394, 95 % CI −0.678- −0.111, p = 0.006); the synergistic effect of rehabilitation exercise has not been ruled out. Whether a sex difference exists in these interventions remains to be investigated. The underlying pathological mechanisms and potential therapeutic strategies for this disease are discussed. ConclusionSex difference, proteostasis, and mitochondrial function may impact the incidence of stroke-related sarcopenia. Understanding the underlying pathological mechanisms and potential therapeutic targets for this disease will provide new insights into disease treatment, prevention, and drug development.