Biomarcadores Precoces de Sarcopenia: Revisão Sistemática da Literatura

Liliana Portela, Mónica Sousa, Marta Silvestre

Resumo


Introdução: Apesar de a sarcopenia ser considerada uma doença do idoso sabe-se que a perda muscular começa no adulto jovem. A sarcopenia, é responsável por uma menor qualidade de vida e perda de independência, pelo que o desenvolvimento e validação de biomarcadores de sarcopenia poderá ser uma estratégia custo efetiva no diagnóstico e monotorização deste problema nos cuidados de saúde primários. Pretende-se rever os principais biomarcadores estudados em indivíduos jovens que nos permitam implementar medidas preventivas em fases iniciais de doença.

Métodos: Revisão sistemática da literatura com os termos MeSH “sarcopenia” e “biomarkers”, entre 2011 e 2021 em bases de dados científicas. Foram incluídos estudos em adultos com menos de 65 anos, nas línguas portuguesa, inglesa e espanhola. Toda a revisão seguiu a metodologia PRISMA. Foi utilizada a Strenght of Recommendation Taxonomy (SORT) da American Academy of Family Physicians para estratificar o nível de evidência e a ferramenta AMSTAR2 (A MeaSurement Tool to Assess systematic Reviews) para avaliação da qualidade da revisão sistemática.

Resultados: Foram incluídos oito estudos (seis observacionais transversais e dois caso controlo). Os biomarcadores fator de diferenciação de crescimento 5, a isoleucina, a leucina, o triptofano, a insulina em jejum, o índice HOMA, os triglicerídeos e o C1q associaram-se a piores resultados de avaliação muscular enquanto que a irisina sérica, o rácio putrescina/ornitina, o rácio quinurenina/triptofano, a lipoprotéina de alta densidade, o fator de crescimento semelhante à insulina e a isoforma solúvel do recetor dos produtos finais de glicação avançada mostraram uma relação positiva com os parâmetros musculares avaliados.

Conclusão: Não parece existir evidência robusta para definir um único biomarcador precoce isolado de sarcopenia, no entanto, alterações em biomarcadores serológicos juntamente com a avaliação física podem ser úteis na prática clínica. Com base na ferramenta SORT foi atribuída uma força de recomendação B e com base na ferramenta AMSTAR2 foi considerada uma revisão de moderada qualidade.


Palavras-chave


Biomarcadores; Sarcopenia/diagnóstico

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DOI: http://dx.doi.org/10.25759/spmfr.461

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