Evidence map›Paper›PMID 41963913›Full record

SynthesisBMC pulmonary medicine2026

Low muscle mass in interstitial lung disease: a systematic review and meta-analysis of prevalence and clinical associations.

Osamah Alsuhimi, Abdullah Alharbi, Wahaj Alnefaie, Husam Alahmadi, Fatma Almaghlouth, Abdullah A Alqarni, Daniel Davies, Thomas M Gill, Jean Woo, Carly Welch and 4 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC pulmonary medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Osamah AlsuhimiUCL Respiratory, University College London, London, UK.
Abdullah AlharbiUCL Respiratory, University College London, London, UK.
Wahaj AlnefaieUCL Respiratory, University College London, London, UK.
Husam AlahmadiDepartment of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
Fatma AlmaghlouthDepartment of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
Abdullah A AlqarniDepartment of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
Daniel DaviesUCL Respiratory, University College London, London, UK.
Thomas M GillYale School of Medicine, New Haven, Connecticut, United States.
Jean WooDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong CUHK University, Hong Kong, China.
Carly WelchExperimental Medicine, King's College London, London, UK.
Richard BeatsonUCL Respiratory, University College London, London, UK.
Martin KolbDepartment of Medicine, McMaster University, Hamilton, Canada.
John R HurstUCL Respiratory, University College London, London, UK.
Joanna C PorterUCL Respiratory, University College London, London, UK. joanna.porter@ucl.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLow muscle mass, a component of sarcopenia, is increasingly recognised as a marker of poor physiological reserve in chronic diseases. While observed in patients with interstitial lung disease (ILD), its prevalence and clinical associations remain inadequately characterised. Furthermore, heterogeneous diagnostic approaches from CT-derived indices to consensus definitions complicate evidence interpretation.

methodsWe conducted a systematic review and meta-analysis to estimate the prevalence of low muscle mass and/or consensus-defined sarcopenia in ILD. Six databases were searched (1988–March 2024). Eight studies comprising 829 patients (701 with idiopathic pulmonary fibrosis [IPF]) met inclusion criteria. The included CT-based studies defined low muscle mass using cohort-specific lowest-quartile cut-offs, which do not meet consensus diagnostic criteria for sarcopenia.

resultsThe pooled prevalence of low muscle mass and/or sarcopenia was 24.3% (95% CI: 19.7–29.0) with substantial heterogeneity (I²=59.2%). A sensitivity analysis restricted to consensus-defined sarcopenia yielded a 27.5% prevalence with moderate heterogeneity (I²=62.5%); however, studies within their respective consensus frameworks (EWGSOP2 or AWGS) demonstrated zero internal heterogeneity (I²=0%). In contrast, CT-based studies using cohort-specific thresholds showed marked variability (I²=75.8%). Meta-regression confirmed diagnostic method (p = 0.044) and mean BMI (p = 0.003) as significant moderators. Low muscle mass was significantly associated with reduced pulmonary function, including lower FVC% predicted (effect size − 0.477, p < 0.001) and DLCO% predicted (effect size − 0.389, p = 0.003), as well as advancing age and lower BMI.

conclusionsWhile low muscle mass or consensus-defined sarcopenia affects approximately one in four ILD patients, this prevalence is largely representative of the IPF phenotype. Muscle mass abnormalities are significantly associated with respiratory decline, supporting muscle depletion as a clinically relevant marker with potential prognostic implication. However, substantial heterogeneity, driven by CT-based cohort-specific quartiles rather than externally validated thresholds, restricts the precision of current prevalence estimates. Future research should employ standardised consensus definitions, differentiate isolated muscle depletion from systemic wasting syndromes, use externally validated cut-offs, adopt multicentre prospective designs.

Indexed as

Lung Diseases, InterstitialSarcopeniaHumansPrevalenceTomography, X-Ray ComputedAgeingInterstitial lung diseaseMortalityPulmonary fibrosisSarcopenia

Identifiers

PMID41963913
PMCPMC13188284

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.