Prevalence of and risk factors for sarcopenia in patients with epilepsy

Background: Epilepsy is a chronic neurological disorder with a burden of comorbidities. Knowledge regarding sarcopenia prevalence and associated risk factors in patients with epilepsy remains limited, which prompted us to conduct the present study. Methods: This cross-sectional study enrolled patients with epilepsy from our epilepsy clinic and controls from the staff at National Cheng Kung University Hospital, Tainan, Taiwan. Sarcopenia was defined using the criteria outlined by the 2019 Asian Working Group for Sarcopenia and the 2010 European Working Group on Sarcopenia in Older People. Muscle mass (skeletal muscle mass index) was measured through bioelectrical impedance, muscle strength was assessed using hand grip tests, and physical performance was evaluated using the 6-m walk test. Hormone (testosterone, growth hormone, and insulin-like growth factor-1) and vitamin D levels were measured. Descriptive statistics and logistic regression models were used to estimate the prevalence of sarcopenia and identify sarcopenia risk factors in patients with epilepsy. Results: This study enrolled 300 adults (mean age: 42.9 ± 14.7 years; women: 53.7 %). The epilepsy and control groups comprised 200 and 100 participants, respectively. The overall prevalence of sarcopenia was 31.3 % and it was significantly higher (p = 0.004) in women (20.7 %) than in men (10.6 %). The prevalence was higher in the epilepsy group than in the control group (36.0 % vs. 22.0 %, p = 0.014). Logistic regression revealed female, age (≥ 65 year) and low body mass index (BMI) were influenced the risk of sarcopenia in all participants. Importantly, epilepsy is significantly associated sarcopenia. The BMI, protein level, calf circumference, and use of enzyme-inducing antiseizure medications (EIASM) influenced the risk of sarcopenia in the epilepsy group. Conclusion: The prevalence of sarcopenia is significantly higher in patients with epilepsy than in the control participants. Low BMI, protein level, calf circumference, and the use of EIASM may increase the risk of sarcopenia in this population. Our findings underscore the need for mitigating sarcopenia risk in patients with epilepsy.