Abstract
Background/objectivesIn the recently introduced GLIM diagnosis of malnutrition (Global Leadership Initiative on Malnutrition), details of how to classify inflammation as an etiologic criterion are lacking. This study aimed to determine at what level of serum C-reactive protein (CRP) the risk of low food intake increases in acutely ill older hospitalized patients.Subjects/methodsA total of 377 patients, who were consecutively admitted to a geriatric acute care ward, were analyzed. Nutritional intake was determined using the food intake item of Nutritional Risk Screening and the plate diagram method and patients were grouped into three categories as >75%, 50–75% and ≤50% of requirements. CRP was analyzed according to standard procedures and patients were classified into different CRP groups as follows: 0.0–0.99 mg/dl, 1.0–1.99 mg/dl, 2.0–2.99 mg/dl, 3.0–4.99 mg/dl, 5.0–9.99 mg/dl and ≥10.0 mg/dl.ResultsOf the total population (mean age of 82.2 ± 6.6 years; 241 females), 82 (22%) had intake <50% of requirements and 126 (33%) demonstrated moderate to severe inflammation. Patients with food intake <50% of requirements had a significantly higher median CRP level compared to patients with food intake >75% of requirements (P < 0.001). The group with serum-CRP levels above 3.0 mg/dl had a markedly higher proportion of patients with low food intake; i.e., <50% and <75% of the requirements.ConclusionA serum-CRP of 3.0 mg/dl appears to be a reasonable threshold of acute inflammation leading to reduced food intake to serve as an orientation with regard to the inflammation criterion of the GLIM diagnosis in acutely ill older patients.
Highlights
Malnutrition with weight and muscle loss is a frequent syndrome in older patients
Patients with food intake 75% of requirements (0.7 mg/dl, P < 0.001, Fig. 1a)
There were no significant differences in median CRP levels across categories of Mini Nutritional Assessment Short Form (MNA-SF) (median CRP levels in malnourished patients: 1.4 (IQR: 0.4–4.3) mg/dl, at risk of malnutrition: 1.4 (IQR: 0.5–4.6) mg/dl and normal nutritional status: 1.1 (IQR: 0.4–4.1) mg/dl)
Summary
Malnutrition with weight and muscle loss is a frequent syndrome in older patients. Malnutrition is caused by an imbalance of energy intake and energy requirements, which in older persons, mostly emerges due to impaired food consumption [2, 3]. Previous studies have demonstrated that disease-related inflammation, besides other causes, frequently diminishes appetite and food intake [4,5,6,7], and is an important risk factor of malnutrition. At least one phenotypic criterion including unintentional weight loss, low body mass index and/or reduced muscle mass, combined with at least one etiologic criterion including reduced food intake, malabsorption or inflammation are required for the diagnosis of malnutrition based on the GLIM criteria [8]. Because the etiologic criterion of low food intake is complemented and could be replaced by the criterion of inflammation (if positive) in accordance with the GLIM construct, it is of particular interest to clarify which level of inflammation may markedly increase the risk of low food intake in older patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
