GLIM Criteria Research Articles

Validation of GLIM criteria for hospital malnutrition diagnosis by comparison of three different anthropometric approaches to evaluate reduced muscle mass: a prospective cohort study

Validation of GLIM criteria for hospital malnutrition diagnosis by comparison of three different anthropometric approaches to evaluate reduced muscle mass: a prospective cohort study

Phase angle: Differences between disease-related malnutrition, obesity and healthy people

IntroductionBioelectrical Impedance Analysis (BIA) is a tool used in clinical nutrition and pure electrical data such as phase angle (PA) has shown prognostic value. It relates resistance and reactance indicating cellular health. ObjectiveTo determine differences in PA between patients with obesity and disease-related malnutrition (DRM) compared to the healthy population, and to establish associations between PA and other body composition (BC) parameters. Materials and methodsRetrospective observational study with 1079 patients from the Obesity and Nutrition Department of the Complejo Asistencial Universitario de León between April/2014 and August/2022 as well as 86 healthy controls. Demographic and anthropometric variables were collected and BC was performed with BIA Tanita MC780®. Diagnosis of malnutrition according to GLIM criteria and obesity with body mass index (BMI). ResultsPA50KHz in obesity group is 5.98º, DRM 4.79º and control group 6.08º. Statistically significant differences in PA between DRM and control groups, as well as DRM and obesity (p < 0.001). Weak positive correlation in total population (r = 0.452, p < 0.001) as well as control group (r = 0.463, p < 0.001) between BMI and PA. Weak negative correlation in the total population (r = −0.408, p < 0.001), DRM (r = −0.268, p < 0.001) and obesity (r = −0.342, p < 0.001) between age and PA. ConclusionsIn this study, significantly lower PA was observed in the DRM group than in the control and obesity groups. No statistically significant differences between PA in the obesity and control groups and no correlation between BMI and PA in the obesity group. More studies are needed to standardize cut-off points in different contexts and populations.

Comparison of CIPA Nutritional Screening with GLIM Criteria for Malnutrition, Prognostic Evolution, and Association with Phase Angle in Hospitalized Patients.

Hospital malnutrition has high prevalence and is associated with worse clinical outcomes. The lack of standardized nutritional screening prompted the creation of the CIPA screening tool. Several studies have shown that the phase angle (PA) is associated with increased nutritional risk and worse clinical outcomes. The aim of this study was to establish the concordance between the CIPA and GLIM criteria and to assess their correlation with PA values and clinical outcomes. A cross-sectional single-center study was carried out, with a prospective six-month follow-up for the prognostic variables. On admission, the CIPA and GLIM criteria and bioimpedanciometry were assessed. A total of 510 inpatients were included; 36.5% had positive CIPA outcomes and 46.1% had positive GLIM outcomes. The correlation between the CIPA and GLIM criteria had a kappa index of 0.26, p < 0.01. Those with positive CIPA had a higher mortality risk (OR = 1.81) and longer mean length of stay (MLS) (OR = 1.45). The PA cut-off points were determined by sex and age for CIPA (men > 65 years: 4.75°, men ≤ 65 years: 5.75°, women > 65 years: 4.75°, and women ≤ 65 years: 5.45°) and GLIM (men > 65 years: 4.95°, men ≤ 65 years: 5.85°, women > 65 years: 4.75°, and women ≤ 65 years: 5.55°). These PA cut-off points were associated with worse clinical outcomes with CIPA (mortality OR = 4.2; MLS OR = 1.51; readmissions OR = 2.28) and GLIM (mortality OR = 2.97; MLS OR = 2.61; readmissions OR = 1.79). CIPA screening shows a low correlation with GLIM nutritional assessment. Positive CIPA and GLIM have lower PAs than negative and worse prognostic outcomes. The PA cut-off points associated with worse outcomes have been established.

Development and validation of a novel prognostic prediction system based on GLIM-defined malnutrition for colorectal cancer patients post-radical surgery.

Malnutrition often occurs in patients with colorectal cancer. This study aims to develop a predictive model based on GLIM criteria for patients with colorectal cancer who underwent radical surgery. From December 2015 to May 2021, patients with colorectal cancer who underwent radical surgery at our center were recruited for this study. We prospectively collected data on GLIM-defined malnutrition and other clinicopathological characteristics. Using Cox regeneration, we developed a novel nomogram for prognostic prediction, which was validated and compared to traditional nutritional factors for predictive accuracy. Among the 983 patients enrolled in this study, malnutrition was identified in 233 (23.70%) patients. Multivariate analysis indicated that GLIM-defined malnutrition is the independent risk factor for overall survival (HR = 1.793, 95% CI = 1.390-2.313 for moderate malnutrition and HR = 3.485, 95% CI = 2.087-5.818 for severe malnutrition). The novel nomogram based on the GLIM criteria demonstrated a better performance than existing criteria, with AUC of 0.729, 0.703, and 0.683 for 1-year, 3-year, and 5-year OS, respectively, in the validation cohort. In addition, the risk score determined by this system exhibited significantly poorer short-term and long-term clinical outcomes in high-risk groups in both malnourished and well-nourished patients. Combining handgrip strength, serum albumin level, and TNM stage would help improve the predictive effect of GLIM criteria for colorectal cancer patients post-radical surgery and benefit the individual prognostic prediction of colorectal cancer.

Reduced muscle mass is an important part of Global Leadership Initiative on Malnutrition criteria in nutritional diagnosis of hepatocellular carcinoma

BackgroundThe Global Leadership Initiative on Malnutrition criteria (GLIM) was established to build a global consensus on the diagnostic criteria for malnutrition. The study aimed to assess the prevalence of the malnutrition diagnosed by GLIM criteria for patients with hepatocellular carcinoma (HCC), and to determine the role of the reduced muscle mass defined by CT scans in the GLIM criteria.MethodsThis cohort research was conducted on adult cirrhotic patients with HCC. The risk of malnutrition was screened by Nutritional Risk Screening 2002 (NRS-2002), and malnutrition was diagnosed by GLIM criteria. The third lumbar vertebrae (L3-SMI) were used to represent the muscle mass in GLIM criteria. The variables associated with overall mortality were assessed by multivariate Cox regression analyses.ResultsThe incidence of malnutrition diagnosed by GLIM criteria was 49.7% (179/360) in patients with HCC. If reduced muscle mass was not included in GLIM criteria, the prevalence of malnutrition was 31.7% (114/360). GLIM-defined malnutrition (HR = 1.979, 95%CI 1.019–3.841, P = 0.044) was independently associated with overall mortality in patients with HCC. However, the GLIM-defined malnutrition (without muscle mass) was not associated with overall mortality (HR = 0.863, 95%CI 0.399–1.867, P = 0.709).ConclusionsSkeletal muscle mass is an integral component of the GLIM criteria for patients with HCC. The malnutrition is common in patients with HCC, and malnourishment is associated with higher overall mortality. GLIM criteria are recommended to assess the nutritional status of hospitalized patients with HCC, which is recommended and can be used as the basis for nutritional interventions.

An intelligent online tool to predict mortality from cancer-related malnutrition using the GLIM criteria

An intelligent online tool to predict mortality from cancer-related malnutrition using the GLIM criteria

Ultrasound cut-off values for rectus femoris for detecting malnutrition (GLIM criteria) in patients with nutritional risk (DRECO study)

Ultrasound cut-off values for rectus femoris for detecting malnutrition (GLIM criteria) in patients with nutritional risk (DRECO study)

Glim criteria as a nutritional assessment tool in cancer patients

Glim criteria as a nutritional assessment tool in cancer patients

Prognostic value of malnutrition using glim criteria and renal insufficiency in very elderly inpatients

Prognostic value of malnutrition using glim criteria and renal insufficiency in very elderly inpatients

Association between anticholinergic burden and nutritional status: MNA-SF and GLIM criteria

Association between anticholinergic burden and nutritional status: MNA-SF and GLIM criteria

Malnutrition diagnosis among geriaric patients admitted to a tertiary medical center using glim criteria: A prospective study

Malnutrition diagnosis among geriaric patients admitted to a tertiary medical center using glim criteria: A prospective study

Nutritional intake and prevalence of malnutrition according to glim criteria in Danish hospitalized patients at nutrition risk – Results of a cohort-study

Nutritional intake and prevalence of malnutrition according to glim criteria in Danish hospitalized patients at nutrition risk – Results of a cohort-study

Impact of glim criteria defined malnutrition on short- and long-term clinical outcomes in patients after gastrointestinal cancer surgery

Impact of glim criteria defined malnutrition on short- and long-term clinical outcomes in patients after gastrointestinal cancer surgery

Are the glim criteria valid for the diagnosis of malnutrition in stroke survivors?

Are the glim criteria valid for the diagnosis of malnutrition in stroke survivors?

Comparison of three objective nutritional screening tools for identifying GLIM-defined malnutrition in patients with gastric cancer.

This study aimed to compare three objective nutritional screening tools for identifying GLIM-defined malnutrition in patients with gastric cancer (GC). Objective nutritional screening tools including geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), and controlling nutritional status (CONUT) score, were evaluated in patients with GC at our institution. Malnutrition was diagnosed according to the GLIM criteria. The diagnostic value of GNRI, PNI, and COUNT scores in identifying GLIM-defined malnutrition was assessed by conducting Receiver Operating Characteristic (ROC) curves and calculating the area under the curve (AUC). Additionally, sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were determined. The Kappa coefficient (k) was used to assess agreement between three objective nutritional screening tools and GLIM criteria. A total of 316 patients were enrolled in this study, and malnutrition was diagnosed in 151 (47.8%) patients based on the GLIM criteria. The GNRI demonstrated good diagnostic accuracy (AUC = 0.805, 95% CI: 0.758-0.852) for detecting GLIM-defined malnutrition, while the PNI and COUNT score showed poor diagnostic accuracy with AUCs of 0.699 (95% CI: 0.641-0.757) and 0.665 (95% CI: 0.605-0.725) respectively. Among these objective nutritional screening tools, the GNRI-based malnutrition risk assessment demonstrated the highest specificity (80.0%), accuracy (72.8%), PPV (74.8%), NPV (71.4%), and consistency (k = 0.452) with GLIM-defined malnutrition. Compared to PNI and COUNT scores, GNRI demonstrated superior performance as an objective nutritional screening tool for identifying GLIM-defined malnutrition in GC patients.

Modified R-GLIM Score Is a Good Prognostic Tool to Predict a Long-Term Prognosis in Poor Conditioned Elderly Patients with Aspiration Pneumonia, a Pilot Study.

While prognostic guidelines for pneumonia have widely allowed clinicians to treat patients, poor prognostic factors for 1- or 2-year survival times have never been mentioned to our knowledge. We conducted this retrospective study to evaluate whether malnutrition according to the GLIM criteria is a poor prognostic factor for 1- or 2-year survival among patients with aspiration pneumonia. All patients with community-onset aspiration pneumonia who were admitted to Aichi Medical University and had intervention from our nutrition support team (NST) in 2019 and 2020 were enrolled in this study. A total of 56 patients were enrolled in the study. The mean age was 86 ± 6.5 and 25 (45%) were male. Thirty-one patients died during this observational period. Comparing the survival and death group, higher respiratory rate (RR) and malnutrition were seen more frequently in the death group than in the survival group. Then, the patients were divided into the following three groups: those with an RR ≥ 22 and malnutrition, those with malnutrition, and a control group [patients who were not malnourished and had a low RR (<22)]. Comparing the three groups, patients with an RR ≥ 22 and malnutrition had significantly shorter overall survival times (OSs) than those in the other groups (p = 0.009 by Log-Rank test) for 1-year prognosis. The result of 2-year prognosis displayed a statistical significance that was the same as that for 1-year prognosis (p = 0.004 by Log-Rank test). The Cox hazard regression model showed that a higher RR was an independent poor prognostic factor for 1- and 2-year survival among aspiration pneumonia patients. This pilot study showed that combined scores of higher RR and malnutrition according to the GLIM criteria (modified R-GLIM score) was an independent poor prognostic factor for 1 or 2-year survival among super-elderly patients (aged over 80 years) with aspiration pneumonia.

A modified GLIM criteria-based nomogram for the survival prediction of gastric cancer patients undergoing surgical resection

BackgroundThis study aimed to develop a comprehensive model based on five GLIM variables to predict the individual survival and provide more appropriate patient counseling.MethodsThis retrospective cohort study included 301 gastric cancer (GC) patients undergoing radical resection. C-reactive protein (CRP) as an inflammatory marker was included in GLIM criteria and a nomogram for predicting 5-year overall survival (OS) in GC patients was established. The Bootstrap repeated sampling for 1000 times was used for internal validation.ResultsOf the total 301 patients, 20 (6.64%) died within 5 years. CRP improved the sensitivity and accuracy of the survival prediction model (AUC = 0.782, 0.694 to 0.869 for the model without CRP; AUC = 0.880, 0.809 to 0.950 for the model adding CRP). Besides, a GLIM-based nomogram was established with an AUC of 0.889. The C-index for predicting OS was 0.878 (95% CI: 0.823 to 0.934), and the calibration curve fitted well. Decision curve analysis (DCA) showed the clinical utility of the nomogram based on GLIM.ConclusionThe addition of CRP improved the sensitivity and accuracy of the survival prediction model. The 5-year survival probability of GC patients undergoing radical resection can be reliably predicted by the nomogram presented in this study.

Evaluation of Muscle Mass and Malnutrition in Patients with Colorectal Cancer Using the Global Leadership Initiative on Malnutrition Criteria and Comparing Bioelectrical Impedance Analysis and Computed Tomography Measurements.

The aim of this investigation was to evaluate the discrepancies between bioelectrical impedance analysis (BIA) and computed tomography (CT) in assessing skeletal muscle mass and identifying low muscle mass in patients with colorectal cancer. This study recruited 137 patients with colorectal cancer from February 2028 to December 2023. CT scans were analyzed at the Lumbar 3 vertebral level to determine the area of skeletal muscle, which was then utilized to estimate whole-body skeletal muscle mass. [BIA] was also employed to measure skeletal muscle. Both skeletal muscle mass values [kg] were divided by height2 [m2] to calculate the skeletal muscle index [SMI, kg/m2], denoted as SMI-CT and SMI-BIA, respectively. The median age was 69.8 + 9.5 years, with the sex ratio being 88/49 [male/female]. Whereas more than one-third of the patients were classified as malnourished based on the Global Leadership Initiative on Malnutrition GLIM-CT criteria using L3-SMI [n = 36.5%], fewer patients were classified as malnourished based on GLIM-BIA using SMI-BIA [n = 19.0%]. According to the CT analysis [low SMI-L3], 52 [38.0%] patients were diagnosed as having poor muscle mass, whereas only 18 [13.1%] patients were identified as having low muscle mass using BIA [low SMIBIA]. The measured SMI showed a positive association with SMI-CT in all patients [r = 0.63, p < 0.001]. Using Bland-Altman evaluation, a significant mean bias of 0.45 + 1.41 kg/m2 [95% CI 0.21-0.70; p < 0.001] between SMI-BIA and SMI-CT was reported. Receiver operating characteristic (ROC) curves were generated to detect poor muscle mass using SMI-BIA with CT as the gold standard. The area under the curve (AUC) for SMI-BIA in identifying poor muscle mass was 0.714 (95% CI: 0.624-0.824), with a good cut-off value of 8.1 kg/m2, yielding a sensitivity of 68.3% and a specificity of 66.9%. BIA generally overestimates skeletal muscle mass in colorectal cancer patients when contrasted to CT. As a result, BIA may underestimate the prevalence of poor muscle mass and malnutrition according to the GLIM criteria in this patient population.

Desnutrición relacionada con la enfermedad

Malnutrition is one of the main public health problems that affects the whole world, not just the most disadvantaged societies. Disease-related malnutrition (DRM) is a new acronym for an old health problem that identifies the pairing of malnutrition and disease. DRM has a very high prevalence and negative consequences for the patient and national health systems. Classically, defining malnutrition has been considered a complex issue. The GLIM criteria for diagnosing malnutrition have become a turning point in the approach to DRM, allowing the scientific community to use the same language regarding this clinical entity. Morphofunctional assessment has entailed a fundamental paradigm shift in its diagnostic approach. Nutritional care is a human right that includes screening, diagnosis, feeding, and evidence-based medical nutrition therapy.

Investigation of nutrition status and analysis of 180-day readmission factors in elderly hospitalized patients with COPD

Background and objectiveMalnutrition is prevalent among elderly patients with COPD, who also experience a high rate of readmission. Therefore, it is imperative to investigate the nutrition status of these patients, identify risk factors for readmission, and offer insights for clinical management. To achieve this, a cross-sectional study was conducted to investigate factors influencing nutrition status using GLIM criteria and explore the 180-day readmission factors among hospitalized elderly COPD patients.Methords and resultsThe data were collected from a hospital in Southwest China, encompassing a cohort of 319 eligible patients. Among elderly hospitalized COPD patients, the prevalence of malnutrition was 49.53% (158/319). Multivariate logistic regression revealed malnutrition (OR = 3.184), very severe airway obstruction (OR = 3.735), and Number of comorbidities ≥ 3 (OR = 5.754) as significant risk factors for 180-day readmission.ConclusionsThese findings suggest that malnutrition is a prevalent issue among elderly hospitalized patients with COPD and constitutes one of the risk factors contributing to the 180-day readmission rate. Therefore, timely identification and treatment for malnourished patients are crucial.