Gordon L. Jensen MD, PhD, Tommy Cederholm MD, PhD, Maria D. Ballesteros-Pomar PhD, MD, Renee Blaauw PhD, RD, M. Isabel T. D. Correia MD, PhD, Cristina Cuerda MD, PhD, David C. Evans MD, Ryoji Fukushima MD, PhD, Juan Bernardo Ochoa Gautier MD, M. Cristina Gonzalez MD, PhD, Andre van Gossum MD, PhD, Leah Gramlich MD, Joseph Hartono MD, PhD, Steven B. Heymsfield MD, Harriët Jager-Wittenaar PhD, RD, Renuka Jayatissa MSc, MD, Heather Keller PhD, RD, Ainsley Malone MS, RD, William Manzanares MD, PhD, M. Molly McMahon MD, Yolanda Mendez MD, Kris M. Mogensen MS, RD-AP, Naoharu Mori MD, PhD, Maurizio Muscaritoli MD, Guillermo Contreras Nogales MD, MSc, Ibolya Nyulasi MSc, APD, Wendy Phillips MS, RD, Matthias Pirlich MD, Veeradej Pisprasert MD, PhD, Elisabet Rothenberg PhD, RD, Marian de van der Schueren PhD, RD, Han Ping Shi MD, PhD, Alison Steiber PhD, RDN, Marion F. Winkler PhD, RD, Charlene Compher PhD, RD, Rocco Barazzoni MD, PhD
{"title":"用于 GLIM 营养不良诊断的炎症病因学标准评估指南:改良德尔菲法。","authors":"Gordon L. Jensen MD, PhD, Tommy Cederholm MD, PhD, Maria D. Ballesteros-Pomar PhD, MD, Renee Blaauw PhD, RD, M. Isabel T. D. Correia MD, PhD, Cristina Cuerda MD, PhD, David C. Evans MD, Ryoji Fukushima MD, PhD, Juan Bernardo Ochoa Gautier MD, M. Cristina Gonzalez MD, PhD, Andre van Gossum MD, PhD, Leah Gramlich MD, Joseph Hartono MD, PhD, Steven B. Heymsfield MD, Harriët Jager-Wittenaar PhD, RD, Renuka Jayatissa MSc, MD, Heather Keller PhD, RD, Ainsley Malone MS, RD, William Manzanares MD, PhD, M. Molly McMahon MD, Yolanda Mendez MD, Kris M. Mogensen MS, RD-AP, Naoharu Mori MD, PhD, Maurizio Muscaritoli MD, Guillermo Contreras Nogales MD, MSc, Ibolya Nyulasi MSc, APD, Wendy Phillips MS, RD, Matthias Pirlich MD, Veeradej Pisprasert MD, PhD, Elisabet Rothenberg PhD, RD, Marian de van der Schueren PhD, RD, Han Ping Shi MD, PhD, Alison Steiber PhD, RDN, Marion F. Winkler PhD, RD, Charlene Compher PhD, RD, Rocco Barazzoni MD, PhD","doi":"10.1002/jpen.2590","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The Global Leadership Initiative on Malnutrition (GLIM) approach to malnutrition diagnosis is based on assessment of three phenotypic (weight loss, low body mass index, and reduced skeletal muscle mass) and two etiologic (reduced food intake/assimilation and disease burden/inflammation) criteria, with diagnosis confirmed by fulfillment of any combination of at least one phenotypic and at least one etiologic criterion. The original GLIM description provided limited guidance regarding assessment of inflammation, and this has been a factor impeding further implementation of the GLIM criteria. We now seek to provide practical guidance for assessment of inflammation.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A GLIM-constituted working group with 36 participants developed consensus-based guidance through a modified Delphi review. A multiround review and revision process served to develop seven guidance statements.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The final round of review was highly favorable, with 99% overall “agree” or “strongly agree” responses. The presence of acute or chronic disease, infection, or injury that is usually associated with inflammatory activity may be used to fulfill the GLIM disease burden/inflammation criterion, without the need for laboratory confirmation. However, we recommend that recognition of underlying medical conditions commonly associated with inflammation be supported by C-reactive protein (CRP) measurements when the contribution of inflammatory components is uncertain. Interpretation of CRP requires that consideration be given to the method, reference values, and units (milligrams per deciliter or milligram per liter) for the clinical laboratory that is being used.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Confirmation of inflammation should be guided by clinical judgment based on underlying diagnosis or condition, clinical signs, or CRP.</p>\n </section>\n </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2590","citationCount":"0","resultStr":"{\"title\":\"Guidance for assessment of the inflammation etiologic criterion for the GLIM diagnosis of malnutrition: A modified Delphi approach\",\"authors\":\"Gordon L. Jensen MD, PhD, Tommy Cederholm MD, PhD, Maria D. Ballesteros-Pomar PhD, MD, Renee Blaauw PhD, RD, M. Isabel T. D. Correia MD, PhD, Cristina Cuerda MD, PhD, David C. Evans MD, Ryoji Fukushima MD, PhD, Juan Bernardo Ochoa Gautier MD, M. Cristina Gonzalez MD, PhD, Andre van Gossum MD, PhD, Leah Gramlich MD, Joseph Hartono MD, PhD, Steven B. Heymsfield MD, Harriët Jager-Wittenaar PhD, RD, Renuka Jayatissa MSc, MD, Heather Keller PhD, RD, Ainsley Malone MS, RD, William Manzanares MD, PhD, M. Molly McMahon MD, Yolanda Mendez MD, Kris M. Mogensen MS, RD-AP, Naoharu Mori MD, PhD, Maurizio Muscaritoli MD, Guillermo Contreras Nogales MD, MSc, Ibolya Nyulasi MSc, APD, Wendy Phillips MS, RD, Matthias Pirlich MD, Veeradej Pisprasert MD, PhD, Elisabet Rothenberg PhD, RD, Marian de van der Schueren PhD, RD, Han Ping Shi MD, PhD, Alison Steiber PhD, RDN, Marion F. Winkler PhD, RD, Charlene Compher PhD, RD, Rocco Barazzoni MD, PhD\",\"doi\":\"10.1002/jpen.2590\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>The Global Leadership Initiative on Malnutrition (GLIM) approach to malnutrition diagnosis is based on assessment of three phenotypic (weight loss, low body mass index, and reduced skeletal muscle mass) and two etiologic (reduced food intake/assimilation and disease burden/inflammation) criteria, with diagnosis confirmed by fulfillment of any combination of at least one phenotypic and at least one etiologic criterion. The original GLIM description provided limited guidance regarding assessment of inflammation, and this has been a factor impeding further implementation of the GLIM criteria. We now seek to provide practical guidance for assessment of inflammation.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A GLIM-constituted working group with 36 participants developed consensus-based guidance through a modified Delphi review. A multiround review and revision process served to develop seven guidance statements.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The final round of review was highly favorable, with 99% overall “agree” or “strongly agree” responses. The presence of acute or chronic disease, infection, or injury that is usually associated with inflammatory activity may be used to fulfill the GLIM disease burden/inflammation criterion, without the need for laboratory confirmation. However, we recommend that recognition of underlying medical conditions commonly associated with inflammation be supported by C-reactive protein (CRP) measurements when the contribution of inflammatory components is uncertain. 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Guidance for assessment of the inflammation etiologic criterion for the GLIM diagnosis of malnutrition: A modified Delphi approach
Background
The Global Leadership Initiative on Malnutrition (GLIM) approach to malnutrition diagnosis is based on assessment of three phenotypic (weight loss, low body mass index, and reduced skeletal muscle mass) and two etiologic (reduced food intake/assimilation and disease burden/inflammation) criteria, with diagnosis confirmed by fulfillment of any combination of at least one phenotypic and at least one etiologic criterion. The original GLIM description provided limited guidance regarding assessment of inflammation, and this has been a factor impeding further implementation of the GLIM criteria. We now seek to provide practical guidance for assessment of inflammation.
Methods
A GLIM-constituted working group with 36 participants developed consensus-based guidance through a modified Delphi review. A multiround review and revision process served to develop seven guidance statements.
Results
The final round of review was highly favorable, with 99% overall “agree” or “strongly agree” responses. The presence of acute or chronic disease, infection, or injury that is usually associated with inflammatory activity may be used to fulfill the GLIM disease burden/inflammation criterion, without the need for laboratory confirmation. However, we recommend that recognition of underlying medical conditions commonly associated with inflammation be supported by C-reactive protein (CRP) measurements when the contribution of inflammatory components is uncertain. Interpretation of CRP requires that consideration be given to the method, reference values, and units (milligrams per deciliter or milligram per liter) for the clinical laboratory that is being used.
Conclusion
Confirmation of inflammation should be guided by clinical judgment based on underlying diagnosis or condition, clinical signs, or CRP.
期刊介绍:
The Journal of Parenteral and Enteral Nutrition (JPEN) is the premier scientific journal of nutrition and metabolic support. It publishes original peer-reviewed studies that define the cutting edge of basic and clinical research in the field. It explores the science of optimizing the care of patients receiving enteral or IV therapies. Also included: reviews, techniques, brief reports, case reports, and abstracts.