{"title":"全球营养不良领导力倡议 \"的标准使用小腿和上臂围度作为评估肌肉质量的表型标准，在诊断住院患者营养不良方面显示出令人满意的有效性：一项前瞻性队列研究。","authors":"Larissa Farinha Maffini, Gabrielle Maganha Viegas, Thais Steemburgo, Gabriela Corrêa Souza","doi":"10.1002/ncp.11200","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Hospitalized individuals present high rates of malnutrition and loss of muscle mass (MM). Imaging techniques for assessing MM are expensive and scarcely available in hospital practice. The Global Leadership Initiative on Malnutrition (GLIM) proposed a framework for malnutrition diagnosis that includes simple measurements to assess MM, such as calf circumference (CC) and mid-upper arm circumference (MUAC). This study aimed to analyze the validity of the GLIM criteria with CC and MUAC for malnutrition diagnosis, using Subjective Global Assessment (SGA) as the reference standard, in inpatients.</p><p><strong>Methods: </strong>A prospective cohort study was conducted on 453 inpatient adults in a university hospital. The presence of malnutrition was assessed within 48 h of hospital admission using SGA and GLIM criteria using CC and MUAC as phenotypic criteria for malnutrition diagnosis. Accuracy, agreement tests, and logistic regression analysis adjusted for confounders were performed to test the validity of the GLIM criteria for malnutrition diagnosis.</p><p><strong>Results: </strong>The patients were aged 59 (46-68) years, 51.4% were male, and 67.8% had elective surgery. Compared with SGA, the GLIM criteria using the two MM assessment measures showed good accuracy (area under the curve > 0.80) and substantial agreement (κ > 0.60) for diagnosing malnutrition. The highest sensitivity was obtained with GLIM<sub>CC</sub> (89%), whereas GLIM<sub>MUAC</sub> showed high specificity (>90%). Also, malnutrition identified by GLIM<sub>CC</sub> and GLIM<sub>MUAC</sub> was significantly associated with prolonged hospitalization and in-hospital death.</p><p><strong>Conclusion: </strong>In the absence of imaging techniques to assess MM, the use of CC and MUAC measurements from the GLIM criteria demonstrated satisfactory validity for diagnosing malnutrition in hospitalized patients.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"1431-1440"},"PeriodicalIF":2.1000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Global Leadership Initiative on Malnutrition criteria using calf and upper arm circumference as phenotypic criteria for assessing muscle mass demonstrate satisfactory validity for diagnosing malnutrition in hospitalized patients: A prospective cohort study.\",\"authors\":\"Larissa Farinha Maffini, Gabrielle Maganha Viegas, Thais Steemburgo, Gabriela Corrêa Souza\",\"doi\":\"10.1002/ncp.11200\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Hospitalized individuals present high rates of malnutrition and loss of muscle mass (MM). Imaging techniques for assessing MM are expensive and scarcely available in hospital practice. The Global Leadership Initiative on Malnutrition (GLIM) proposed a framework for malnutrition diagnosis that includes simple measurements to assess MM, such as calf circumference (CC) and mid-upper arm circumference (MUAC). This study aimed to analyze the validity of the GLIM criteria with CC and MUAC for malnutrition diagnosis, using Subjective Global Assessment (SGA) as the reference standard, in inpatients.</p><p><strong>Methods: </strong>A prospective cohort study was conducted on 453 inpatient adults in a university hospital. The presence of malnutrition was assessed within 48 h of hospital admission using SGA and GLIM criteria using CC and MUAC as phenotypic criteria for malnutrition diagnosis. Accuracy, agreement tests, and logistic regression analysis adjusted for confounders were performed to test the validity of the GLIM criteria for malnutrition diagnosis.</p><p><strong>Results: </strong>The patients were aged 59 (46-68) years, 51.4% were male, and 67.8% had elective surgery. Compared with SGA, the GLIM criteria using the two MM assessment measures showed good accuracy (area under the curve > 0.80) and substantial agreement (κ > 0.60) for diagnosing malnutrition. The highest sensitivity was obtained with GLIM<sub>CC</sub> (89%), whereas GLIM<sub>MUAC</sub> showed high specificity (>90%). Also, malnutrition identified by GLIM<sub>CC</sub> and GLIM<sub>MUAC</sub> was significantly associated with prolonged hospitalization and in-hospital death.</p><p><strong>Conclusion: </strong>In the absence of imaging techniques to assess MM, the use of CC and MUAC measurements from the GLIM criteria demonstrated satisfactory validity for diagnosing malnutrition in hospitalized patients.</p>\",\"PeriodicalId\":19354,\"journal\":{\"name\":\"Nutrition in Clinical Practice\",\"volume\":\" \",\"pages\":\"1431-1440\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nutrition in Clinical Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ncp.11200\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nutrition in Clinical Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ncp.11200","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/7 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
Global Leadership Initiative on Malnutrition criteria using calf and upper arm circumference as phenotypic criteria for assessing muscle mass demonstrate satisfactory validity for diagnosing malnutrition in hospitalized patients: A prospective cohort study.
Background: Hospitalized individuals present high rates of malnutrition and loss of muscle mass (MM). Imaging techniques for assessing MM are expensive and scarcely available in hospital practice. The Global Leadership Initiative on Malnutrition (GLIM) proposed a framework for malnutrition diagnosis that includes simple measurements to assess MM, such as calf circumference (CC) and mid-upper arm circumference (MUAC). This study aimed to analyze the validity of the GLIM criteria with CC and MUAC for malnutrition diagnosis, using Subjective Global Assessment (SGA) as the reference standard, in inpatients.
Methods: A prospective cohort study was conducted on 453 inpatient adults in a university hospital. The presence of malnutrition was assessed within 48 h of hospital admission using SGA and GLIM criteria using CC and MUAC as phenotypic criteria for malnutrition diagnosis. Accuracy, agreement tests, and logistic regression analysis adjusted for confounders were performed to test the validity of the GLIM criteria for malnutrition diagnosis.
Results: The patients were aged 59 (46-68) years, 51.4% were male, and 67.8% had elective surgery. Compared with SGA, the GLIM criteria using the two MM assessment measures showed good accuracy (area under the curve > 0.80) and substantial agreement (κ > 0.60) for diagnosing malnutrition. The highest sensitivity was obtained with GLIMCC (89%), whereas GLIMMUAC showed high specificity (>90%). Also, malnutrition identified by GLIMCC and GLIMMUAC was significantly associated with prolonged hospitalization and in-hospital death.
Conclusion: In the absence of imaging techniques to assess MM, the use of CC and MUAC measurements from the GLIM criteria demonstrated satisfactory validity for diagnosing malnutrition in hospitalized patients.
期刊介绍：
NCP is a peer-reviewed, interdisciplinary publication that publishes articles about the scientific basis and clinical application of nutrition and nutrition support. NCP contains comprehensive reviews, clinical research, case observations, and other types of papers written by experts in the field of nutrition and health care practitioners involved in the delivery of specialized nutrition support. This journal is a member of the Committee on Publication Ethics (COPE).
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