GLIM共识方法诊断营养不良:5年更新

IF 3.2 3区 医学 Q2 NUTRITION & DIETETICS
Gordon L. Jensen MD, PhD, Tommy Cederholm MD, PhD, M. Isabel T. D. Correia MD, PhD, M. Cristina Gonzalez MD, PhD, Ryoji Fukushima MD, PhD, Veeradej Pisprasert MD, PhD, Renee Blaauw PhD, RD, Diana Cardenas Braz MD, PhD, Fernando Carrasco MD, MS, Alfonso J. Cruz Jentoft MD, PhD, Cristina Cuerda MD, PhD, David C. Evans MD, Vanessa Fuchs-Tarlovsky PhD, MD, Leah Gramlich MD, Han Ping Shi MD, PhD, Jeanette M. Hasse PhD, RD, Michael Hiesmayr MD, Naoki Hiki MD, PhD, Harriët Jager-Wittenaar PhD, RD, Shukri Jahit MD, Anayanet Jáquez MD, Heather Keller PhD, RD, Stanislaw Klek MD, PhD, Ainsley Malone MS, RD, Kris M. Mogensen MS, RD-AP, Naoharu Mori MD, PhD, Manpreet Mundi MD, Maurizio Muscaritoli MD, Doris Ng MRCP, DPhil, Ibolya Nyulasi MSc, APD, Matthias Pirlich MD, PhD, Stephane Schneider MD, PhD, Marian de van der Schueren PhD, RD, Soranit Siltharm MD, Pierre Singer MD, Alison Steiber PhD, RDN, Kelly A. Tappenden PhD, RD, Jianchun Yu MD, PhD, André van Gossum MD, PhD, Jaw-Yuan Wang MD, PhD, Marion F. Winkler PhD, RD, Charlene Compher PhD, RD, Rocco Barazzoni MD, PhD
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Mogensen MS, RD-AP,&nbsp;Naoharu Mori MD, PhD,&nbsp;Manpreet Mundi MD,&nbsp;Maurizio Muscaritoli MD,&nbsp;Doris Ng MRCP, DPhil,&nbsp;Ibolya Nyulasi MSc, APD,&nbsp;Matthias Pirlich MD, PhD,&nbsp;Stephane Schneider MD, PhD,&nbsp;Marian de van der Schueren PhD, RD,&nbsp;Soranit Siltharm MD,&nbsp;Pierre Singer MD,&nbsp;Alison Steiber PhD, RDN,&nbsp;Kelly A. Tappenden PhD, RD,&nbsp;Jianchun Yu MD, PhD,&nbsp;André van Gossum MD, PhD,&nbsp;Jaw-Yuan Wang MD, PhD,&nbsp;Marion F. 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引用次数: 0

摘要

全球营养不良领导倡议(GLIM)于2019年推出了一种营养不良诊断方法,该方法包括筛查,然后评估三个表型标准(体重减轻、低体重指数(BMI)和低肌肉质量)和两个病因标准(食物摄入/同化减少和炎症/疾病负担)。这次计划的更新基于过去5年出版的知识和经验重新考虑了GLIM框架。方法一个工作组(n = 43名成员)使用关键词“全球营养不良领导倡议或GLIM”进行了2019-2024年的文献检索。回顾了以往GLIM在使用肌肉质量和炎症标准方面的指导活动。采用了连续几轮的修订和审查来达成共识。结果在同行评议的期刊上发表了400多篇科学报告,形成了10个系统综述的基础,其中一些包括对GLIM效度的元分析,显示出较强的结构效度和预测效度。讨论了局限性和未来的优先事项。工作组的研究结果表明,对低肌肉量的评估应以经验和现有技术资源为指导。临床判断可能足以评估炎症/疾病负担的病因学标准。不建议修改体重减轻、低BMI或减少食物摄入/同化标准。经过两轮审查和修订,工作组确保与5年更新报告的结论100%一致。正在进行的倡议的重点包括营养不良风险筛查程序,GLIM对重症监护环境的适应,支持减少食物摄入/同化标准的评估,以及肥胖症营养不良的确定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

GLIM consensus approach to diagnosis of malnutrition: A 5-year update

GLIM consensus approach to diagnosis of malnutrition: A 5-year update

Background

The Global Leadership Initiative on Malnutrition (GLIM) introduced an approach for malnutrition diagnosis in 2019 that comprised screening followed by assessment of three phenotypic criteria (weight loss, low body mass index [BMI], and low muscle mass) and two etiologic criteria (reduced food intake/assimilation and inflammation/disease burden). This planned update reconsiders the GLIM framework based on published knowledge and experience over the past 5 years.

Methods

A working group (n = 43 members) conducted a literature search spanning 2019–2024 using the keywords “Global Leadership Initiative on Malnutrition or GLIM.” Prior GLIM guidance activities for using the criteria on muscle mass and inflammation were reviewed. Successive rounds of revision and review were used to achieve consensus.

Results

More than 400 scientific reports were published in peer-reviewed journals, forming the basis of 10 systematic reviews, some including meta-analyses of GLIM validity that indicate strong construct and predictive validity. Limitations and future priorities are discussed. Working group findings suggest that assessment of low muscle mass should be guided by experience and available technological resources. Clinical judgment may suffice to evaluate the inflammation/disease burden etiologic criterion. No revisions of the weight loss, low BMI, or reduced food intake/assimilation criteria are suggested. After two rounds of review and revision, the working group secured 100% agreement with the conclusions reported in the 5-year update.

Conclusion

Ongoing initiatives target priorities that include malnutrition risk screening procedures, GLIM adaptation to the intensive care setting, assessment in support of the reduced food intake/assimilation criterion, and determination of malnutrition in obesity.

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来源期刊
CiteScore
7.80
自引率
8.80%
发文量
161
审稿时长
6-12 weeks
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.
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