Department of Geriatric Medicine, Uppsala University Hospital and Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
The Dean's Office and Department of Medicine, The University of Vermont College of Medicine, Burlington, VT, USA.
Clin Nutr. 2017 Feb;36(1):7-10. doi: 10.1016/j.clnu.2016.12.001. Epub 2016 Dec 16.
During the ESPEN Congress in Copenhagen, Denmark (September 2016) representatives of the 4 largest global PEN-societies from Europe (ESPEN), USA (ASPEN), Asia (PENSA) and Latin America (FELANPE), and from national PEN-societies around the world met to continue the conversation on how to diagnose malnutrition that started during the Clinical Nutrition Week, Austin, USA (February 2016). Current thinking on diagnostic approaches was shared; ESPEN suggested a grading approach that could encompass various types of signs, symptoms and etiologies to support diagnosis. ASPEN emphasized where the parties agree; i.e. that the three major published approaches (ESPEN, ASPEN/AND and Subjective Global Assessment (SGA)) all propose weight loss as a key indicator for malnutrition. FELANPE suggested that the anticipated consensus approach needs to prioritize a diagnostic methodology that is available for everybody since resources differ globally. PENSA highlighted that BMI varies by ethnicity/race, and that sarcopenia/muscle mass evaluation is important for the diagnosis of malnutrition. A Core Working Committee of the Global Leadership Initiative on Malnutrition (GLIM) has been established (comprised of two representatives each from the 4 largest PEN-societies) that will lead consensus development in collaboration with a larger Working Group with broad global representation, using e-mail, telephone conferences, and face-to-face meetings during the up-coming ASPEN and ESPEN Congresses. Transparency and external input will be sought. Objectives include: 1. Consensus development around evidence-based criteria for broad application. 2. Promotion of global dissemination of the consensus criteria. 3. Seeking adoption by the World Health Organization (WHO) and the International Classification of Diseases (ICD).
在丹麦哥本哈根举行的 ESPEN 大会期间（2016 年 9 月），来自欧洲（ESPEN）、美国（ASPEN）、亚洲（PENSA）和拉丁美洲（FELANPE）的 4 个最大的全球 PEN 协会以及来自世界各地的国家 PEN 协会的代表齐聚一堂，继续讨论在美国奥斯汀举行的临床营养周期间开始的营养不良诊断问题（2016 年 2 月）。会上分享了关于诊断方法的最新想法；ESPEN 提出了一种分级方法，该方法可以包含各种类型的体征、症状和病因，以支持诊断。ASPEN 强调了各方达成一致的地方，即三种主要的已发表方法（ESPEN、ASPEN/AND 和主观全面评估（SGA））都将体重减轻作为营养不良的关键指标。FELANPE 建议，预期的共识方法需要优先考虑一种适用于所有人的诊断方法，因为全球资源存在差异。PENSA 强调 BMI 因种族/民族而异，肌肉质量评估对营养不良的诊断很重要。已经成立了一个全球营养不良领导倡议（GLIM）核心工作组（由 4 个最大的 PEN 协会各派出两名代表组成），该工作组将与一个具有广泛全球代表性的更大工作组合作，共同制定共识，利用电子邮件、电话会议和面对面会议，在即将举行的 ASPEN 和 ESPEN 大会期间进行。将寻求透明度和外部投入。目标包括：1. 围绕广泛应用的循证标准达成共识。2. 促进全球传播共识标准。3. 寻求世界卫生组织（WHO）和国际疾病分类（ICD）的采纳。
