Department of Public Health and Caring Sciences, Uppsala University, Uppsala.
Theme Ageing, Karolinska University Hospital, Stockholm, Sweden.
Curr Opin Clin Nutr Metab Care. 2020 Sep;23(5):361-366. doi: 10.1097/MCO.0000000000000678.
To review recent reports on techniques and tools for screening and diagnosis of malnutrition in gastrointestinal disease, in the light of the newly published definition of malnutrition by the Global Leadership Initiative on Malnutrition (GLIM).
In 2019, the GLIM concept of malnutrition was published advocating a two-step procedure; first, screening, and second confirmation of the diagnosis that requires a combination of phenotypic and etiologic criteria. Three studies in patients with gastrointestinal disorders so far published utilize the GLIM criteria. Otherwise, traditional tools, as Nutrition Risk Screening-2002, Malnutrition Universal Screening Tool or Subjective Global Assessment are used, and confirm that malnutrition is observed in a substantial number of patients with inflammatory bowel diseases (IBDs), serious liver disorders and various forms of pancreatitis. Common for these disorders is an extensive loss of muscle mass, which is one of the GLIM phenotypic criteria. Such patients often undergo abdominal computed tomography scans that enable psoas muscle mass at L3 or L4 level to be calculated.
The GLIM criteria for the diagnosis of malnutrition are feasible for IBD, liver and pancreas diseases. Pending studies expect to provide data on the clinical relevance to diagnose malnutrition by the GLIM concept.
根据全球营养不良领导倡议（GLIM）新发表的营养不良定义，回顾胃肠道疾病中营养不良筛查和诊断的技术和工具的最新报告。
2019 年，GLIM 营养不良概念发表，提倡两步程序；首先是筛查，其次是需要结合表型和病因标准来确认诊断。迄今为止，已有三项针对胃肠道疾病患者的研究采用了 GLIM 标准。否则，将使用传统工具，如营养风险筛查 2002 版、营养不良普遍筛查工具或主观全面评估，并证实炎症性肠病（IBD）、严重肝脏疾病和各种形式的胰腺炎患者中存在大量营养不良。这些疾病的共同点是广泛的肌肉质量损失，这是 GLIM 表型标准之一。这些患者经常接受腹部计算机断层扫描，可计算 L3 或 L4 水平的竖脊肌质量。
GLIM 诊断营养不良的标准适用于 IBD、肝脏和胰腺疾病。正在进行的研究有望提供关于通过 GLIM 概念诊断营养不良的临床相关性的数据。
