Department of Surgery, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA.
Clin Nutr. 2022 Mar;41(3):687-697. doi: 10.1016/j.clnu.2022.01.018. Epub 2022 Feb 1.
BACKGROUND & AIMS: The diagnosis of malnutrition remains a significant challenge despite various published diagnostic criteria. In 2018, the Global Leadership Initiative on Malnutrition (GLIM) published a set of evidence-based criteria as a framework for malnutrition diagnosis in adults. A scoping review was conducted to understand how the GLIM criteria have been used in published literature and compare the reported validation methods to published validation guidance.
Dialog and Dimensions databases were searched by publication date (January 1, 2019, through January 29, 2021). Data were extracted and mapped to the research objectives.
Seventy-nine studies were reviewed; 32% were in patients at least 65 years of age; 67% occurred in hospitals. The majority were cohort studies (61%). Fifty-seven percent employed all 5 GLIM criteria. Regarding phenotypic criteria, 92% used low BMI, and 45% applied anthropometry as a marker for muscle mass, of which 54% used calf circumference. Regarding etiologic criteria, 72% used reduced food intake/assimilation, and 85% applied inflammation/disease burden. Validation of GLIM criteria was described in 77% of publications.
The GLIM criteria have been studied extensively since their publication. Low BMI was the phenotypic criterion used most often, whereas both reduced food intake/assimilation and inflammation/disease burden were frequently employed as the etiologic criteria. However, how the criteria were combined and how validation was conducted were not clear in most studies. Adequately powered, methodologically sound validation studies using the complete GLIM criteria are needed in various patient populations and disease settings to assess validity for the diagnosis of malnutrition.
尽管已经有多种发表的诊断标准，但营养不良的诊断仍然是一个重大挑战。2018 年，全球营养不良领导倡议（GLIM）发布了一套基于证据的标准，作为成人营养不良诊断的框架。进行了范围综述，以了解 GLIM 标准在已发表文献中的使用情况，并将报告的验证方法与已发表的验证指南进行比较。
按发表日期（2019 年 1 月 1 日至 2021 年 1 月 29 日）在 Dialog 和 Dimensions 数据库中进行搜索。提取数据并映射到研究目标。
共审查了 79 项研究；32%的研究对象为至少 65 岁的患者；67%的研究发生在医院。大多数为队列研究（61%）。57%的研究采用了全部 5 项 GLIM 标准。在表型标准方面，92%使用低 BMI，45%将人体测量用作肌肉量的标志物，其中 54%使用小腿围。在病因标准方面，72%使用食物摄入/吸收减少，85%应用炎症/疾病负担。77%的出版物中描述了 GLIM 标准的验证。
自发表以来，GLIM 标准已得到广泛研究。低 BMI 是最常用的表型标准，而食物摄入/吸收减少和炎症/疾病负担经常被用作病因标准。然而，大多数研究中不清楚如何组合这些标准以及如何进行验证。在各种患者人群和疾病环境中，需要使用完整的 GLIM 标准进行充分有力、方法合理的验证研究，以评估营养不良诊断的有效性。
