Endocrinology and Nutrition Department, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain.
Department of Medicine, Universitat Autònoma de Barcelona, 08023 Barcelona, Spain.
Nutrients. 2022 May 27;14(11):2244. doi: 10.3390/nu14112244.
The Global Leadership Initiative on Malnutrition (GLIM) criteria were recently proposed to build a global consensus on the diagnostic criteria for malnutrition. This study aimed to evaluate the GLIM criteria for its prognostic significance in outpatients with heart failure (HF), and to compare them to a previous validated method, such as the Mini Nutritional Assessment (MNA).
This was a post hoc observational analysis of a prospectively recruited cohort, which included 151 subjects that attended an outpatient HF clinic. At baseline, all patients completed the nutritional screening MNA short form and the nutritional assessment MNA. In a post hoc analysis, we evaluated the GLIM criteria at baseline. The outcomes were based on data from a five-year follow-up. The primary endpoint was all-cause mortality. Secondary endpoints were cardiovascular (CV) mortality and recurrent HF-related hospitalizations. We also investigated whether the GLIM criteria had better prognostic power than the MNA.
Abnormal nutritional status was identified in 19.8% of the patients with the GLIM criteria and in 25.1% with the MNA. In the multivariate analyses (age, sex, NYHA functional class, diabetes, and Barthel index), nutritional status assessed by the MNA, but not by the GLIM criteria, was an independent predictor of all-cause mortality, CV mortality, and recurrent HF-related hospitalizations during the five-year follow-up.
Malnutrition assessed by MNA, but not by the GLIM criteria, was an independent predictor of all-cause mortality, CV mortality, and recurrent HF-related hospitalization in our cohort of outpatients with HF.
全球营养不良领导倡议（GLIM）标准最近被提出，旨在建立营养不良诊断标准的全球共识。本研究旨在评估 GLIM 标准在门诊心力衰竭（HF）患者中的预后意义，并将其与之前经过验证的方法（如微型营养评估（MNA））进行比较。
这是一项前瞻性招募队列的事后观察性分析，共纳入 151 名就诊于门诊 HF 诊所的患者。在基线时，所有患者均完成了营养筛查 MNA 简短版和营养评估 MNA。在事后分析中，我们评估了基线时的 GLIM 标准。结局基于 5 年随访的数据。主要终点是全因死亡率。次要终点是心血管（CV）死亡率和复发性 HF 相关住院。我们还研究了 GLIM 标准是否比 MNA 具有更好的预后能力。
根据 GLIM 标准，19.8%的患者存在营养状况异常，根据 MNA，25.1%的患者存在营养状况异常。在多变量分析（年龄、性别、NYHA 功能分级、糖尿病和巴氏指数）中，MNA 评估的营养状况，但不是 GLIM 标准，是全因死亡率、CV 死亡率和 5 年随访期间复发性 HF 相关住院的独立预测因素。
在我们的 HF 门诊患者队列中，MNA 评估的营养不良，但不是 GLIM 标准，是全因死亡率、CV 死亡率和复发性 HF 相关住院的独立预测因素。
